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Permit (164) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT R COMMUNITY DEVELOPMENT Permit#: ELR2018 00212 T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/04/2018 . Parcel: 1 S135BD00100 Jurisdiction: Tigard Site address: 9600 SW OAK ST 560 Project: SW Financial Services Subdivision: ASHBROOK FARM Lot: 5 Project Description: HVAC system. Contractor: HUNTER DAVISSON INC Owner: PLAZA WEST OWNER LLC 1800 SE PERSHING ST BY CHIEF FINANCIAL OFFICER PORTLAND, OR 97202 680 FIFTH AVE 20TH FL NEW YORK, NY 10019 PHONE: 503-542-3628 PHONE: FAX: 503-542-3654 FEES Description Date Amount Specifics: Restricted Energy Permit 12/04/2018 $75.00 12%State Surcharge-Electrical 12/04/2018 $9.00 Type of Use: COM Class of Work: ALT Total Number of Systems: 1 Audio&Stereo: 0 Boiler Controls: 0 CCTV: 0 Clock Systems: 0 Data&Telecommunications: 0 Fire Alarm: 0 HVAC: 1 Instrumentation: 0 Intercom/Paging: 0 Landscape/Irrigation: 0 Landscape Lighting: 0 Medical: 0 Nurse Calls: 0 Protective Signal: 0 Security Alarm: 0 Other: 0 Total $84.00 Other Desc: Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAA 952-001-0010 through OAR 952-001-0090. You may obtain a cop'oTthe rules or uestions to OUNC by calling 503.232. 87 or1.800.31444. Issued By: Permittee Signature: - /11 f OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale,lease or rent. OWNER'S SIGNATURE: Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR.ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Electrical Permit Application FOR OFFICE USE ONLY 7,1 Cl O TiaP(1 �� -' �3 Received �j Permit#: ."' "J f g y ,•.. 1 Date/By: f -/Ii//D . �E',,z8c 8 ,,,,..� • 't 13125 SW Hall Blvd.,Tigard,OR9,22.3...', Plan Review Phone: 503.718.2439 Fax: 503.598.1960 DateBy: Related Permit#: Ay�.•,peI`� ,,3,)J Inspection Line: 503.639.4175 1`.'' /. ? "' Ready Date/By: Juris: 0 See Page 2 for TIGARD `"Intentet: www.tigard-or.gov Notified/Method: Supplemental Information :.TYPE'-OFr� �) �'�it r,4, +�� ��,5 _ ` ;,. PLAN HEV1EW ❑New construction ®Addition/arcit'ltilibrt/replaceitent Please check all that apply(submit 2 sets of plans w/items checked): ❑Service or feeder 400 amps or more ❑Budding over three stories. ❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards. CATEGORY:OP CONSTRUCTFQN , exceeds 10,000 amps at 150 volts or ❑Floating buildings. CII-and 2-family dwelling gl Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or 4011 SITE INFORMATION LAND LOCATION ❑Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: /6738•6 I Job site address: ?goo ,Sw Oq 1 S Tree i, 1 OOHP or more. 0"A","E","1-2","1-3", / ❑Six or more residential units. occupancy. City/State/ZIP: T; arU 04. ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: Pro Project name:.../ a ❑Hazardous locations. 0 Supply voltage for more than } Js s � =�+ t i 600 volts nominal. ❑Service or feeder 600 amps or more. Cross street/directions to job site: .PEE,SCHEDULE Description I Qty. I Each I Total New residential single-or multi-family dwelling unit. Subdivision: I Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1 ".,DESOWEI©N OF.'4*,01 I( .,,, r Limited energy,residential 75.00 2 / 71-r ( -tit above sq.ft.) Q /C e L O Ch e, -4,-.e.S-A./S 7OQ G cox?Mo /Q. Limited energy,multi-family 75.00 2 residential(with above sq.ft.) z• Renewable Ener, 0 See Pale 2 `A PROPERTY OWNER __ LI:'-TENANT,,..' Services or feeders installation,alteration,and/or relocation Name:(Xp)CoM//trC,cl Co r4L:1;,t-S'/ --Ink_• 200 amps or less 100.70 2 201 amps to 400 amps 133.56 2 Address: 5.3",y S /Sf C rc e 401 amps to 600 amps 200.34 2 City/State/ZIP: ','U-e F'J 0/4 77C V__ 601 amps to 1,000 amps 301.04 2 Phone:(Sc,?) '7/6—2534' Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: dA I/Q• 66-6 n/(m CC i9 G, e6/K relocation Owner installation: This installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 Branch circuits—new,alteration,or extension, er anel , ,Ai'PECCAN , w«. ,.'.i., .• -• - ,0 ONrAC'T PER$UN , A.Fee for branch circuits with Business name://t^lder.. YGv/s-SoN 7`/t/c . above service or feeder fee, 7.42 2 / each branch circuit Contact name: ,, A7Q7 ' B.Fee for branch circuits without / service or feeder fee,first 56.18 2 /'r Address: /800 j—e- r—Sh/N ,SY''ree—fr branch circuit City/State/ZIP: )G ae 9 7.20.2 Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(5;? ) .5"%'2—3c gcs, Fax: :( ) Each manufactured or modular 67.84 2 // —// dwellin ,service and/or feeder Email.Ii ,ee— 0044,4-te,r G(4✓/.SSO//• Co AA Reconnect only 67.84 —© / V GoNTRt1C''f)R Pump or irrigation circle 67.84 11S Business name: ,Me r 4 ve. Sign or outline lighting • 67.84 Signal circuit(s)or limited energy ❑ See Page 2 l 2 Address: panel,alteration,or extension. Each additional inspection over allowab e in any o e a love City/State/ZIP: Additional inspection(I hr min) 66.25/hr Phone:( ) Fax:( ) Investigation(I hr min) 90.00/hr Email: Industrial plant(I hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.///a Electrical Li :a‘_ 2aEl Suprv.Lic.:6o 0 ZLCE s.ecificall listed % min 'ELEChrTRICAL PERMIT ]FEES , Suprv.Electrician signature,required: Subtotal: J Print name:—J17M OaV/.SON Date: //- c'-/er'''' 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: 4 TOTAL PERMIT FEE: IIEM r.6.--/,� Z /�dG(4✓ This permit application expires if a permit is not obtained within 180 Print name: 17, a, A/ee f' Date: ///-02 9--/:::F" days after it has been accepted as complete. * Number of inspections allowed per permit. 1:\Building\'ermits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: " UE RESIDENTJ� ' .e o ONLY:. Descr _ w Fee for all residential systems combined: $75.00 iEach Total n Qty.Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 2 ❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 ❑ Vacuum Systems* >100 kva—no additional charge 0.0 3 Each additional inspection over allowable in any of the above: ❑ Other: Each additional inspection is 66.25/hr charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(%2 hr min OSIOC � '_ 4!fiaiF E...,.u r PER IIT FEES1 Fee for each commercial system: $75.00 Subtotal(Enter on Page 1): * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation �] HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015