Permit 7 CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
n
COMMUNITY DEVELOPMENT Permit #: ELR2009 -00173
13125 S H all Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/02/2009
TIGARD Parcel: 25101 DB00103
Jurisdiction: Tigard
Site address: 7360 SW HUNZIKER RD 100
Subdivision: Lot: 0 •
Project: Hilltop
Project Description: Install restricted energy for HVAC.
FEES
Owner:
HILLTOP BUSINESS CENTER LLC & Description Date Amount
HUNZIKER LLC, 9430 NW KAISER RD Restricted Energy Permit 07/02/2009 $75.00
PORTLAND, OR 97231 12% State Surcharge - Electrical 07/02/2009 $9.00
PHONE:
Contractor:
CASCADE HYDRO -AIR OF OREGON LLC
PO BOX 10894
PORTLAND, OR 97296
PHONE: 503 - 224 -1100
FAX: 503 - 235 -8540
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: N Fire Alarm: N
HVAC: Y Instrumentation: N Total $84.00
Intercom /Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N Required Items and Reports (Conditions)
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N
Other Desc:
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 OAR
952- 001 -0010 throu OAR 952-001-0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: l l 1l t ,YV U X A,N Permittee Signature: j 4�
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 an inspection that business day.
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.
From: CASCADE HYDRO -AIR 503- 235 -8540 To: City Of Tigard Date 7/1/2009 Time: 10:59:30 AM Page 2 of 4
Electrical Permit Applicati it - V,C . _ FOR OFFICE SE ONLY
009 Recci
City of Tigard 1 '� ed
Permit ,.
Date B..
13125 SW Nall Blvd., Tigard, OR 97223 �U,�. Man Rerieo
Phone: 503.639.4171 Fax_ 503.598 196 r � 7 ( P ate, Other Permit
T I G A R D Inspection Line: 503 - 639.4175 (, 11 V �l % O •ate Rend.: Bs tt�t i > @ Sec Page : for
Internet www.tigard- or.gov O r l C i �1 1 Nonfted�Method. Supplemental Information
TYPE OF Ry t 1 'V PLAN REVIEW
❑ New construction ® Addition /alteration/replacement Please shock all that apply (.submit 2 sets of plans viitemc cheated below)
❑ Service or feeder 400 amps or more ❑ Building over three stories
❑ Demolition ❑ Other: whew the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
leas to gloom], ea e.cccds 14,000 ❑ Commercial -use ap'+curmml
❑ I- and 2-family dwelling ®Commercial /industrial Accessory building maps for all other installations. buildings
El Multi-family ❑ Master builder ❑Other: ❑ F ire pump ❑ Installation of 75 KVA or
❑ Emergency system larger separately ve
i
derved system
JOB SiTE INFORMATION AND LOCATION 12 Addiuor, of new orator load of ❑ "n", "E ", °a ` ` derived
' 10011P or more. occupancy
Job no.: iob site address: 7360 Hunziker 1 Floor ❑ Recreational vehicle parks
❑ Six or more residential sods
City/State /ZIP: Tigard, OR 97223 ❑ Health facilities. ❑ Supply voltage for more than
❑Hazard locations 600 volts nominal
Su ite /bldg /apt. no.: Project name: Hilltop ❑ Service or feeder600 amps or store.
FEE SCHEDULE
ty . Fee. Total '
Cross streeUdirections to job site: 72 A + Hunziker Description
New residential single or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq ft. or less 145.15 4
---- Ea. add'I 500 sq ft. or portion 33.40 1
Tax map /parcel no.: Limited mercy_ residential
75.00 2
DESCRIPTION OF WORD with abate nq 0.)
Limited energy. multi- famiIn 75.00 2
Low Voltage H VAC Thermostat Installation tcstdential (aids a base sit. ft.)
- Services or feeders installation, alteration, and /or relocation
200 amps or less 80 30 _ 2
® PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: Robenson Construction 401 amps to 600 amps 160.60 2
601 amps to 1(1(10 amps 240.60 2
Address; 21360 NW Amberwood Dr. Over 1,000 amps or volts 454.65 2
• City/State /ZIP. Hillsboro, OR 97214 Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease- rent - or exchange_ according to ORS 447, 449. 670, and 701. 401 amps to 599 amps 133 75 2
Branch circuits - new, alteration, or extension, per,panel
Owner signature: Date: A- Fee for branch circuits with
❑ APPLICANT ® CONTACT PERSON above service or feeder fee. 6.65 2
each branch circuit
Business name: CASCADE HYDRO - AIR B. Fee for branch circuits
without service or feeder fee, 46 85 2
Contact name: Kevin Bibler first branch c ircuit
Each add'l branch circuit 6.65 2
Address: P.O. Box 10894
Miscellaneous (service or feeder not included)
City /Stale /ZIP: Portland, OR 97296 Each manufactured or modular
90.90 2
dwelling. service and /or feeder
Phone: (503) 224 -1100 6538 Faz:: (503) 235 - 8540 Reconnect wily 66 85
E -mail: kevin@cascadehydroair.com Pump or irrigation circle 53 40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal cireuit(s) or limited -
Business name: CASCADE HYDRO - AIR energy panel. alteration. or
extension. Describe: 1 Page 75.00 2
Address: P.O. Box 10894
City /State /ZIP: Portland, OR 97296 Each additional inspection over allowable in any of the above
Per Inspection 62.50
Phone' (503) 224 -1100 I Ftiv. (503) 235-8540 i Investigation per hour (1 hr min) 62.50
CUB Lie.: 159918 Electrical Lie.: 26 -1222C Suprv. Lie.: 566LEB industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: ((_, ,_ Lrv+ ,, Subtotal 75.00
Plan review (25% of permit fee):
Print name: Randy Drake Dale: 7/1/09 -
state surcharge (12% of permit fee). 9.00
-
Authorized signature: TOTAL PERMIT FEE. 84.00
This permit application expires if a permit is not obtained stithin 180
Print name: Date: d after it has been accepted as complete.