Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
,11 s COMMUNITY DEVELOPMENT Permit #: ELR2013 00090
T t G AR O 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/23/2013
Parcel: 2S102CC00500
Jurisdiction: Tigard
Site address: 13500 SW PACIFIC HWY 86
Project: Go Wireless Subdivision: FREWING'S ORCHARD TRACTS Lot: 15
Project Description: (1) low voltage for Data/Telecommunications
Contractor: HAMER ELECTRIC INC Owner: MK EP TIGARD LLC
126 INDUSTRIAL WAY 623 5TH AVE, 18TH FLR
LONGVIEW, WA 98632 NEW YORK, NY 10022
PHONE: 360 - 636 -2227 PHONE:
FAX: 360 - 636 -1618
FEES
Description Date Amount
Specifics: Restricted Energy Permit 04/23/2013 $75.00
12% State Surcharge - Electrical 04/23/2013 $9.00
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: y Fire Alarm: N
HVAC: N Instrumentation: N
Intercom/Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N 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 OAR
952- 001 -0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2322.1987 or 1.800.332.2344.
Issued By: I�JL�� e ' er-bvt Permittee Signature: ON AP PO C Ti D" A i
/// 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.
APR. 22. 2013 5; 05PM H�1VE130) 636 -1618 O. 842 P. 1/4
Electrical Permit Applicatli FOR OFr•i(T (SE c)\1.1
- Cl _APR Received
City of Tigard
? 3 / Sr PetmitNo.:
■ 13125 SW Hall E1vd., Tigard, Old 9722"3 P R 2 2 2 013 Plan U (
Re
Phone: 503.718.2439 Fax: 503.59 B Other Pamir: J
TIC ....RD Inspection Line: 503.6394175 I1' Date
OF TIGARD p a t s y B y: J 1 a roc
Intcrpet: www.tigard -or.gov BUILDING DIVISION Noti£ed2vlethod: . snpplcmentallnformit;otl
' . T`Y'PE OF WORK ' "
PLA11I REVIEW
0 New construction 121 Addition/alteration/replacement Besse check all that apply (submit 1 sets of plans w/lten s ecla wow): ow): -
El Service or ,Feeder 400 amps more ❑ Building over storks. Demolition El Other:
_ where the available fault cumin ❑Marinas and b ds•
' Cl, GORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating bail gs.
D. 1 and 2 -frlil • dwelIin t� • . less to ground, or exceeds 14,000 1:1 Commerciale agricultural
Y g ICs Commercial/industrial ❑ Accessory building amps for all other installations. buildings, I
Q Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 5 KVA or
' 3013 SUE 114ORMATION AND 1,0CA, XON ❑ Em `�` n ` 7 sY larger Sara y derived system.
❑ Addition of new motor load of U "A", "E", "1,21^, "1 -3 ',
Job no_: ! Job site address: 13500 SW PACIFIC HWY 100111' or more. occupancy.
0 Six or more residential units. ❑ Recreational v&tiele paekg,
City/State /ZIP: TIGARD, OR ❑Health -earn facilities, ❑ Supply volta�oe than
❑ Hazardous locations, 600 volts no
Suite/bldg. /apt no.: 86 Project name: GO WIRELESS Q Servie* or feeder 600 amps or more 1
FEE SCHEDULE
Gross street/directions to job site: -- d,n 7q Fe II read
New residential single- or multi - family dwelling Molt.
Includes attached garage.
Subdivision: Lot no_: 1,000 sq. ft. or less 168.54 11
Ea. add'I 500 sq, It or portion 33.92 1 1
Tax map /parcel no.: Limited energy, residernial 1
DCRIFITON OF *DM (with above s9.1) 75.00 2
ES
- - CAT 6 & 120V Limited energy, multi- family 7500 I 2
residential (with above sq. ft.) �
— Renewable Energy . . 0 See page 2 1
Services or feeders instalation, alteration, and/or Irelocatlon
u 1PROP'ERTY' OWI - 1 El 'z,l N 200 amps or less 100,70 ' I 2
"" 201 amps to 400 amps 133.56 2
Name: GO WIRELESS " —
401 amps to 600 amps 200.34 2
Address: 60I amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation, afterat$ion, and/o
Phone: ( ) 1;au: ( ) relocation I
200 amps or less 59.36 1 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125M5 j 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 ' 2
Owner sate: Date: Branch circuits - new, alteration, or extens p panel
ISI APPLICANT . 1D CONTACF PERSON A. Fee for branch circuits with I •
above service or feeder fee.
7.42 2
Business name: HAMER ELECTRIC, INC each branch circuit
B. Fee for branch circuits without
Contact name: CHERYL COLE service or feeder fee, first 56.I8 2
branch circuit
Address: 126 INDUSTRIAL WAY Each add'l branch circuit 7.42 ; 2
City /State /ZIP: LONGVIEW, WA 98632 Miscellaneous (service or feeder not inducted)
Each manuPaetured or modular
67.8 I 4
Phone: (360) 636 -2227 1 Fax: : (360) 636 -1618 dwelling, service and/or feeder
Reconnect only 67,84 I 2
E -mail: ChetylCole@HamerElectric.com Pump or irrigation circle 67.84 j 2
CONTRACTOR Sign or outline lighting 57,84 I 2
Business name: TTA,MER ELECTRIC, INC Signal circuit(s) or limited-energy - - panel. alteration, or extension, l Page 2 i 2
Address: 126 INDUSTRIAL WAY Each additional ins. • etion over allowable in . ' or the abov
Additional inspection (1 hr min) 66.25/ hr
City /State/ZIP: LONGVIEW, WA 98632
Investigation (1 hr min) 66,25 / hr
Phone: (360) 636 - 2227 Fax: (360) 636 -1618 Industrial plant (1 hr min) 7s.15/ hr
CC/3 Lic_: 33818 l 12'1'' Elecnit al Lic.: 37 -144C Suprv_ Inc_: 34798
inspections
t lY listed (. hr mtn)
90.00/ hr
Suprv. Electrician. signature, required: ` ' ELECTRI 1 PERMIT EIi S
Subtotal:
Print name: TERRY D. COLE Date: 04/22/2013 >' (25°t of permit fee): 1
_ State surcharge (12% of permit fee): J
Authorized signature; / f ,1 L{-' TOTAL PERMIT FEE: Oil. CO
Print name: t t� Date: This pelt application expires if a Penn* is net obtained within 180
days after it has boon accepted as ....pieta- I
• Number of inspections allowed per permit, 1
I:18n3ding1Pare aslit,C PermitApp 040913•doc 44o- 4615T(11ro5FCOM/WFB
1
APR. 22.2013 5:05PM HAMER ELECTRIC (360) 636 -1618 NO. 842 P. 2/4
for all other installations
EIectrical Permit Application — City of Tigard
Page 2 — Supplemental Information
Limited Energy Permit Fees:
RESIDENTIAL WQRJ<•ONLY., ' .
Fee for all residential systems combined_..... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
p Burglar Alarm
❑ Gauge Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL 'WORK ONLY:
Fee for each commercial system......._.___.. 575.00
(SEE OAR 918-309 -0000)
Check Type of Work Involved_
❑ Audio and Stereo Systems
El 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*
El Protective Signaling
❑ Other
•
Total number of commercial systems:
*No licenses are required. Licenses are required
ns�au i.mc oaos13.aee
APR. 22.2013 5:06PM HAMER ELECTRIC (360) 636 -1618 _ NO. 842 P. 3/4
Each additional kva over 25 T 742 3
>100 kva —no additional charge 0.0 3
Each additional inspection over allowable in any o f the above:
Each additional inspection is 66,E hr I
Renewable Energy Permit Fees: _ charged at an hourly (1 hr min)
Inspections for which no Ike is 90.00/ br
spa ifically liste min
FEE, SCIF DME ,ELECTRICAL PERMIT irT FEES;
llewer■p Om Q I Fee I Tons I ' Subtotal: 75.00
Renewable electrical energy systems: Plan review, if %of
required (25% permit fx):
5 kva or less 100.70 2 State surcharge (12% of permit fee): 9.00
5.01 to 15 kva 133.56 2 TOTAL PER.1441T PEE: • 84.00
I5.01 to 25 kva 20034 2 This permit application expires if a permit is not obtained within 110
days after it has been accepted as complete-
Wind generation systems in excess of 25 kva: • Malibu of inspocaom allowed per petnit.
25.0I to S0 kva 301.04 2
50.01 to 100 kva 552.26 2
>1001cva (fix in accordance with
55226 2
OAR 918- 309-0040) ,
Solar generation systems in excess of 25 kva:
t:l8biteie5WeneitsE .C,Pcim MApp o4w91s.eoc
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
13500 SW PACIFIC HWY 86, TIGARD, OR,
97223
Commercial - Electricial Limited Energy
199 Electrical final
05/13/2013 00:00
ELR2013-00090
PASS - No C of O
Violation Summary:
Inspector Contractor