Permit I " CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
11111 - 3. COMMUNITY DEVELOPMENT Permit #: ELR2013 -00106
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/13/2013
Parcel: 1 S126CD00300
Jurisdiction: Tigard
Site address: 9500 SW WASHINGTON SQUARE RD
Project: JC Penney Subdivision: FAIRVIEW PLACE CONDO Lot: 20
Project Description: Installation of low voltage for data, in server room.
Contractor: BRY -COM Owner: PPR WASHINGTON SQUARE, LLC
14244 SE BUSH BY J C PENNEY 0288 -1
PORTLAND, OR 97236 TAX SERVICES
PO BOX 10001
DALLAS, TX 75301
PHONE: 503 - 761 -5156 PHONE:
FAX: 503 - 760 -7501
FEES
Description Date Amount
Specifics:, Restricted Energy Permit 05/13/2013 $75.00
12% State Surcharge - Electrical 05/13/2013 $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 ac • , . • - . ith approved plans. This permit will expire if work is not started within 180 days of issuance, or if ork is suspended for more tie 180
days. • NTION: Oregon .w requires you to follow the rules adopted by the Oregon Utility Notification Cente hose - s are et fort I� OAR
952 -01 -0010 through OAR 952 -0■ :190. ay obtain a copy of the rules or direct questions to OUNC by calling 503.232. or .800.3 44.
I ued By: . 4 1 Permittee Signature: ..tef aill,
■
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 Applicatio Foli oFFICF USE ONLY
EC�UC® Received ®��
11111 City of Tigard 5 I s Re : / Permit No.: D —co/do 13125 SW Hall Blvd., Tigard,OR 9722 Plan Review
q 1 7 Phone: 503.718.2439 Fax: 503.598.19 A1/ Date/By: Other Permit:
132013
TI G A R U Inspection Line: 503.639.4175 Date Ready/By: Suns: See Page 2 for
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
CITY OF TIGARD
TYPE OF gg� DIVISION PLAN REVIEW
ILVIfiG UI • ISIO J Plhk ll tht l (
❑ New construction I -Addition/alteration/replacement Please check all that apply 2 sets of plans w /items checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling 15 ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "l -2 ", "1 -3 ",
Job no.: Job site address: Cicet See l w kof 100HP or more. occupancy.
❑
0 Six or more residential units. Recreational vehicle parks.
City/State /ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than
600 volts nominal.
iJ ❑Hazardous locations.
Suite/bldg. /apt. no.: Project name _ G h�J ) ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
1 „ ` j . /�J -,,-
Limited energy, multi-family
�' � T/ '--- K4)(2.11) ^(,ILIT T �•+��� residential above (with above ove sq. q. ft.) 75.00 2
�T Renewable Energy ❑ See Page 2
<(jt,`. --a.f 3.Q.4 e -) Services or feeders installation, alteration, and/or relocation
❑ PROPERTY OWNER ❑ TENANT 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
Address: 601 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, alteration, and /or
Phone: ( ) Fax: ( ) relocation
200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 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 signature: Date: Branch circuits — new, alteration, or extension, 1 er panel
❑ APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with
above service or feeder fee,
7.42 2
Business name: each branch circuit
B. Fee for branch circuits without
Contact name: service or feeder fee, first
branch circuit 56.18 2
Address: Each add'I branch circuit 7.42 2
City/State /ZIP: Miscellaneous (service or feeder not included)
Each manufactured or modular 67.84 2
Phone: ( ) Fax: : ( ) dwelling, service and/or feeder
Reconnect only 67.84 2
E - mail: Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: �y /11 Signal circuit(s) or limited- energy '
II`-� f panel, alteration, or extension. I 7 �
Page 2 / 2
Address: /52v, S ,13.1,,,_9# Each additional inspection over allowable in any of the above
^+,� 6 Investigation inspection 66.25/ hr
City/State /ZIP: (� <l Investigatgat (I mi
ion (1 hr min) 66.25/ hr
Phone: (g)3) /76 ) ✓575/ Fax: (4 )74,.0 �3g Industrial plant (1 hr min) 78.18/ hr
,/ Inspections for which no fee is
ZifJ/ )f
CCB Lic.:'. Electrical Lic.. (e ./ I uprv. Lic.:(3g Lk/'. specifically listed (V2 hr min) 90.00 / hr
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: , t Subtotal: 7�'c'v
Print name: �9p�i S , hk' � te: 5 --/ / 3 Plan review (25% of permit fee): o
State surcharge (12% of permit fee):
Authorized signature: TOTAL PERMIT FEE: DC)
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
Number of inspections allowed per permit.
I:\Building\ Permits \ELC_PermitApp_040913.doc 440 -46! 5T( I 1 /05 /COM/WEB
Electrical Permit Application — City of Tigard
Page 2 — Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
•
Fee for all residential systems combined ... $75.00 Description I Qn. I Fee I Total I
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
IT 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
1=1 Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva (fee in accordance,with'. 552.26 2
OAR 918- 309 -0040)
El Heating, Ventilation and Air Conditioning sDlar'generarionsgstems in excess of 25 kva:
System*
Each additional kva over25 7.42 3
❑ Vacuum Systems* >100 kva— no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
El 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 (%z hr min)
[COMMERCIAL WORK ONLY: ' ' 1 ELECTRICAL PERMIT .FEES
Fee for each commercial system . $75.00 Subtotal:
(SEE OAR 918- 309 -0000) Plan review, if required (25% of permit fee):
State surcharge (12% of permit fee):
Check Type of Work Involved: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
El Audio and Stereo Systems days after it has been accepted as complete.
* Number of inspections allowed per permit.
❑ Boiler Controls
❑ Clock Systems
El Data Telecommunication Installation
❑ Fire Alarm Installation
El HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
El Landscape Irrigation Control*
❑ Medical
El Nurse Calls
❑ Outdoor Landscape Lighting*
El Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\ Building \Permits\ELC_PermitApp_0409 13, doc