Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
III = COMMUNITY DEVELOPMENT Permit#: ELR2014-00101
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/24/2014
Parcel: 25101 BB01500
Jurisdiction: Tigard
Site address: 12242 SW GARDEN PL, BLDG#1
Project: Chester Labs Subdivision: CROW PARK 217 Lot: 3
Project Description: Low voltage for data
Contractor: BRY-COM Owner: WALTON CWOR PARK BC 8 LLC
14244 SE BUSH BY EQUITY OFFICE MANAGEMENT LLC
PORTLAND, OR 97236 PO BOX A-3879
CHICAGO, IL 60690
PHONE: 503-761-5156 PHONE:
FAX: 503-760-7501
FEES
Description Date Amount
Specifics: Restricted Energy Permit 04/24/2014 $75.00
12%State Surcharge-Electrical 04/24/2014 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 0
Audio&Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data&Telecommunications: 0 Fire Alarm: 0
HVAC: 0 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 i ued subject to •: regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done • accordance with approve. plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspe •-. for mor 180
days. TENTION: Oregon law requ - you to follow the rules adopted by the Oregon Utility Notification C=, - Those rule- -'7 set fo in OAR
952-0 -0010 thro {e h OAR 952-001-0r r You m#-in a copy of the rules or direct questions to OUNC by calling 503.2"r•':;oorr 11..8 r 332. ,j
Is ued By: I / Permittee Signature: I C-.-4f // /
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.
Electrical Permit Applicatio
City of Tigard "i v "D Date vedy /f
Permit No.: k_;_61 if.-00 lb /
IN II 13125 SW Hall Blvd.,Tigard,OR 9 2 Plan Review
Phone: 503.718.2439 Fax: 503.598.19 Date/By: Other Permit:
Inspection Line: 503.639.4175 �P R 2 4 2014 Date Ready/By: Juris: ® See Page 2 for
I i■' \i'.1 i
Inte Internet: www.tigard-or.gov CITY OF r Notified/Method: Supplemental emental Information
PLAN REVIEW
TYPE OFpYt
El
construction El Addition/alteration/replacement Please check all that apply(submit a sets of plans w/items checked below):
❑Service or feeder 400 amps or more ❑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 ®Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A","E","1-2","l-3",
Job no.: Job site address: Wei YZ s (jhtjeSzdO (, 100 or or o more residential occupancy.
❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: 7)Gi A (t a s 2, 3 ❑Health-care facilities. ❑Supply voltage for more than
*` v ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: Ci{e.ST A0i) ❑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
Limited energy,multi-family
1,S r L_ J g( /�r�s eIRd o L residential(with aove sq.ft.) 75.00 2
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER I ❑ 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,per panel
❑ APPLICANT I ❑ 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
56.18 2
branch circuit
Address: Each add'l 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: 1
c Signal circuit(s)or limited-energy See 75 Crz
panel,alteration,or extension. I Page 2 2
Address: (Y Z( -I SF gict1,1 Each additional inspection over allowable in any of the above
Additional inspection(1 hr mm) 66.25/hr
City/State/ZIP: 3 n„isck Q Z 6 Investigation(1 hr min) 66.25/hr
Phone:56 1 l7ag l S f Fax:(P3 )r)l—'733 q Industrial plant(1 hr min) 78.18/hr
u )�G Inspections for which no fee is 90.00/hr
/��y
CCB Lic.:i f �3 Electrical Lic• *11 up ,t.Lic% f 37Yr specifically listed(%hr min)
- ELECTRICAL PERMIT FEES ��
Suprv.Ele rician signature,required: Subtotal: '7S
Print name �Il1S' , 1'�• zw_'L� Plan review(25%of permit fee):
G t ! State surcharge(12%of permit fee): 9.0e,
Authorized signature: TOTAL PERMIT FEE: g Cl/.00
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_ELR_ERE.doe Rev 05/21/2013 440.4615T(11/05/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 QIY• 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
❑ Audio and Stereo Systems*
15.01 to 25 kva 200.34 2
[1] Burglar Alarm Wind generation systems in excess of 25 kva:
25.01 to 50 kva 301.04 2
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance with 552.26 2
❑ Heating,Ventilation and Air Conditioning OAR 918-309-0040)
System* Solar generation systems in excess of 25 kva:
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
ElOther: additional inspection over allowable in any of the above:
Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(Y:hr min)
COMMERCIAL WORK ONLY: _ 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
❑ Audio and Stereo Systems days after it has been accepted as complete.
Number of inspections allowed per permit.
❑ Boiler Controls
❑ Clock Systems
g 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
l.\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12242 SW GARDEN PL BLDG 1, TIGARD, OR,
97223
Commercial - Electricial Limited Energy
199 Electrical final
PASS - No C of O
May 20, 2014 at 2:38:55 PM
ELR2014-00101
Jeff Grove
Violation Summary:
Inspector Contractor