Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit#: ELR2014-00230
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/05/2014
Parcel: 1 S126CB00300
Jurisdiction: Tigard
Site address: 9200 SW WASHINGTON SQUARE RD
Project: Wells Fargo Subdivision: FAIRVIEW PLACE CONDO Lot: 20
Project Description: Replace of multiple rooftop units.
Contractor: HUNTER DAVISSON INC Owner: PPR WASHINGTON SQUARE LLC
1800 SW PERSHING ST BY WELLS FARGO BANK
PORTLAND, OR 97202 C/O DELOITTE TAX LLP
PO BOX 2609
CARLSBAD, CA 92018
PHONE: 503-542-3628 PHONE:
FAX: 503-542-3654
FEES
Description Date Amount
Specifics: Restricted Energy Permit 11/05/2014 $75.00
12%State Surcharge-Electrical 11/05/2014 $9.00
Type of Use:
Class of Work:
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 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 Notificatio nter. Those rules ar set forth in OAR
952-001-0010 through OAR 952-001-0090. You may ob ' of the rules or direct questions to OUNC by calling 50 232.1 87 or`t•400. .2344.
Issued By: Permittee Signature:
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 ApplicatioRECEIVEP FOR OFFICE USE ONLY
Cl of Ti and Received
City g Date/By: ; cf� /y Permit No.: Et i 2,24/ -66 '�
111
13125 SW Hall Blvd.,Tigard,OR 9722 Plan Review
Phone: 503.639.4171 Fax: 503.598.1 T 21 2014 Date/By: Other Permit:
T 1 G A R U Inspection Line: 503.639.4175 Date Ready/By: runs: RI See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
tirr ., AAN REVIEW
❑New construction V Addition/alteration/replacement
Please check all that apply(submit 2 sets of plans w/items checked below):
❑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 E Commercial/industrial ❑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","1-2","1-3",
Job no.: /`t 7 6 I Job site address: q2 00 .5W � , Q�! 100HP or more. Recreational occupancy.
��t�7 it���� I�` ❑Six or more residential units. ❑R vehicle parks.
City/State/ZIP: t 3 ✓ ❑Health-care facilities. ❑Supply voltage for more than
(� � ❑Hazardous locations.
Suite/bldg./apt.no.:J I Project name:Ott V .r-44: o ,q()6 c ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. 1 Total
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq.ft.or less 145.15 4
Ea.add'l 500 sq.ft.or portion 33.40 1
Tax map/parcel no.: Limited energy,residential
x*y r 75.00 2
-s. '•. ''' =' -4' ur*`....DE CR I' O r O'-'i 'O -, (with above sq.ft.)
� Limited energy,multi-family 75.00 2
. ❑ i4 c.e -S-�G.-{-J ffo C 1 Gt.7�d (.0 l residential(with above sq.ft.)
r 1 Services or feeders installation,alteration,and/or relocation
tJ
VLQ i 004 , ii'V " C ,)tn.t L 200 amps or less 80.30 2
..tiltaX 0•41: R,... z ® ' erY.4 y, 201 amps to 400 amps 106.85 2
Name: / . . ti Li �,,_ 36,K 401 amps to 600 amps 160.60 2
t v � 601 amps to 1,000 amps 240.60 2
Address: g. o0 S t� tc.)�4 ttiC " �.J� u't-- Over 1,000 amps or volts 454.65 2
City/State/ZIP: 1 / JJ 7 Temporary services or feeders installation,alteration,and/or
t1' GWGt ) tJ� t�a relocation
Phone:( 3)6,3 ,s- Fax:( ) 200 amps or less 66.85 1
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
.,,s -A ' ' �`�` 1'. :' a` ® ,CO ACT PERSON above service or feeder fee,
' '� `' each branch circuit 6.65 2
Business name: mythic Ly_a:tit1 \ B.Fee for branch circuits
without service or feeder fee,
Contact name: I vi, LA r-e V1.L first branch circuit 46.85 2
Address: r ) C.� ` G, - Each add'I branch circuit 6.65 2
` cam" Miscellaneous(service or feeder not included)
City/State/ZIP:` c l)c / q7Z0Z Each manufactured or modular 90.90 2
dwelling,service and/or feeder
Phone:(53)Z3e- 04---r 7 I Fax: :( j"31 $9 2 sc_i Reconnect only 66.85 2
E-mail: e-Q L0✓ln Pump or irrigation circle 53.40 2
lrtiwre✓i� �nuv�,-�e-r cl.V 111c�v� ,
;cf ,' I "'- r CO RACTOR Sign or outline lighting 53.40 2
Signal circuit(s)or limited-
Business name: Hurrbt(-1T I.v(5.50{1 I L energy panel,alteration,or / <(.
extension.Describe: / Page 2 �� 2
Address: /ea) r XeCSWit7S-t-,
City/State/ZIP: D.c- /0 r 7az Each additional inspection over allowable in any of the above
2 Per inspection 62.50
Phone:(() 74-Q��7 Fax:(S(j' 5tt7. c�6 514 p, Investigation per hour(1 hr min) 62.50
CCB Lie.: /6/? I Electriil Li, • le �., ; Suprv.Lic.:3149f .Lf Industrial plant per hour 73.75
I�'*Jt, $ ELECTRICAL PERMIT FEES
Suprv.Electrician signature,re4ulred: ( Subtotal: 75 c>
Cl `.. Plan review(25%of permit fee):
Print name: 1 C' efArktp6_94, E Date: /O/a I /y State surcharge(8%of permit fee): 9'"' "'
Authorized signature: l J TOTAL PERMIT FEE: gY, OCR
� ^ �.1 JThis permit application expires if a permit is not obtained within 180
Print name: Y1 n LA t--G(4V r-e 'i c.Q Date: /O/ 21-/Y days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC-PermitApp.doe 05/23/06 440-4615T(11/05/COM/WEB