Permit f n
CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit#: ELR2015-00082
T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/23/2015
Parcel: 2S113BA00400
Jurisdiction: Tigard
Site address: 7632 SW DURHAM RD 305
Project: Hi Tech Subdivision: ROSEWOOD ACRE TRACTS Lot: D
Project Description: Data telecommunications system for TI.
Contractor: HECKTEC TECHNICAL LLC Owner: PORTLAND SW CENTER LLC
3484 HILLSIDE CT BY FELTON PROPERTIES INC
HUBBARD, OR 97032 ATTN: FELTON, MATT
520 SW 6TH AVE, STE 610
PORTLAND, OR 97204
PHONE: 503-572-1938 PHONE:
FAX: 503-982-4823
FEES
Description Date Amount
Specifics: Restricted Energy Permit 03/23/2015 $75.00
12%State Surcharge-Electrical 03/23/2015 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio&Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data&Telecommunications: 1 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 other appli =•le 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, • if work is susp•nded fo y more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Ce-er. Those rule. are s17 forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a ••y of the rules or direct questions to OUNC by calling 503.23 1987•r 1.800.3/V 44. }�
Issued By: - 1"' Permittee Signature: /I A,�itt rf
i fly
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 Application I ()It III I I( I 1 .t ()NI.N
City of Tigard `f Received _
• �,V Date/B : r r�Il! .it
11111
13125 SW Hall Blvd.,TFax: 50l�� 1. ` Plan Review
1 Phone: 503.718.2439 Fax: 503 60 015 DateB : Related Permit#: f� •i LP S— . •'elp
Inspection Line: 503.639.4175 np 3 Ready Date/By: luris: ® See Page 2 for
i `' Internet: www.tigard-or.gov 1'tP Notified/Method: e Supplemental Information
TYPE OF W —,0,`l^ftpl 5��� PLAN REVIEW
❑New construction ddition/alt �ment Please check all that apply(submit 2 sets of plans w/items checked):
v ❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition Other: where the available fault current ❑Marinas and boatyards.
• CA GORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
❑ 1-and 2-family dwelling ommercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
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
Job#: Job site address:-7 6-3-2_ Sid 0a-k�I ❑100H oo of oew motor load of system.
��,CCC IOO ti or more. ❑system.
"E","1-2","1-3",
occupancy.
v V 7wu- ❑❑HSiex aloth r mcore e freacsiidlietnetsial units.Ci /State/ZIP: ` `la T ❑Recreational l vehicle parks.Suite/bldg./apt.#: I ❑Hazardous locations. 0 Supply voltage for more than
Project name: TCG�
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Each I Total I •
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: -
Ea.&W 1 500 sq.ft.or portion 33.92 1
DISCRIPT7N OF WORK Limited energy,residential .
� n I/ (with above sq.ftJ 75.00 2
IIG��� ra l/{ JACKS kacie... L imited energy,multi-family
residential(with above sq.ft.) 75.00 2
Renewable Energy ❑ See Page 2
❑ PROPERTY OWNER I ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 100.70 2
Address: 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) I Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature:_ Date: 401 amps to 599 amps 168.54 2
'gl APP CANT I ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
/ A.Fee for branch circuits with
Business name: 1( G ��c��`��( above service or feeder fee,
7.42 2
1� ` each branch circuit
Contact name: I e J`� Lp r. B.Fee for branch circuits without
Address: �r-C L '"r service or feeder fee,first 56.18 2
f�6Y l N. L 6 vW1f tc, �% branch circuit
City/State/ZIP: of, Each add'1 branch circuit 7.42 2
tY � 1 Z�I 3 Miscellaneous(service or feeder not included)
Phone:5 3 ) 5-7 2— I -, 1 Fax: :( ) Each manufactured or modular 67.84 2
Email: �[ � ut, (`v• (Ury�, dwelling,service and/or feeder
htk'' �`•' l Reconnect only 67.84 2
tiff. ` /CONTRACTOR Pump or irrigation circle 67.84 2
Business name: I/�„p _ Sign or outline lighting 67.84 2
[� ' �/ Signal circuit(s)or limited-energy • See Page 2 �5`��2
Address: G 6 ler.Cifkli \.CCJ
V `r./ panel,alteration,or extension. —
C rrr/// y
Each additional inspection over allowable in any of the above
City/State/ZIP:Y � o Additional inspection(I hr min) 66.25/hr
Phone: ) '1 1 to Fax:( ) Investigation(I hr min) 66.25/hr
_ Industrial plant(1 hr min) 78.18/hr
Email: t\.ectt (� , bMS L. Caw. . / 7 4.1 Q(dLb� Inspections for which no fee is
CCB Lie.: Z Electrical Lie.: �6�r4.Lic. £ I q specifically listed('A hr min) 90.00/hr
ll]� / ELECTRICAL PERMIT FEES •
Suprv.Electrici sigblu required: 10 "t'
t�17 Subtotal: 7S —
Print name: )(,,FINikei Date: 3/21,r- ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): Lf
Authorized signat �� r TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: r— C IC- Date:z 7 1 days after it has been accepted as complete.
✓/ • Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 04/21/2014 15 (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 Qty. I Each I Total
3' 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
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
El Garage Door Opener* >100 kva(fee in accordance 552.26 2
with OAR 918-309-0040)
❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over25 7.42 3
El Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ 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: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
y • Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
El Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
IAData Telecommunication Installation
El Fire Alarm Installation
El HVAC
El Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control*
El Medical
El Nurse Calls
El Outdoor Landscape Lighting*
El Protective Signaling
❑ Other:
Total number of commercial systems: I
*No licenses are required. Licenses are required for all
other installations
C\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 04/21/2014