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Permit
CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT II 1 n COMMUNITY DEVELOPMENT Permit#: ELR2015-00242 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/14/2015 Parcel: 1 S135AB03400 Jurisdiction: Tigard Site address: 10260 SW GREENBURG RD 710 Project: Axiom Subdivision: METZGER,TOWN OF Lot: 9 Project Description: Low voltage for audio system sound masking. Contractor: AZIMUTH COMMUNICATIONS INC Owner: LINCOLN CENTER LLC PO BOX 508 BY SHORENSTEIN PROPERTIES LLC WILSONVILLE, OR 97070 235 MONTGOMERY ST, 16TH FLOOR SAN FRANCISCO, CA 94104 PHONE: 503-639-0110 PHONE FAX: 503-639-0115 FEES Description Date Amount Specifics: Restricted Energy Permit 10/14/2015 $75.00 12%State Surcharge-Electrical 10/14/2015 $9.00 Type of Use: COM Class of Work: ALT Total Number of Systems: 1 Audio&Stereo: 1 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 applic-•e aw. 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 ork is susp nde• for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notificatio enter. hose rule ar set forth in OAR 952-001-0010 through OAR 952-001-0090. You ma • : •-rules or direct questions to OUNC by callin 3.2 .1987 0 .800.332.2 4. Issued By: ✓`i - —.' i _ -rmittee 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 Application ,‘, "ii.)4 City of Tigard Received Permit�:• �J f g Cr() Date/By 1O l'� l s 1 r� &--f`-�b t 5'-Cx 2Ltd, 71 13125 SW Hall Blvd.,Tigard,OR 97 `i Plan Review e Phone: 503.718.2439 Fax: 503. h'.� rLQ.h Date/By: Related Permit S: Inspection Line: 503.639.4175 Ready Date/By: - Juris: Ed See Page 2 for i I(,A R I) Internet: www.tigard-or.gov `1 NS' :Notified/Method: Supplemental Information• r``� TYPE OF WORK ON:\\ %.° PLAN REVIEW ❑New construction ❑Addition/alteration/rep,` 4 Please check all that apply(submit 2 sets of plans w/items checked): ❑ Demolition 0 Other: 44.) ❑Service or feeder 400 amps or more ❑Building over three stories. ` where the available fault current ❑Marinas and boatyards. _ CATEGORY OF CONSTRIN exceeds 10,000 amps at 150 volts or ❑Floating buildings. ❑ 1-and 2-family dwelling , `Conunercial/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 ❑Addition of new motor load of system. Job#: Job site address:10Z4,0 sw 6, ,/� � IOOHP or more. ❑ A',"E"."l-2",°t-3 City/State/ZIP: ,,�,�/n 2 ❑Six or more residential units. occupancy. � '"'"v ��Z2/ 0 Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: 7 (Q Project name:4x,/orii E j ❑Hazardous locations. ❑Supply voltage for more than D ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: jt./6✓1 FEE SCHEDULE _Description I Qts• I Each I Total New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: La.add'l 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK ` , Limited energy,residential 75.00 2 Lad , I 0 <U(J� Pi/i"Sy iN/' (with above sq.ft.) (�f/xa/ V b`T (•� Limited energy,multi-family 75.00 residential(with above sq.ft.) Renewable Energy ❑ See Page 2 ID PROPERTY OWNER [ ❑ TENANT _ Services or feeders installation,alteration,and/or relocation Name: 200 amps or less 100.70 2 201 amps to 400 amps 133.56 2 Address: - 401 amps to 600 amps 200.34 2 City/State/ZIP: 601 amps to 1,000 amps 301.04 2 Phone: ( ) 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 ❑ APPLICANT I ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel Ai A.Fee for branch circuits with Business name: Aiz//N v7 CeOf'?"0it/( c4--7701)S above service or feeder fee, 7.4_ _ each branch circuit Contact name: t./ ,jAJ6Q B.Fee for branch circuits without R 0. � Sw „ ���_s ,/4�� p branch or feeder fee,first 56.18 2 Address: hL branch circuit City/State/ZIP: jA'C.477// Cg- q 7696 z Each add'l branch circuit I 7.42 2 p 2 6 2 Gy Miscellaneous(service or feeder not included) Phone: (Oj(/�j) I. 6 7kU Fax: :( f )6, ( — �?I f 7! _ S Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email: Q W(/ U ®/t2 i V _ /N'�1 �/L r Q.uS. c©/ti Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 • Business name:/4-2,..+ M U7-1-1- &MA/aAJ(cA1-1704/5- Sign or outline lighting 67.84 2 —' ,/�� ,�}-�,� / , Signal circuit(s)or limited-enemy j Address: 9500 SW i �f"Pt7 r/v-S��i jp panel,alteration,or extension. See Page 2 '�T City/State/ZiP: "---tJ4 .4i 77/1/ ©L 0( 706,2_ Each additional inspection over allowable in any of the above g Additional inspection(1 hr min) 66.25/hr Phone:03 ) S l 3.- (p`j d o Fax: (;'6g ) 63?_a/5 Investigation(1 hr min) 90.00/hr (� r. v��� Co Industrial plant(1 hr min) 78.18/hr Email: (/U U t� �//y(/Lt(J/l/l �(Q Inspections for which no fee is specifically listed('/hr min) 90.00/hr CCB Lic.: 1 y5 y2r Electrical Lic.:3(.- r iy« Suprv. Lic.:0731,4 ELECTRICAL PERMIT FEES Suprv. Electrician signature,required: Subtotal: 75;!I:- Print name: Date: ❑Plan Review Required(25%of permit fee): "- rState surcharge(12%of permit fee): `x' // y Authorized signature:/ TOTAL PERMIT FEE: kik 6* t ` This permit application expires if a permit is not obtained within 180 Print name: y .1 U vl(��v Date:1t9/( Li/(S days after it has been accepted as complete. //// • Number of inspections allowed per permit. I:BuitdingTermits.ELC_PermitApp_ELR ERE.doc Rev 06 17 2015 440-461 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 Description I Qty. I Each I Total I Fee for all residential systems combined: $75.00 Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 n A• udio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: n Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 n G• arage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 2 ❑ H• eating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 n V• acuum Systems* >100 kva—no additional charge 0.0 3 Each additional inspection over allowable in any of the above: ❑ Other: Each additional inspection is charged at an hourly(1 hr inin) 66.25/hr I Inspections for which no fee is 90.00/hr specifically listed('L hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Subtotal(Enter on Page I): Fee for each commercial system: $75.00 * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: Audio and Stereo Systems 5 o\-)1--f b e-SK-(A.C) n Boiler Controls ❑ Clock Systems n Data Telecommunication Installation ❑ Fire Alarm Installation n HVAC n Instrumentation n Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical n Nurse Calls n Outdoor Landscape Lighting* ❑ Protective Signaling n Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:Building' Rev 06-17-2015