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Permit (44) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT Permit#: ELR2016-00161 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/28/2016 Parcel: 2S 110AB00200 Jurisdiction: Tigard Site address: 14405 SW PACIFIC HWY Project: Ham Radio Outlet Subdivision: CANTERBURY PLACE,AMENDED Lot: PTS 1-4 Project Description: Data telecommunications system. Contractor: TELEDIGIT INC Owner: BULL MOUNTAIN INVESTMENTS LLC PO BOX 22287 ATTN JERRY KOLVE PORTLAND, OR 97269 14389 SW PACIFIC HWY TIGARD, OR 97224 PHONE: 503-722-8084 PHONE: FAX: 503-722-9914 FEES Description Date Amount Specifics: Restricted Energy Permit 06/28/2016 $75.00 Type of Use: COM 12%State Surcharge-Electrical 06/28/2016 $9.00 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. Specia 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 .s nce, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notifica on .-nter. Those rules - e se forth ' OAR 952-001-0010 through OAR 952-001-0090. You may obtain a cop s or direct questions to OUNC by calling 50' - . ' 44. Issued By: . ,. �� Permittee Signature: /11.40 �► 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 ., '7-. FOR 0141(1: 1 SE ON FN .As° ' Received City of Tigard , U 13125 SW Hall Blvd.,Tigard,OIt 17"2,23 Date/B : �) _. =IN Plan Review Phone: 503.718.2439 Fax: 503.'548.'1960 Date/B : Related Permit#: .S L•�f✓ e Zj- •A) A Inspection Line: 503.639.4175 ?l Ready Date y: ® See Page 2 for Tl C.A R 1 /B Internet: www.ti and-or. ov Supplemental Information g g \''\ � Notified/Method: PE OF WO }�ltS T >CAet' PLAN REVIEW ❑New construction Addition/alt rdttall%rep ace4*tjt Please check all that apply(submit 2 sets of plans w/items checked): o Demolition4 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Other: ;,-• where the available fault current 0 Marinas ng d boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floatibuildings. ❑ 1-and 2-family dwellingCommercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑Master builder 0 Other: 0 Fireum P P• 0 Installation of]50 KVA or JOB SITE INFORMATION AND LOCATION° ❑Emergency system. larger separately derived Job#: I Job site address: , �{©5 J 0 Addition of new motor load of system. �t A Ct'c1 C �.t., 100HP or more. ❑"A» "E,> «l Z» «1.3> Ci /State/ZIP: / } ❑Six or more residential units. occupancy. 0 Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: Project name: 0 Hazardous locations. 0 Supply voltage for more than �"� A�1 600 o g ❑Service or feeder 600 amps or more. volts nominal. Cross street/directions to job site: C 14.4 eDe -jr- °6 9C1 FEE SCHEDULE Description I Qty. I Each I Total New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 168.54 4 Ea.add'l 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential \XD,Vc t_ t01;44 C--.,A a\-I (with above sq.ft.) 75.00 2 Limited energy,multi-family 75.00 2 residential(with above sq.ft.) 0 PROPERTY OWNER. 0 TENANT Renewable Energy 0 See Page 2 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 City/State/ZIP: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2 Email: Temporary services or feeders installation,alteration,and/or 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 0 APPLICANT 0 CONTACT PERSON Branch circuits-new,alteration,or extension,per panel A.Fee for branch circuits with Business name: above service or feeder fee, each branch circuit 7.42 2 Contact name: B.Fee for branch circuits without Address: service or feeder fee,first 56.18 2 branch circuit City/State/ZIP: Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Fax: :( ) Each manufactured or modular dwellin s 67.84 2 Email: g, ervice and/or feeder Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: ��, t\ t i ; C Sign or outline lighting 67.84 2 J Signal circuit(s)or limited-energy Address: 0 c� a� 5-1 panel,alteration,or extension. ❑ See Page 2 2 City/State/ZIP: Owl 0 0 2 s b Each additional inspection over allowable in any of the above i Additional inspection(1 hr min) 66.25/hr Phone:('603) —1,4,a., GO O gFax:( ,O Investigation(1 hr min �� 34, �� 1 g ) 90.00/hr Email: t N 1�Ie-D( �."C C.0,- Industrial plant(I hr min) 78.18/hr Inspections for which no fee is CCB Lic.: 11 0$ ectrical Lic.:3-4/1 9.CLE Sup\., --1*g LEll specifically listed(/z hr min) 90.00/hr Suprv.Electrician signature,required: ELECTRICAL PERMIT FEES Print name: r^--- ` o Subtotal: '7 e-'-')14,,,v a . lb . A Date: b 1 a� sol k El Review Required(25/o of permit fee): State surcharge(12%of permit fee): Cf*0 Authorized signature: TOTAL PERMIT FEE: ,; Vt. t\ This permit application expires if a permit is not obtained within 180 Print name: -3---lp r Al\e--..) Date: 1:D451 Ail b days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_: R_ERE.doc Rev 0. 7/2015 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 Description I QlY• I Each I Total I ` Fee for all residential systems combined: $75.00 Renewable electrical energy systems: 5 kva or less 100.70 2 Check Type of Work Involved: 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 ❑ 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 over 25 7.42 3 ❑ Vacuum Systems* >100 kva—no additional charge 0.0 3 Each additional inspection over allowable in any of the above: Each additional inspection is 66.25/hr • Other: charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed('/2 hr min) �„ ELECTRICAL PERMIT TEES' COMMERCIAL WORK ONLY: Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: n Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems 11 Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ L• andscape Irrigation Control* n M• edical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* n P• rotective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015 Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 14405 SW PACIFIC HWY, TIGARD, OR, 97224 Commercial - Electrical Limited Energy 198 Low voltage ﬁnal PASS - No C of O ELR2016-00161 Chip Barnett Violation Summary: Inspector Contractor