Permit (32) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
IN.. ''- COMMUNITY DEVELOPMENT Permit#: ELR2016-00173
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/25/2016
Parcel: 1 S136AD04000
Jurisdiction: Tigard
Site address: 11507 SW PACIFIC HWY B
Project: The Bridge Subdivision: VILLA RIDGE Lot: 7
Project Description: Low voltage for data. Tenant is expanding into adjacent suites C and D.
Contractor: INDEPENDENT TELEPHONE SERVICE LLC Owner: PACIFIC TERRACE COMMERCIAL LLC
20303 S SOUTH END RD BY SMITH, EDITA M
OREGON CITY, OR 97045 833 NW 170TH DR
BEAVERTON, OR 97006
PHONE: 503-650-5050 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Restricted Energy Permit 07/25/2016 $75.00
12%State Surcharge-Electrical 07/25/2016 $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 all other applicable law. All work will
be done in acc rrce'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. ATT ION: Oregon law equires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules - set forth in OAR
952-001- 10 through OAR 95 001-00•: You may obtain a copy of the rules or direct questions to OUNC by calling 503.2 or 1.80. 32. •'4.
� , t
Iss ed By: Permittee Signature: 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:
C' T CTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' -'T, Date: 7/4-5/
sow
LICENSE NO. 32'60 L /9-
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 Appli wFi‘1 FOR OFFI( 1. FSF Oy1.1
City of Tigard I • Receivedff / / Permit 4: E)/�D Co/73
13125 SW Hall Blvd.,Tigard,OR, 22 Plan eRevie� /
Phone: 503.718.2439 Fax: 503J5 1 0 2016 DaeB : Related Permit#:Au42c.,M,061 7
Inspection Line: 503.639.417-511-v E1° Ready Date/By: 7uris: H See Page 2 for
Internet: www.tigard-or. .„ € „r a Notified/Method: Supplemental Info
rmation
❑New construction ®Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition ❑Other:
availablewherethestcurrent 0
Marinas and boatyards.
' i `� ,t S a' a 00 exceeds 10,000 amps volts or
0 Floating buildings.
❑ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder ®Other:
['Fire pump. 0 Installation of 150 KVA or
( i ,• ❑Emergency system. larger separately derived
Job#: Job site address: 11507 SW Pacific Hwy. ❑Addition of new motor load of system.
100HP or more. ❑"A","E","1-2","1-3",
City/State/ZIP:Tigared Or.97223 ❑Six or more residential units. occupancy.
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#:D Project name:The Bridge 0 Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site:SW 715t Ave. Kx t N ; ,
Description I..Qty. Each I Total I*
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#
Ea.add 1500sq.ft.or portion 33.92 1
.E,E,'., . a ,, „_, i.. it„„( , . .. ,..?d.at .., Limited energy,residential 75.00 2
(with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
_. t� Renewable Energy 0 See Page 2
a t ?t t,r Services or feeders installation,alteration,and/or relocation
..;.�P ..., a ,,..�+v „�. . .:�.,.. t-. .,� ��..x ....-.fir�„.��... ��. �,� ,A�'.
Name: 0-4/le, —Cif-I C,L z eiO4,01 200 amps or less 100.70 2
// &6 7 S� nidi�'t il�y2
201 amps to 600 amps 133.56 2
Address: /�
401 amps to 600 amps 200.34 2
City/State/ZIP: 7/ ,1 len of. 9 7 Z Z 7 601 amps to 1,000 amps 301.04 2
Phone:(SID)) 4 99 9I/4 IJ/3 Fax:( ) Over 1,000 amps or volts 552.26 2
//��
Temporary services or feeders installation,alteration,and/or
Email:l'Ax co at, ti.1S2dojg Qk w •ed e” relocation
Owner installation:This installation is beifig 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
y®,' r Branch circuits-new,alteration,or extension,per panel
" " "` �'` ..� A.Fee for branch circuits with
Business name: _nu m-eirs s cnr 7FLt p1-,46.t Se-K✓iee LL.r=, aach bbove ranch service cirorcufeederit fee, 7.42 2
e
Contact name: 544.4/404, C,4 wl 47B.Fee for branch circuits without
service or feeder fee,first
Address:20303 S.South End Rd. branch circuit 56.18 2
City/State/ZIP:Oregon City,OR.97045 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)650-5050 Fax::(NA) Each manufactured or modular 67.84 2
dwelling,serviceand/or feeder
Email:stevencawley@yahoo.com Reconnect only 67.84 2
,. .<'CON` Pump or irrigation circle 67.84 2
Business name:independent Telephone Service LLC. Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address:20303 S.South End Rd panel,alteration,or extension. See Page 2 2
City/State/ZIP:97045 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)650-5050 Fax:(NA) Investigation(1 hr min) 90.00/hr
Email:stevencawley@yahoo.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee 1s 90.00/hr
CCB Lic.: 211149 (bpi& Electrical Lic..LL.►_yVG Suprv.Lie.: 5060LEA s?eclficall7y hsted(1{hr mm)
Suprv.Electrician signature,required: Subtotal:
Print name: Steven Cawley Date: 7.18.2016 0 Plan Review Required(25%of permit fee):
Authorized signature
f State surcharge(12%of permit fee):
TOTAL PERMIT FEE: g'(1/.
e This permit application expires if a permit is not obtained within 180
Print name: Steven Cawley Date: 7.18.2016 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:'Building\Permits\ELC 'ermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEu
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
fif ,. -*,t ., .p: )i;.. .=x.,.. -a'f1 '�*c".j;-'+ # M i,' ig 1+ t.,=''. r x,.4t ^o.. ...m IJSfi iff : �R„
Fee for all residential systems combined: $75.00 �Deseription Qty.
t" ,I Each I ^Total � `�
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
0 Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
❑ 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:
❑ 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
,specrfically listed(V2 hr min))
.j . .. +. _c j.xc,�� .-.c�. t:.
y
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
* Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
O Boiler Controls
❑ Clock Systems
• Data Telecommunication Installation
O Fire Alarm Installation
O HVAC
❑ Instrumentation
O Intercom and Paging Systems
O Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
O Protective Signaling
O Other:
Total number of commercial systems: 1
*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
11507 SW PACIFIC HWY B, TIGARD, OR, 97223
Commercial - Electrical Limited Energy
198 Low voltage final
PASS - No C of O
ELR2016-00173
Jeff Grove
Violation Summary:
Inspector Contractor