Permit (64) IN0.--- CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
' COMMUNITY DEVELOPMENT Permit#: ELR2016 00184
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/03/2016
TIGARD g Parcel: 2S101 BD00100
Jurisdiction: Tigard
Site address: 7650 SW BEVELAND RD 200
Project: Womens Healthcare Associates Subdivision: None Lot: None
Project Description: Low voltage wiring and T-stats.
Contractor: AMERICAN HEATING INC Owner: PNWP LLC#2
5035 SE 24TH AVE PO BOX 2206
PORTLAND, OR 97202-4765 BEAVERTON, OR 97075
PHONE: 503-239-4600 PHONE:
FAX: 503-239-7038
FEES
Description Date Amount
Specifics: Restricted Energy Permit 08/03/2016 $75.00
12%State Surcharge-Electrical 08/03/2016 $9.00
Type of Use: COM
Class of Work: ALT
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 Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0o•I. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ' 1 '' / 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 Application FOR OFFICE USE ONLY
City of Tigard Receivedyry // ��! , Permit Not' /� to/f/
1114 a 13125 SW Hall Blvd.,Tigard,OR 972231. DateB J k% f j''
g t, Plan Revie
2,. Phone: 503.718.2439 Fax: 503.598.1960 ,Date/By: Other Permit %po/,_00523 y,-
T 1 CARD Inspection Line: 503.639.4175 Date Ready/By: Juris. H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
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Please check all that apply(submit 2 sets of plans w/items checked below):
CI New construction ®Addition/alteration/replacement
❑Service or feeder 400 amps or more CI Building over three stories.
❑Demolition 0 Other: where the avail current
a it CATTORY CMO exceeds 10,000 amps att150 volts or 0 Floating buildings.nas boatyards.
, :���/' less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building amps for all other installations. buildings.
❑Multi-family 0 Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
Emergency system. larger separately derived system.
OB*-,..;1051F4,.., TION AI1i1? TIQis1
� L�C��,., �,•c__ ❑Addition of new motor load of
Job no.: 116238 Job site address:7650 SW Beveland 2"d floor 100HP or more. occupancy.
❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:Tigard OR 97224 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.:2"d fir Project name:WI-IA LAb El Service or feeder 600 amps or more.
k / tB SC tita,E r ziii
Cross street/directions to job site: Description I Qty. I Fee. I Total I '
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4
a sq.ft.or portion
33.92 1Tax map/parcel no.: Limited energy,residential 75.00 2
� „rxy. . IPT_t6N OF %. ' ..:= (with above sq.ft.)
' Limited energy,multi-family 75.00 2
low volt wiring and T-stats residential(with above sq.ft.)
Renewable Energy ' p See Page 2
Services or feeders installation,alteration,and/or relocation
TfPIZppER i Owr4' 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name:
401 amps to 600 amps 200.34 2
Address: 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation,alteration,and/or
Phone:( ) Fax:( ) relocation
200 amps or less 59.36 1
Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits—new,alteration,or extension, ler panel
'467%% .11145'W-'---' % ►tet;roIy PISO y A.Fee for branch circuits with
' above service or feeder fee,
Business name:American Heating Inc. each branch circuit 7.42 2
B.Fee for branch circuits without
Contact name:Brandon Hutchinson service or feeder fee,first 56.18 2
branch circuit
Address:5035 SE 24th Ave. Each add'I branch circuit 7.42 2
City/State/ZIP:Portland,OR.,97202 Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
Phone:(503)239-4600 Fax: :(503)239-7038 dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail:b.hutchinson@americanheating.net Pump or irrigation circle 67.84 2
� A(:TOL1 " .
'� �/' ' .•' N• ��' `.,,,,� IT �. -•:.. ✓ �' Sign or outline lighting 67.84 2
Business name:American Heating Inc. Signal circuit(s)or limited-energySee
panel,alteration,or extension. 1 Page 2 75.ClU 2
Address:Brandon Hutchinson Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
City/State/ZIP:Portland,OR.,97202 Investigation(1 hr min) 66.25/hr
Phone:(503)239-4600 Fax:(503)239-7038 Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lie.: 33135 Electrical L'c.: 26993C Suprv.Lic.: 2640LEB specifically listed(%2 hr mm)
! Q��
_EI CT`II .L P RMIT; ,f$ .
Suprv.Electrician signature,require � Subtotal: -75, ro
Print name: T Steve Young Date: '7,., 7//‘ Plan
`C/ Plan review(25%of permit fee):
State surcharge(12%of permit fee): 1,rt
Authorized signature: TOTAL PERMIT FEE: Ry LJ 4
Print name: Brandon Hutchinson Date:
.4--Print
� This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(11/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
may. ,. . � F ,
vgsc*;Gl"i)Le
I
Fee for all residential systems combined........ $75.00 Description j Qty. Fee Tota,
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
Burglar Alarm Wind generation systems in excess of 25 kva:
25.01 to 50 kva 301.04 2
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance with
Heating,Ventilation and Air Conditioning
OAR 918-309-0040) 552.26 2
System* Solar generation systems in excess of 25 kva:
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva-no additional charge 0.0 3
I I Each additional inspection over allowable in any of the above:
Other: Each additional inspection is
charged at an hourly(1 hr min) 66.25/hr 1
Inspections for which no fee is
specifically listed(V hr min) 90.00/hr
C±1:}11 ISOlt ATr 0140: I1 L'3V
tgagnuomOrEgivirrats 01:
Fee for each commercial system $75.00 Subtotal:
(SEE OAR 918-309-0000) Plan review,if required(25%of permit fee):
State surcharge(12%of permit fee):
Check Type of Work Involved: TOTAL PERMIT FEE:
❑ This permit application expires if a permit is not obtained within 180
Audio and Stereo Systems days after it has been accepted as complete.
* Number of inspections allowed per permit.
❑ Boiler Controls
❑ Clock Systems
Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\Building\Permits\ELC_PerntitApp_ELR_ERE.doc Rev 05/21/2013
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
7650 SW BEVELAND RD 200, TIGARD, OR,
97223
Commercial - Electrical Limited Energy
198 Low voltage final
PASS - No C of O
ELR2016-00184
Chip Barnett
Violation Summary:
Inspector Contractor