Permit (21) 14 CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
8 COMMUNITY DEVELOPMENT
Permit#: ELR2016-00204
TfGA.RJ 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/22/2016
Parcel: 1 S 1260000300
Jurisdiction: Tigard
Site address: 9355 SW WASHINGTON SQUARE RD T19
Project: Lululemon Subdivision: None Lot: None
Project Description: Data telecommunications and audio systems.
Contractor: INDEPENDENT COMMUNICATIONS&CABLE Owner: PPR WASHINGTON SQUARE LLC
3425 SW 121ST AVE PO BOX 847
BEAVERTON, OR 97005 CARLSBAD, CA 92018
PHONE: 971-216-9204 PHONE:
FAX:
FEES
Description Date Amount
Specifics:
Restricted Energy Permit 08/22/2016 $75.00
Type of Use: COM 12%State Surcharge-Electrical 08/22/2016 $9.00
Class of Work: ALT Restricted Energy Permit 08/22/2016 $75.00
Total Number of Systems: 2 12%State Surcharge-Electrical 08/22/2016 $9.00
Audio&Stereo: 1 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 $168.00
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 folio, e rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. -. -, :; n a copy of ':rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ✓ �,�! Permittee Signature: �� 1 W - --
0 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 (OR OFFK I. t se oNl.l
City of Tigard �n. Received min
_ 13125 SW Hall Blvd.,Tigard,OR r .; !IlliDate/B : Permit#: �; Lr 1/`— ; ty
Plan Review
kif�J� 11
1 Phone: 503.718.2439 Fax: 503.5'•.. 60 tl ��16 Date/B Related Permit#. �t (3/�
Inspection Line: 503.639.4175 PSC, P U „co Ready Date/By: H See Page 2 for
TIC A RD Internet: www.tigard-or.gov ( Notified/Method:
d� �� �,w4t . Supplemental Information
TYPE OF WO �� �����\� PLAN REVIEW
Addition/alteratf Cement Please check all that apply(submit 2 sets of plans w/items checked):
0 New constructiontg)
0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition ❑Other:
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑ 1-and 2-family dwelling g Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
0 Multi-family ❑Master builder 0 Other: ❑Fire pump. 0 Installation of 150 KVA or
et_ JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: Job site address: ' 0 Addition of new motor load of system.
:3�.! �� 4,/,,b1/,`,45 64+f �` 100HP or more. ❑"A" "E" "1-2""1-3»
City/State/ZIP: Pdn' flz
Ol°�,afy JJ
El Six or more residential units. occupancy.
.d/ ❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: '77c Project name: 10 j. `il,,,";
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:
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:
❑ 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
specifically listed('/hr min)
yr
..,":
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES: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 f Work Involved:
Audio and Stereo Systems
❑ Boiler Controls
[11C ock 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
1:\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
9355 SW WASHINGTON SQUARE RD T19,
TIGARD, OR, 97223
Commercial - Electrical Limited Energy
135 Low voltage rough-in
PASS
ELR2016-00204
Jeff Grove
Violation Summary:
Inspector Contractor