Permit (62) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
1 COMMUNITY DEVELOPMENT Permit#: ELR2016-00231
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/26/2016
T " RC' 9 Parcel: 1S135CB00600
Jurisdiction: Tigard
Site address: 11530 SW TIEDEMAN AVE
Project: Harris Work Systems Subdivision: None Lot: None
Project Description: Voice and data cable
Contractor: WEST COAST BUSINESS COMMUNICATIONS INC Owner: MCCALL PROPERTIES LLC
10005 SE STARK BY NED MCCALL
PORTLAND, OR 97216 5480 NW FRONT AVE
PORTLAND, OR 97210
PHONE: 502-465-9222 PHONE:
FAX: 503-489-1806
FEES
Description Date Amount
Specifics: Restricted Energy Permit 09/26/2016 $75.00
12%State Surcharge-Electrical 09/26/2016 $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 $84.00
Other Desc: Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OA 2-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
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Issued By: f/� Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale,lease or rent.
OWNER'S SIGNATURE: Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Electrical Permit Applicata . uilVED FOR OFFICE USE ONLY
City of Tigard Received ...-1, { a41--- Permit#
DateB : < a2W 6 . ag itp 40'423
II '1 13125 SW Hall Blvd.,Tigard,OR 9722Plan Review
Phone: 503.718.2439 Fax: 503.598.1 P 2 6 2016 DateB : Related Permit#:
T I GA RD Inspection Line: 503.639.4175 Ready Date/By: Juris ® See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
tk e 5 * l! : ea$ =r ttkl4;c>'341(''''-i'1 1 ,z,. itAM'" tti . @ GIPOCI
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❑New construction ®Addition/alteration/rep acement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other:
. ,
where the available fault currentt Marinas and boatyards.
s.ur @io ;� ti1 �Ry� n � �
!� i A exceeds 10,000 amps at 150 volts or ❑Floating buildings.
1=11-and 2-family dwelling 1=1Commercial/industrial 1=1 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
29 1 `1 1` ",', ti1 , 11, #,W5,,:;y _ 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address: 11530 SW Tiedeman Ave 100HP or more. ❑"A "E","1-2",°`1-3",
City/State/ZIP:Tigard,OR 97223 0 Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Harris WorkSystems 0 Hazardous locations. 0 Supply voltage for more than
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site:Tideman&Tigard - 14' - '1" " iii G
Description I Qty. I 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#:
E dd'133.92 1
Ea a 500 sq.ft.or portion
phi i� 41 ll ` 1`' - -tat,alai' i' = + -:...z-'•,-,„„12Limited energy,residential
75.00 2
Voice and Data cable (with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
. Renewable Energy 0 See Page 2
: i r:'- 'iii 1 kr., t*N2ggG ;r
N ' 11II111 = . u R� V a' Services or feeders installation,alteration,and/or relocation
Name:Harris WorkSystems 200 amps or less 100.70 2
Address: 11530 SW Tiedeman St 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Tigard,OR 97223 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
t ,',- _} :l,::� i ,r,-i _ , i' Branch circuits-cnew,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:West Coast Business Communications,Inc. above service or feeder fee,
7A2 2
each branch circuit
Contact name:Grady Abernathy B.Fee for branch circuits without
Address: 10005 SE Stark St branch circuit
City/State/ZIP:Portland,OR 97216 Each add'1 branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)465-9222 Fax: :( ) Each manufactured or modular 67.84 2
Email: dwelling,service and/or feeder
Reconnect only 67.84 2
(il ( (iiiii iR = Y !rt TOTt i i!gr Ailiblarrrir Pump or irrigation circle 67.84 2
Business name:West Coast Business Communications,Inc Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address: 10005 SE Stark St panel,alteration,or extension. El See Page 2 75.00 2
City/State/ZIP:Portland,OR 97216 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)465-9222 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:service@westcoastbc.net Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 174150 Electrical Lic.: CLE81 Suprv.Lic.: 3392LEA specifically listed(/Z hr min)
1 Viii; @ 1RTC81 '1 4 i) :
Suprv.Electrician signature,required: /411//f Subtotal "7
Print name: Grady Abernathy Date: 09-26-2016 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 9.crt)
�tl ,� TOTAL PERMIT FEE: D
Authorized signature: "V fit, U
'�"'V This permit application expires if a permit is not obtained within 180
Print name: Cr-4'4A_, A,b ,„, _ Date: Ct/3/i days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC PermitApp_EL 1_ERE.doc Rev 06/17/2015 440-46151(11/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
a
�
�® r ' ® �'� U i liiiii➢� it��'� � t i
I Qty. Each Total
Renewable for all residential systems combined: $75.00 Deecription
3' enewable 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
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)
811
iil
Fee for each commercial system: $75 00 Subtotalkr
Enter on Page 1):
y * Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ 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: 1
*No licenses are required. Licenses are required for all
other installations
I:ABuilding\Permits\ELC_PermitApp_ELR ERE.doc Rev 06/17/2015