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Permit (9) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT 14 - COMMUNITY DEVELOPMENT Permit#: ELR2016 00235 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/29/2016 TIC., I?C� g Parcel: 1 S134AA02100 Jurisdiction: Tigard Site address: 10300 SW NIMBUS AVE PC Project: DaBella Exteriors Subdivision: (KOLL BUSINESS CENTER,TIGARD Lot: 3 Project Description: Low voltage for HVAC Contractor: AMERICAN HEATING INC Owner: ROBINSON,JERRY CHRISTOPHER TRUS 5035 SE 24TH AVE ROBINSON, MICHAEL WILLIAM PORTLAND, OR 97202-4765 HANSON, RONALD D ET AL 203604 EAST FINLEY RD KENNEWICK,WA 99331 PHONE: 503-239-4600 PHONE: FAX: 503-239-7038 FEES Description Date Amount Specifics: Restricted Energy Permit 09/29/2016 $75.00 12%State Surcharge-Electrical 09/29/2016 $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: 1 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. ATT ••: -.on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-%010 through OAR••2-'r -a s'•0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issue By: I 4 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 Ap li p t FOR OFFICE USE ONLY ErCity of Tigard ReDaceived `J g _�� ,� � � • a �j e� /� /� Permit No.: 5/ 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 50 ] Y Other Permit: p 2(�1 f� Date/B T I GARD Inspection Line: 503.639.4175 < I Date Ready/By- Ju is: H See Page 2 for Internet: www tl and-or. ov Notified/Method: g g Supplemental Information "£ f 4 PP 4 'yJ f � TY#[; I - , PLAN REVIEW', Li New construction ®A 1 > l ra i � Please check all that apply(submit 2 sets of plans w/items checked below): El Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards. Aexceeds 10,000 ams at 150 volts or ❑ buildings. _, �; `= �ATECORX-OF GU�15TR(I+C:�'lUI�1 „ 41p Floating less to ground,or exceeds 14,000 ❑Commercial-use agricultural ❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: El Fire pump. 0 Installation of 150 KVA or )O$ O0 Emergency system. larger separately derived system. � 117A:04.$ k4, LpCATIOI I ,,:-x. ❑Addition of new motor load of ❑"A","E","1-2","1-3", Job no.:116365 Job site address: 10300 SW Nimbus Ave 1001IP or more. occupancy. 0 Six or more residential units. 0 Recreational vehicle parks. City/State/ZIP:Tigard OR 97223 0 Health-care facilities. ❑Supply voltage for more than 0 Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: Project name:DaBella Exteriors 0 Service or feeder 600 amps or more. ,:,FEE SCHEDULE Cross street/directions to job site: Description I QtyFee. 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 Ea.add'l 500 sq.ft.or portion 33.92 1 Tax map/parcel no.: Limited energy,residential 75.00 2 DE CRIPTION OFrfWORK- ,` (with above sq.ft.) Limited energy,multi-family 75.00 2 low volt wiring and T-stats residential(with above sq.ft.) Renewable.Energy l See Page 2 Services or feeders installation,alteration,and/or relocation "PROPERTY OWNER „N "•- ;D TENANT 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, 1 er panel z A.Fee for branch circuits with ®;�APPI,ICANT ® 4©NTACT PERSt3, lf above service or feeder fee, 7.42 2 Business name:American Heating Inc. each branch circuit 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't branch circuit 742 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 1,'W . ,CONTRAGTOIt" :. AV ',Ake' Sign or outline lighting 67.84 2 Business name:American Heating Inc. Signal circuit(s)or limited-energy 1 See panel,alteration,or extension. Page 2 2 Address:Brandon Hutchinson Each additional inspection over allowable in any of the above Additional inspection(1 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 ic.: 26993C Suprv.Lie.: 2640LEB specifically listed(%hr min) Suprv.Electrician signature,re ' ed,t 5E ECTRICAL PER IIT Fes” / Subtotal: Print name: T Steve Young ate:y f-4 Plan review(25%of permit fee): !!! State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: Print name: Brandon Hutchinson Date: f.-2,- 14( - 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\ELCPermitAppELR_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: RESIDENTIAL WORK ONLY: Fee for all residential systems combined $75.00 Description ► Qty. I Fee I Total I Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 I I 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 Garage Door Opener* 50.01 to 100 kva 552.26 2 >100 kva(fee in accordance with 552.26 2 n Heating,Ventilation and Air Conditioning OAR 918-309-0040) 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 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 specifically listed(%hr mm) 90.00/hr COMMERCIAL WORK ONLY. ELECTRICAL PERMIT rEE;S: 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. I I Boiler Controls ❑ Clock Systems Data Telecommunication Installation I I Fire Alarm Installation HVAC I I Instrumentation ❑ Intercom and Paging Systems H Landscape Irrigation Control* ❑ Medical Nurse Calls H 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_PermitApp_ELR ERE.doe Rev 05/21/2013