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Permit (238) CITY OF TIGARDIN ELECTRICAL RESTRICTED ENERGY PERMIT : COMMUNITY DEVELOPMENT Permit#: ELR2016-00271 T t GEAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/29/2016 Parcel: 2S1136000600 Jurisdiction: Tigard Site address: 16060 SW 85TH AVE Project: Clean Water Services-0&M Building Subdivision: None Lot: None Project Description: Low voltage for HVAC Contractor: AMERICAN HEATING INC Owner: CLEAN WATER SERVICES 5035 SE 24TH AVE 2550 SW HILLSBORO HWY PORTLAND, OR 97202-4765 HILLSBORO, OR 97123 PHONE: 503-239-4600 PHONE: FAX: 503-239-7038 FEES Description Date Amount Specifics: Restricted Energy Permit 12/29/2016 $75.00 12%State Surcharge-Electrical 12/29/2016 $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: 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: Orego law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001- 10 through OAR 952 .01-0.• Yo ay obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Iss ed By: t / / 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 ONLYs , _ Cityof Tigard `� t Received /R s/lv ���av/6 O'017/ g '�' ? y ,t7,, Pennit No.: `� 13125 SW Hall Blvd.,Tigard, 9713 Plan Review Phone: 503.718.2439 Fax: 503.598.4-960 ) Date/By: r�' Other Permit: TIGARD Inspection Line: 503.639.4175 LJ +) (U 16 Date Ready/By: turfs: El See Page 2 for Internet: www.tigard-or.gov Notified/Method: /1/14/f( Supplemental Information aI ie 0 , ti imittl- SI r 5. , s..PI AN REVIEW - f '' t Please check all that apply(submit 2 sets ofplans w/items checked ❑New construction ®Additlorl/a!&ration/replacement 400 y below): 0 Service or feeder amps or more ❑Building over three stones_ ❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards. TE UR (3+Gt isISTRiTC 'IOAI - exceeds 10,000 amps at 150 volts or ❑Floating buildings. less to ground,or exceeds 14,000 0 Commercial-use agricultural ❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building amps for all other installations. buildings. ❑Multi-family ❑Master builder 0 Other: ❑Fire pump. El Installation of 150 KVA or err dr Emergency system. larger separately derived system. .2 1NFOR AT ON AND- Loc,„ t)lK ❑Addition of new motor load of >r. �����r w.. %�'.:" ❑ .A„..E„ X1_2„..1_3„ Job no.:416410 Job site address:16060 SW 85th Ave 10011P or more. occupancy. ❑Six or more residential units. 0 Recreational vehicle parks. City/State/ZIP:Tigard OR 97224 0 Health-care facilities_ 0 Supply voltage for more than ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: Project name:Clean Water Services ❑Service or feeder 600 amps or more. FEE SCHEDULE: . Cross street/directions to job site: Description oty. I Fee- I �Total 1 New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq.R.or less 168.54 4 Ea.add'1500 sq.ft.or portion 33.92 I Tax map/parcel no.: Limited energy,residential 1 5c iii . D 1lJP TION©F W� „,,,,,55.5-'5,..” (with above sq.ft.) 75.00 2 Limited energy,multi-family 75.00 2 low volt wiring and T-stats residential(with above sq.ft.) Renewable Energy ( ❑ See Page 2 Services or feeders installation,alteration,and/or relocation :---0--iiitO'I Igr,OWI R y i,"❑ •EIN 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,per panel _ adAPPLICANT-; Eg:'CONTACT;PEI2SI.TtY 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 "CONTRACTOR , 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 TS' 2 Address:Brandon Hutchinson Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 6625/hr City/State/ZIP:Portland,OR.,97202 Investigation(1 hr min) 6625/hr Phone:(503)239-4600 Fax:(503)239-7038 Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.001 hr CCB Lie.: 33135 Electrical Lic.: 26993CRE Suprv.Lie.: 2640LEB specifically listed(4 hr min) j ELECTRICAL PERMIT FEES ,. Suprv.Electrician signature,requirAiletit-'Y"liti, Subtotal: 7S v0 Print name: T Steve Young E ae: JPlan review(25%of permit fee): __.---- State surcharge(12%of permit fee): ( OU Authorized signature: TOTAL PERMIT FEE: l�,6U This permit application expires if a permit is not obtained within 180 Print name: Brandon Hutchinson Date:/p) �� days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitAppELR ERE doe 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: RESID0ITIAL'W3RK ONLY Fee for all residential systems combined ... $75.00 Description I 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 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 I Garage Door Opener* 50.01 to 100 kva 552.26 2 >100 kva(fee in accordance with 552.26 2 ❑ 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 ElOther: 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 90.001 hr specifically listed(%hr mm) CO ERCIALWORKONI�Y ELECTRICAL PERMIT FEES:- 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 I I Clock Systems Data Telecommunication Installation ❑ Fire Alarm Installation HVAC I .1 Instrumentation Intercom and Paging Systems I I Landscape Irrigation Control* Medical I I Nurse Calls I I 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 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 16060 SW 85TH AVE, TIGARD, OR, 97224 Record Type: Record ID: Commercial - Electrical Limited Energy ELR2016-00271 Inspection Type: Inspector: 198 Low voltage final Chip Barnett Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor