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Permit (16) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT Permit#: ELR2017-00095 Date Issued: 05/03/2017 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 1S126CA01100 Jurisdiction: Tigard Site address: 9009 SW HALL BLVD 100 Project: Target Subdivision: None Lot: None Project Description: Move(2)devices from old fitting room to new fitting room. Contractor: COSCO FIRE PROTECTION INC. Owner: DAYTON HUDSON CORPORATION 2501 SE COLUMBIA WAY SUITE 100 BY TARGET CORP T-0345 VANCOUVER,WA 98661 PROPERTY TAX DEPT/TPN-0950 PO BOX 9456 MINNEAPOLIS, MN 55440 PHONE: 360-816-8418 PHONE: FAX: 360-883-6390 FEES Description Date Amount Specifics: Restricted Energy Permit 05/03/2017 $150.00 12%State Surcharge-Electrical 05/03/2017 $18.00 Type of Use: COM Class of Work: ALT Total Number of Systems: Audio&Stereo: Boiler Controls: CCTV: Clock Systems: Data&Telecommunications: Fire Alarm: HVAC: Instrumentation: Intercom/Paging: Landscape/Irrigation: Landscape Lighting: Medical: Nurse Calls: Protective Signal: Security Alarm: Other: 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 Coes 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 issua -, 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 enter. Those rules are set forth in OAR 952-001-0010 through OA- 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.23 .1987 or 1.80. 2.2344. f� • Issued By:6 4` _ Permittee Signature: yam 4 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 ApplicatiOI ECEIVED 10k 0111(E t x1:0N1.1 City of Tigard 1�7 V Received /��, Date/B : 51 3 /7 it#:CL/��(//7 / 111 114 13125 SW Hall Blvd.,Tigard,OR 97223 MAY 3.2017 Plan Review ,/,„..-110.3 Phone: 503.718.2439 Fax: 503.598.1960 Date/B Related PermitBi/O Z179 T I G A 1 D Inspection Line: 503.639.4175 Ready Date/By: Juris: H See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information BUILDING DIVISION TYPE OF WORK PLAN REVIEW ❑New construction pi Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑Demolition VVV❑��Qth 0 Service or feeder 400 amps or more 0 Building over three stories. where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. 0 1-and 2-family dwelling IYr i Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: ❑Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived CI 0 Addition of new motor load of system. Job#: Job site address: _l�'`' I 5,..:) 1.v,IL iA_i;' 100HP or more. ❑ A","E","1-2",°1-3", City/State/ZIP: `Tu tQ 1) ©C et/ a 2 ❑Six or more residential units. occupancy. n ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: '/�(2 6.)f. -R Y ,5 t DZ ❑vHazardous locations. 0 Supply voltage for more than 111 ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Qty. I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 168.54 4 Ea.add'l 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 2 (with above sq.ft.) 75.00 2 N f Jt GL's Fi�fi t)L� ri 7 Zt 4)( — Limited energy,multi-family 75.00 2 :oyi --ED I.Js.a.) f(�uJe., p.y),�;M residential(with above sq.ft.) Renewable Energy 0 See Page 2 0 PROPERTY OWNER 1 0 TENANT Services or feeders installation,alteration,and/or relocation Name: 1A 2 , 7 200 amps or less 100.70 2 Address: Q —q Sf) A L/ i� vt• 201 amps to 400 amps 133.56 2 �l +� 401 amps to 600 amps 200.34 2 City/State/ZIP: -T i co� C..-4T- 17 2 2 3 601 amps to 1,000 amps 301.04 2 Phone:60S )6 Z41— 0 Fax:( ) Over 1,000 amps or volts 552.26 2 Email: Temporary services or feeders installation,alteration,and/or 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 APPLICANT I ❑ CONTACT PERSON Branch circuits—c new,alteration,or extension,per panel A.Fee for branch circuits with Business name: above service or feeder fee, 7 42 2 each branch circuit Contact name: B.Fee for branch circuits without service or feeder fee,first Address: branch circuit 56.18 2 City/State/ZIP: Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Fax: :( ) Each manufactured or modular Email: dwelling,service and/or feeder 67.84 2 Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: e�C Ft Qi. pso, 6 C-rkDi 3 Sign or outline lighting 67.84 2 Address: c L. /� �1 ��/ Signal circuit(s)or limited-energy at So I ' — C}J i 9(JA �f 1 -'7L,/co panel,alteration,or extension. See Page 2 2 City/State/ZIP: L �,, / W� 1 Each additional inspection over allowable in any of the above cyd / Additional inspection(1 hr min) 66.25/hr Phone:(3‘..0883_ 6,....361,;V Fax:( ) &e3 ,3% Investigation(1 hr min) 90.00/hr Email: vL Cu wn^ Industrial plant(1 hr min) 78.18/hr -I f e G to C c cC`*si f•e i I _1 _ Inspections for which no fee is CCB Lic.:(,7 s-(),t� Electrical Lie.: (i /S Suprv.Lic.:) L specifically listed(%z hr min) 90.00/hr f t ? ` ELECTRICAL PERMIT'FEES Suprv.Electrician signature,requ red: kr.i,/ /Q f/�� Subtotal: icc 1 e t) t . Print name: Kg u� !m r/d Date: c it ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): `f",p L Authorized signatur : TOTAL PERMIT FEE: / ,4t Print name: 5xi cr6 This permit application expires if a permit is not obtained within 180 7 tA'L v6 i,E Date: C / ?>/1 days after it has been accepted as complete. / * Number of inspections allowed per permit. I:\Building\Permis\ELC_PecmitApp_ELR_ERE.doc Rev 06/17/2015 440-46151(1 1/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Description I Qty. I Each Total 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: n Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 D Garage Door Opener* >100 kva(fee in accordance 552.26 2 with OAR 918-309-0040) n H• eating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 n V• acuum 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) 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 of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls Fl Clock Systems ❑ Data Telecommunication Installation M.Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems n Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling V. Other: C i7;) TFfr 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 06/17/2015