Permit (47) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit#: ELR2017-00100
Tt GA;R.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/11/2017
Parcel: 1 S134BC00300
Jurisdiction: Tigard
Site address: 12262 SW SCHOLLS FERRY RD
Project: Advantis Greenway Subdivision: None Lot: None
Project Description: Low voltage for fire alarm
Contractor: T&L COMMUNICATIONS INC Owner: FW OR-GREENWAY TOWN CENTER LLC
PO BOX 87387 PO BOX 790830
VANCOUVER, WA 98687-7387 SAN ANTONIO, TX 78279
PHONE: 360-737-9725 PHONE:
FAX: 360-737-9648
FEES
Description Date Amount
Specifics: Restricted Energy Permit 05/11/2017 $75.00
12%State Surcharge-Electrical 05/11/2017 $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: 1
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 Notifi.-t•n Center. Those rules are set forth in OAR
952-001-0010 throughhOAR
_952-001-0090. You may obtain a of the rules or direct questions to OUNC by calling 503 32.1 7 or 1.800.332.2344.
Issued Byt � 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.
i V
Electrical Permit Application
FOR OFFICE. OSE O'�"LY
City of Tigard 4CEIVED Received
lig - 13125 SW Hall Blvd.,Tigard,OR Date/B : Permit#: aQt,.-�f��
Phone: 503.718.2439 Fax: 503.598.19 0 Plan Review
y®Q 2 4 2017 Date/B : Related Permit#:cii6 p/7 1X4f5 (�
T I G A R D Inspection Line: 503.639.4175 1 . Ready Date/By: J,uis: Page 2 J
Internet: www.ti ardor ov S See 2 Informationnr
g g
Notified/Method: Supplemental
OF Tl04
❑New construction ; � �, .: ,..N�,r ,.
®Addition/a - a 10 rep acement Please check all that apply(submit 2 sets of plans w/items checked):
❑Demolition ❑Other: ❑Service or feeder 400 amps or more ❑Building over three stories.
where the available fault current 0 Marinas and boatyards.
r 1.1C oli. CONsTRUCTIONr , , "Ra =s exceeds 10,000 amps at 150 volts or 0 Floating buildings.
1:11 and 2-family dwelling ®Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder
0 Other: 0 Fire pump. 0 Installation of 150 KVA or
r° 8$ '4,�1 ❑Emergency system. larger separately derived
Job#: l Job site address: 12262 SW Scholls Ferry Road "v" ❑Addition of new motor load of system.
100HP or more. ❑"A","E","1-2","I-3",
City/State/ZIP:Tigard,OR 97223 ❑Six or more residential units, occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: I Project name:Advantis Credit Union ❑Hazardous locations. 0 Supply voltage for more than
Cross street/directions to job site: ❑Service or feeder 600 amps or more. 600 volts nominal.
�"
1 " .£" 1J[.E
Description I Qty. I Each ) Total, :?1*
New residential single-or multi-family dwelling unit.
Subdivision: I 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
F OF, Limited- -�" energy,residential 75.00 2
Fire Alarm Tenant Improvement (with above sq.ft.)
Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
` a" R ,O ti . --1,,` _ a T 7, RenewEnergy ❑ See Page 2
Name:
Services orable feeders installation,alteration,and/or relocation
200 amps or less 100.70 2
Address: 201 amps to 400 amps 133.56 2
City/State/ZIP: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Phone:( ) 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
+ YCA Branch circuits—new,alteration,or extension,per panel
� `', - " A.Fee for branch circuits with
Business name:T&L Communications,Inc. above service or feeder fee,
Contact name:Larry Bushaw
each branch circuit 7.42 2
B.Fee for branch circuits without
Address:PO Box 87387 service or feeder fee,first
branch circuit 56.18 2
City/State/ZIP:Vancouver,WA 98687 Each add'l branch circuit 7.42 2
Phone:(360)737-9725 I Fax: :(360)737-9648 Miscellaneous(service or feeder not included)
Each manufactured or modular
dwelling,service and/or feeder
Email:office@tl-communications.com 67.84 2
Reconnect only 67.84 2
Pump or irrigation oircle 67.84 2
Business name:T&L Communications,Inc. Sign or outline lighting 67.84 2
Address:PO Box 87387 Signal circuit(s)or limited-energy
panel,alteration,or extension. 0 See Page 2 757.6f) 2
Each additional inspection over allowable in any of the above
City/State/ZIP:Vancouver,WA 98687
Additional inspection(1 hr min) 66.25/hr
Phone:(360)737-9725 I Fax:(360)737-9648 Investigation(1 hr min) 90.00/hr
Email:office@tl-communications.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 67787 I Electrical Lic.: 37428CLE I Suprv.Lic.: 684LEA specifically listed('IA hr min)
Suprv.Electrician signature,required:41v�y
ELECTRICAL CALj PERISubt tai:
66 Subtotal: 76CX)
Print name: Larry Bushaw I Date: 4/20/2017 0 Plan Review Required(25%of permit fee): ,...—
�C "-"9 "L State surcharge(1T %L PERMIT
fee):E �l
Authorized signature: TOTAL PERMIT FEE: W
i
This permit application expires if a permit is not obtained within 180
Print name: Larry Bushaw I Date: 4/20/2017 I days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\BuildingTermits\ELC PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(I1/05/COM/WEB
a
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
,.;1R�II�EN'I't,At.� 7'►����1,3-ir,, G �;.,, ,,. ,, ,,., ,,, er ,, ^, „., ,,, ��y
Fee for all residential systems combined: $75.00 Description I [ Ee ( Tota,, 1
Renewable electrical energy systeto ms:
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
ElBurglar Alarm Wind generation systems in excess of 25 lova:
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 OAR 918-309-0040) 552.26 2
Heating, Ventilation and Air Conditioning
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
E] Each additional inspection over allowable in any of the above:
Other: Each additional inspection is
charged at an hourly(I hr min) 66.25/hr 1
which nois 90. r
...'CO CIAL WORK. . . listed(/�hr
Inspections for fee
specifically min)
Oh
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1): r
(SEE OAR 918-309-0000) * Number of inspections allowed per permit.
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
® Fire Alarm Installation
❑ HVAC
O Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
O Medical
❑ Nurse Calls
O Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems: 1
*No licenses are required. Licenses are required for all
other installations
I:\Building\Permits\ELCPermitApp_ELRERE.doc Rev 06/17/2015
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12262 SW SCHOLLS FERRY RD, TIGARD, OR,
97223
Record Type: Record ID:
Commercial - Electrical Limited Energy ELR2017-00100
Inspection Type: Inspector:
135 Low voltage rough-in Jeff Grove
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor