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Permit (14) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT iv `" COMMUNITY DEVELOPMENT Permit#: ELR2017-00139 T-t GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/29/2017 Parcel: 2S 102AD03000 Site address: 12850 SW ASH AVE Jurisdiction: Tigard Project: Burnham&Ash Apartments Subdivision: BURNHAM TRACT Project Description: Low volt wiring and t-stats. Lot: 5 Contractor: AMERICAN HEATING INC Owner: PREMIUM PROPERTY-TIGARD LLC 5035 SE 24TH AVE 1015 NW 11TH AVE., STE 243 PORTLAND, OR 97202-4765 PORTLAND, OR 97209 PHONE: 503-239-4600 PHONE: 503-226-1972 FAX: 503-239-7038 FEES Description Date Amount Specifics: Restricted Energy Permit 06/29/2017 $75.00 Type of Use: COM 12%State Surcharge-Electrical 06/29/2017 $9.00 Class of Work: NEW 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 Other Desc: Total $84.00 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a or direct questions to OUNC by calling 503.23 r 0.33 1.8 Issued By: .� 7--- -ys� //p !� Permittee Signature: C `+ 6 C f !}s= T ` OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale,lease or rent. OWNER'S SIGNATURE: Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR.ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Electrical Permit Application FOR OFFICE USE ONLl City of Tigard Received �` .71 N 13125 SW Hall Blvd.,Tigard,OR 9;RECEIVEDate/By: 6 A O (?A Permit N°.:ELR,2 5/2....401 j C� �`. Phone: 503.718.2439 Fax: 503.5981960 Plan Review EL /�^C/! i) Inspection Line: 503.639.4175 ' Z��yV Date Re Olra Permit:6t/1/12013---00/1":3 (/iS ee Page z ,/)D�� TIGARD p DateReady/By: /}7vG (/ Internet: www.tigard-or.gov 1 ��ediM'.' pplernestal Information t w It ':: m,�t„?f r s ` !,�`,'9F '', �I<? 3'i"4 , s ii�$ 4 a f U --g t i - J .e t 0 New construction I � "" � ����� El t ti•p a cement Please check all thatapply -- : ❑DemolitionOther: amps ort 2 sets of plans iv/items checked below): ❑Other ❑Service or feeder 400 more ❑Building over three stories- where the available fault current ❑Marinas and >�- -` E(-E;!R� O �,' 't3 gboatyards. 4O 4 rs F exceeds 10,000 amps at 150 volts or 0 Floating buildings 0 1 and 2-family dwelling ®Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 p Commercial use agricultural amps for all other installations. ❑Multi-family 0 Master builderm 3 ,, 0 Other: ❑Fire pump. 0 Installation of 150 KVA or .JOB- >I�(3R�TIf)I+I p� " u ❑Emergency system- larger separately parate-,derived system. < -�--6, -�.. D Addition of new motor load of Job no.: I Job site address:12850 SW Ash Ave Occ"E'',-I-2-, 1-3", 100HP or more. y�noy City/State/ZIP:Tigard OR 97223 ElSix or more residential units, I]Recreational vehicle parks. ❑Health-care facilities. 0 Supply voltage for more than ❑Hazardous locations. 600 volts nominal.Suite/bld Suite/bldg./apt.no.:#200 Project name:Burnhamd and Ash Retail ❑Service or feeder 600 amps or more. Cross street/directions to job site: R�$( 1EDI3I7 +: Description I Qty. I Fee. I :Total I '•- New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: I Lot no.: 1,000 sq.ft.or less 168.54 4 Tax map/parcel no.: Ea.add'1500 sq.ft-or portion 33-92 1 Limited energy,residential l t'`t ° t (with above sq:R-) 75.00 2 low volt wiring and T-stats Limited energy,multi-family residential(with above sq.ft) 75.00 2 Renewable Energy - : , 0 See Page 2' Services or feeders installation,alteration,and/or relocation f-**'ERT'Y WNER r s r; 200 am �� � - �_ • � ".�=T���� ` Ps or less 100.70 2 Name: ' 201 amps to 400 amps 133.56 2 Address: 401 amps to 600 amps 20034 2 601 amps to 1,000 amps 301.04 2 City/State/ZIP: Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Phone:( ) I Fax:( ) relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 5936 I 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: 401 amps to 599 amps 168.54 2 Date: Branch circuits—new,alteration,or extension A)'PLICAN"1`, r ,Per panel s � ;? ,E � 1Wf1I�i`I'A ` I'ERS()11T' A.Fee for branch circuits with 1 Business name:American Heating Inc. ea each r nch circuit feeder fee, branch circuit 7.42 i 2 Contact name:Brad Manchester B.Fee for branch circuits without service or feeder tee,first Address:5035 SE 24th Ave. branch circuit 5618 2 Each add'1 branch circuit 742 2 Miscellaneous(service or feeder not included) City/State/ZIP:Portland,OR.,97202 Each manufactured or modular Phone:(503)239-4600 I Fax::(503)239-7038 dwelling,service and/or feeder 67.84 2 E-mail:b.hutchinson@americanheating.net Reconnect only 67-84 2 Pump or irrigation circle 67.84 2 ,x , ' lv©15lTttACTOR -- - - .. Signor outline lighting 67-84 Business name:American Heating Inc 2 Signal circuit(s)or limited-energy See panel,alteration,or extension. 1 Page 2 2 Address:Brad Manchester Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66 25/hr City/State/ZIP:Portland,OR.,97202 Phone:(503)239 4600 Investigation(1 hr min) 6625/hr I Fax:(503)239-7038 Industrial plant(1 hr min) 78.18/hr CCB Lie.: 33135 I Electrical Lie.: 26993CRE I SuP s rv.Lic.: 2640LEB spepecaficalllly for which no fee is listed(''/z hr mm) 90.00/hr ;. I TI2tlL PMII<<. Suprv.Electrician signature,required —_- 2---- Subtotal: Print name: T Steve Young I Date: Gi -/2-/7 Plan review(25%of permit fee): Authorized signature: `....& G".,.. -h-3?"—A----; State surcharge(12%of permit fee): TOTAL PERMIT FEE: -/2/ This permit application expires if a permit is not obtained within 180 Print name: Brad Manchester I Date: days after it has been accepted as complete. * Number of inspections allowed per permit T:\ uildinglPernaitsiEt,C_Permi[App_ELR LRE.doc Rev 05/21/2013 B 440-4615 T(11/05/COMJWEB