Loading...
Permit (162) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT l ill 2:'f COMMUNITY DEVELOPMENT Permit#: ELR2017-00168 Date Issued: 07/31/2017 T( RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 151260000300 Jurisdiction: Tigard Site address: 9632 SW WASHINGTON SQUARE RD G09 Project: Bath&Body Works Subdivision: None Lot: None Project Description: Security system. Contractor: SIMPLE SECURITY Owner: PPR WASHINGTON SQUARE LLC PO BOX 80577 PO BOX 847 PORTLAND, OR 97280 CARLSBAD, CA 92018 PHONE: 503-574-2254 PHONE: FAX: 503-245-2998 FEES Description Date Amount Specifics: Restricted Energy Permit 07/31/2017 $75.00 12%State Surcharge-Electrical 07/31/2017 $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: 0 HVAC: 0 Instrumentation: 0 Intercom/Paging: 0 Landscape/Irrigation: 0 Landscape Lighting: 0 Medical: 0 Nurse Calls: 0 Protective Signal: 0 Security Alarm: 1 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 Notification Ce - Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503. 42 /or 1.800.332.2344 Issued By: �, 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 -1(EV y-A.) FOR OFFICE I SI,ONEl City of Tigard7 � Received Date/B Arm Permit#: /�1 13125 SW Hall Blvd.,Tigard,OR 9T 3 v ' II Phone: 503.718.2439 Fax: 503.598.1960 i \1111 DateBPlan eview - Related Permit#: p Inspection Line: 503.639.4175 _ // ; TIGARD "t11_ t ReadyDate/By: ® See Page Internet: www.tigard-or.gov i_ IIliftMl 2l nf Notified/Method: InformationSupplemental TYPE OF Welik .rviv I7M PLAN REVIEW 0 New construction ®Addition/altera Please check all that apply �� pp y(submit 2 sets of plans w/items checked): ❑Demolition ❑Other: v 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. ❑ 1-and 2-family dwelling Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural ❑Multi-family 0 Master builder amps for all other installations. buildings. ❑Other: 0 Fire pump. JOB SITE INFO 0 Installation 150 KVA or O LOCATION 0 Emergency system. larger separately derived Job#: I Job site address: �.vtJ, 0451t.' // n ❑Addition of new motor load of system. �Stl t(.�s` S(,�tJ tea_ 100HP or more. ❑"A" "E" "1-2" «1-3" City/State/ZIP: t—��4 4/ ✓0/ ❑Six or more residential units. occupancy. Suite/bldg./apt.#: $�4�e ❑Health-care facilities. 0 Recreational vehicle parks. I Project name' V- G(j+Ir j ❑Hazardous locations. 0 Supply voltage for more than Cross street/directions to job Site: / • ❑Service or feeder 600 amps or more. 600 volts nominal. FEE SCHEDULE Description I Qty'. I Each I Total I 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 DESCRIPTION OF WORK Ea.addl energy, sq.ft.or portion 33.92 1 Limited energy,residential 1.e G UV t Sy S" i(" (with above sq.ft.) 75.00 2 /! j Limited energy,multi-family residential(with above sq.ft.) 75.00 2 Renewable Energy 0See Page 2 0 PROPERTY OWNER I 0 TENANT Name: Services or 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:( ) I 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 0 CONTACT PERSON Branch circuits—new,alteration,or extension,Per panel 0Business name: / A.Fee for branch circuits with �;.. c{S L.%) above service or feeder fee, Contact name: each branch circuit 7.42 2 B.Fee for branch circuits without Address: service or feeder fee,first 56.18 branch circuit 2 City/State/ZIP: Each add'l branch circuit 7.42 2 Phone:( ) I Fax: :( ) Miscellaneous(service or feeder not included) 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: .--04 rp(Q 5.,r_.c.,uY"ry t ti G Sign or outline lighting 67.84 2 Address: © ��1" a L J Signal circuit(s)or limited-energy o !/ ! 7 panel,alteration,or extension. See Page 2 go"'2 City/State/ZIP: G?0 YT q/�� Z 7— Q i5 Each additional inspection over allowable in any off the above ! � Fax:Cj )('Z-r G _ 2 Additional inspection(1 hr min) 66.25/hr Phone:(j 3) 'Z Y l � ���j Investigation(1 hr min) 90.00/hr Email: !a N� �a v.,.. 1-,..,mfe. • c,-^ ^ ^ Industrial plant(1 hr min) 78.18/hr 7 5�c.� �—Cl '"' Inspections for which no fee is CCB Lic.:i 92,i/ I Electrical Lic.:7q.. 03c i.d Suprv.Lic.: .19 i 6- specifically listed('/hr min) 90.00/hr Suprv.Electrician signature,required: ��u. ELECTRICAL PERMIT FEES /f Subtotal: tib ', Print name: -n / V I Date: ?�/ ` j� gt, ( 0 Plan Review Required(25%of permit fee): ll (JGj� / State surcharge(12%of permit fee): �', ` Authorized signature: TOTAL PERMIT FEE: at/ df.. IPrint name: I Date: * I 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\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: FEE SCHEDULE RESIDENTIAL WORK ONLY, Description I Qty. I Each I Total I * 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 IS kva 133.56 2 ❑ 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 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 kva(fee in accordance 552.26 2 with OAR 918-309-0040) ❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 ❑ >100 kva—no additional charge 0.0 3 Vacuum Systems* 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(YY.hr min) ELECTRICAL. PERMIT FEES 'COMMERCIAL WORK ; : 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 ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015