Permit Support Document (16) CITY OF TIGARDEVISED ELECTRICAL RESTRICTED ENERGY PERMIT
11,
7//407 Permit#: ELR2017 00122
COMMUNITY DEVELOPME T
Date Issued: 06/05/2017
T[GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9538 SW WASHINGTON SQUARE RD H14
Project: NESPRESSO Subdivision: None Lot: None
Project Description: ELECTRICAL AND FIRE ALARM. 7/18/17,REPRINTED to add audio/stereo wiring. 7/18/17,REPRINTED to
correct address to 9538 from 9536 SW Washington Square Rd
Contractor: FRAHLER ELECTRIC COMPANY Owner: PPR WASHINGTON SQUARE LLC
11860 SW GREENBURG RD PO BOX 847
TIGARD, OR 97223 CARLSBAD, CA 92018
PHONE: 503-639-4627 PHONE:
FAX: 503-639-4673
FEES
Description Date Amount
Specifics: Restricted Energy Permit 06/05/2017 $150.00
12%State Surcharge-Electrical 06/05/2017 $18.00
Type of Use: COM Restricted Energy Permit 07/18/2017 $75.00
Class of Work: ADD 12%State Surcharge-Electrical 07/18/2017 $9.00
Total Number of Systems: 2
Audio&Stereo: 1 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data&Telecommunications: 1 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 $252.00
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. ATTE -e is • -:.n law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0' 0 through OAR 9' -00 -.4'0. ou may obtain a copy of the rules or direct questions to OUNC by calling-5' -.1987 or 1.800.332.2344.
•
Iss ed By: • Permittee Signa •• ..- -moi
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 APPlicati FOR OFFICE USE ONLY
lig
C FIVE Received
- City of Tigard Permit#: E.-44 617-4w/3-
OR
a 13125 SW Hall Blvd.,Tigard, 97223 DateDate/BPlan Review
Phone: 503.718.2439 Fax: 503.598.14U L 18 2017 Date/B : Related Permit#:
Inspection Line: 503.639.4175 Ready Date/By: ]uric: ® See Page 2 for
TIGARD Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
I `"i ''tx:4,,,r. W az i 1: . 'ri': 417 i ,�, :C:i:V
?;� _ i `��m rv__..3,r.,'-�' '� i� Vii, > , ..
O New construction 0 Addition/alteration/replacement 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.
I (1 41, _ D i =*-o tr ,. !„..t a K exceeds 10,000 amps at 150 volts or 0 Floating buildings.
0 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building tens to ground,or exceeds 1a,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
o Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
rt 1':1 y ; i ' nom.`v g',72:1" t-.. '1064t,----_—_-=4:: ❑Emergency system. larger separately derived
Job#: Job site address: �_\ �!e ❑Addition of new motor load of system.
C /04-611-. [ C 100HP or more. ❑«A„ «E„ «l_2„ «l_3„
City/State/ZIP: /?S 3 ❑Six or more residential units. occupancy.
7 0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: ( Project name: G 5 p(2 5 c� 0 Hazardous locations. 0 Supply voltage for more than
C ❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: g ;ll ::,-.1i.::,:::: (41ti
Description I Qty. I Each Total I *
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
1,000 Tax map/parcel#: r 1
sq. o ess 168.54 4
Eaadd'1500 sqft.or portion 33.92 1
M-41111A "I 6 0_a' l` Ii :01140 4
, , Limited energy,residential
i. k. n (with above sq.ft.) 75.00 2
IcTo� 6 i 7��rf ./ Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
DTP [.1:. /, eCO
w i1�.> � T*,� � 1 ;� �$ i�p,���,; _ Renewable Energy See Page 2
+- -� �1�� : Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Address:
401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:
relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less _ 5936 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 si l nature: Date: 401 amps to 599 amps 168.54 2
".11411.:V14
' U^'1' , Ii i�i , y 'ti Y, Branch circuits—new,alteration,or extension,per panel
.... -_ ice ',.:1-- Pa- i�-. A.Fee for branch circuits with
Business name: above service or feeder fee,
each branch circuit 7.42 2
Contact name: B.Fee for branch circuits without
Address: service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP: Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: Reconnect only 67.84 2
a>> a_ '_ t 0 »' f r 4r _
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
tr- W _ ', �m�riR� 6r T�.Ii.... (�i °,,. Gii�ii .-_ i�'.` f:.k,tyr
- '�-=-dyi�' Description I Qt9 Each I Total I *
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
PAvi 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
with OAR 918-309-0040) 552.26 2
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
El 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
1t specificall listed(1/2 hr min)
. ,� r 1p lrfgil�
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
3' * 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
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015
CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
,11, . COMMUNITY DEVELOPMENT � ! Permit#: ELR2017-00122
T[ .at'�P D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/05/2017
Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9538 SW WASHINGTON SQUARE RD H14
Project: NESPRESSO Subdivision: None Lot: None
Project Description: ELECTRICAL AND FIRE ALARM. 7/18/17,REPRINTED to add audio/stereo wiring. 7/18/17,REPRINTED to
correct address to 9538 from 9536 SW Washington Square Rd -
Contractor: FRAHLER ELECTRIC COMPANY Owner: PPR WASHINGTON SQUARE LLC
11860 SW GREENBURG RD PO BOX 847
TIGARD, OR 97223 CARLSBAD, CA 92018
PHONE: 503-639-4627 PHONE:
FAX: 503-639-4673
FEES
Description Date Amount
Specifics: Restricted Energy Permit 06/05/2017 $150.00
Type of Use: COM 12%State Surcharge-Electrical 06/05/2017 $18.00
Restricted Energy Permit 07/18/2017 $75.00
Class of Work: ADD 12%State Surcharge-Electrical 07/18/2017 $9.00
Total Number of Systems: 2
Audio&Stereo: 1 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data&Telecommunications: 1 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 $252.00
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: Ore.- -, requires you to follow the rules adopted by the Oregon Utility Notification ter. Those rules are set forth in OAR
952-001-0010 throu•. I. R 952-001-3090. u m obtain a copy of the rules or direct questions to OUNC by calling 1987 or 1.80002,2.2344.
Issue �'�y'r Permittee Signatur>• __rot ✓ /i /
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.