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Permit (39) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT Permit#: ELR2017-00162 TIG RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/08/2017 Parcel: 1 S 134BC00300 Jurisdiction: Tigard Site address: 12284 SW SCHOLLS FERRY RD Project: Cyclebar 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 08/07/2017 $75.00 12%State Surcharge-Electrical 08/07/2017 $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 Notification Center. Those rules are set forth in OAR 952-001-0010 through OA 52-00^1-0090.,You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. FI Issued By: - . ' .,. - Permittee Signature: J,�.,,Z ��_.�.x - d 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 Applic jj IV l FOR OFFICE t SE OM�1_1 �+ Received City of Tigard / Permit#: II q 13125 SW Hall Blvd.,Tigard,OR 97223 PlanDa2 o'zb 7 ��7^!.TUL(y Review II Phone: 503.718.2439 Fax: 503.59 1 60 2 0 21117 Date/By: Related Permit#: T,G n x D Inspection Line: 503.639.4175 Ready Date/By: -7 Juris: ® See Page 2 for Internet: www.tigard-or.gov CITY OFTIGARD Notified/Method: //�'/IV 0.Y Supplemental Information ..k,;.:;: VII 10- ' SIO :. %. � ,.. '. ❑New construction ®Addis na eratlon/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition 0 Other: where the available fault current 0 Marinas and boatyards. � ' �A .stmt cnoN �` exceeds 10,000 amps at 150 volts or 0 Floating buildings. o I-and 2-family dwelling ®Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. o Multi-family 0 Master builder 0 Other: ❑Fireum . p p 0 Installation of 150 KVA or : 30**TE',DIFORProW014 : 'LOCATION : .; 0 Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: Job site address: 12284 SW Scholls Ferry Road 100HP or more. ❑"A "E","1-z","1-3", City/State/ZIP:Tigard,OR 97223 El or more residential units. occupancy. 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#:A Project name:Cyclebar ❑Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: 1 FEE'SCHEDULE" . Description ( Qty. I" Each I Total 1" 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 DI©N OF WORK a ; _• , tiESCRIPTv _ Limited energy,residential (with above sq.ft.) 75.00 2 Limited energy,multi-family 75.00 2 Fire Alarm Tenant Improvement residential(with above sq.ft.) Renewable Energy 0 See Page 2 0 PROPERT t ©1'E V TENANT „., Services or feeders installation,alteration,and/or relocation Name: 200 amps or less 100.70 2 Address: 201 amps to 400 amps 133.56 2 401 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 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 �� APP.ICAN "_ 0CONTAC``�N Branch circuits—ne ,alteration,or extension,per panel A.Fee for branch wcircuits with Business name:T&L Communications,Inc. above service or feeder fee, 7.42 2 each branch circuit Contact name:Larry Bushaw B.Fee for branch circuits without Address:PO Box 87387 service or feeder fee,first 56.18 2 branch circuit City/State/ZIP:Vancouver,WA 9887 Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(360)737-9725 Fax: :(360)737-9648 Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email:office@tl-communications.com Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name:T&L Communications,inc. Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address:PO Box 87387 panel,alteration,or extension. ® See Page 2 2 City/State/ZIP:Vancouver,WA 98687 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(360)737-9725 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 Electrical Lic.: 37428CLE Suprv.Lic.: 684LEA specifically listed(/2 hr min) !� ELECTRICAL PERMIT FEES Suprv.Electrician signature,required:,eljz,v, 4, J Subtotal: 751-0 Print name: Larry Bashaw Date: 7/20/2017 0 Plan Review Required(25%of permit fee): ,-- �� State surcharge(12%of permit fee): 4/. Authorized signature: jy, :�(,{_'" J TOTAL PERMIT FEE: g7 This permit application expires if a permit is not obtained within 180 Print name: Larry Bushaw Date: 7/20/2017 days after it has been accepted as complete. * Number of inspections allowed per permit. l:\Building\Permits\ELC_PermitAppELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB 1 Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: F ,s, FEE A IJLt Fee for all residential systems combined: $75.00 Rene d°" Qty. Each Tom, Renewable electrical energy systems: 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 2 111 Wind generation systems in excess of 25 kva: Burglar Alarm 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 Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 ❑ Vacuum Systems* >100kva-noadditional charge 0.0 3 ❑ Each additional inspection over allowable in any of the above: Other: Each additional inspection is 66.25/hr charged at an hourly(1 hr min) Inspections for which no fee is t- ecifically listed('/2 hr min) r sp COMMERCIAL WORK ONLY; ELEcuttem, pts Fee for each commercial system: $75.00 subtotal(Enteron rage 1): (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 ❑ 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.doe Rev 06/17/2015