Permit (43) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit#: ELR2017-00175
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/07/2017
Parcel: 151260000300
Jurisdiction: Tigard
Site address: 9538 SW WASHINGTON SQUARE RD H14
Project: Nespresso Subdivision: None Lot: None
Project Description: Low voltage for HVAC
Contractor: AMERICAN HEATING INC Owner: PPR WASHINGTON SQUARE LLC
5035 SE 24TH AVE PO BOX 847
PORTLAND, OR 97202-4765 CARLSBAD, CA 92018
PHONE: 503-239-4600 PHONE:
FAX: 503-239-7038
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: 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 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. ATTEe .t: : -eon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0/10 through OAR t -10 0090. You may obtain a copy of the rules or direct questions to OUNC by calling 50 . 32.1987 or 1.800.332.2344.
./AIL /
Is ued 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' '-I— L`_ �-j –
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 Applicatl FOR OFFICE CSE ONLY
City of Tigard / 11 Received
M` 13125 SW Hall Blvd.,Tigard,OR 97223 PlDate/By: 7 17 Permit No.: GL t 9O/7-�/7c
Phone: 503.718.2439 Fax: 503.598.�!y�����-((� 7 Date/
view
1 Ivc 2 0'17 DateBy: Other Permit: M lL C�/�UO tri 7/
f 1 CARD Inspection Line: B Date Read
Internet www.tigard-or.gov CITY OF Notified/Method: rnr's I S See Page 2 for
pp TIGARDSupplemental Information
❑New construction Please check all that apply
Ig pp y(submit 2 sets of plans w/items checked below):
❑ ❑Other
0 Service or feeder 400 amps or more 0 Building over three stories.
Demolitionwhere the available fault current
0 Martiand boatyards.
�. � � � exceeds 10,000 amps at 150 volts or 0 Floating
buildings.
❑ 1-and 2-family dwelling ®COmmerClal/1ridllStrlalless to ground,or exceeds 14,000 0 Commercial-use agricultural
0 Accessory buildingg"
❑Multi-family ❑,Master builderamps for all other installations. buildings.
0 Other: 0 Fire pump.
1 ❑Emergency system. 0 Installation separately of 1d KVA or
14 1f T R t It I � ger E","1 ",derived system.
❑Addition of new motor load of ❑"A","E","1-2","1-3",
Job no.: I Job site address.' SW Washington Square Road 1001W or more. occupancy.
95-3
v
El Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP:Tigard OR 97223 /'�3 0 0 Health-care facilities. 0 Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.:#250 Project name:Nespresso 0 Service or feeder 600 amps or more.
Cross street/directions to job site: ... t* 1 .
Description I Qty. ;
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
� ",a, ' Limited energy,residential
7 .1 :; SI {?IFVR with above sq )
75.00 2
(
ft.
low voltage wiring and T-stats Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
Renewable Energy D See Page 2
Services or feeders installation,alteration,and/or relocation
�,v �>� 200 amps or less2
100.70
Name: 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Address: 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 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: 401 amps to 599 amps 168.54 2
Date: Branch circuits—new,alteration,or
A � A AA�PLf�� y � extension,per panel
' TAS lA •4 p� l^o dr ' 01, ' A.Fee for branch circuits with
Business name:American Heating Inc. above service or feeder fee,
each branch circuit 7.42 2
Contact name:Brad Manchester B.Fee for branch circuits without
service or feeder fee,first
Address:5035 SE 24th Ave.
branch circuit 56.18 2
Each add'l branch circuit 7A2 2
Miscellaneous(service or feeder not included)
City/State/ZIP:Portland,OR.,97202
Each manufactured or modular
Phone:(503)239-4600 Fax::(503)239-7038 dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
E-mail:brad@americanheating.net
' u% � � I �Op04I 4 Pump or irrigation circle 67.84
2
�..� Sign or outline lighting 67.84 2
Business name:American Heating Inc. Signal circuit(s)or limited-energy See
panel,alteration,or extension. 1 Page 2 s 5 2
Address:Brad Manchester Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
City/State/ZIP:Portland,OR.,97202
Investigation(1 hr min) 66.25/hr
Phone:(503)239-4600 I Fax:(503)239-7038 Industrial plant(1 hr min) 78.18/hr
CCB Lic.: 33135 Electrical Lie.: 26993CRE Suprv.Lic.: 2640LEBtiono fee n(I hr m(,y lfit drwh/hr in)ich is
90.00/hr
Suprv.Electrician signature,req
Subtotal:ft + i*Ait "1;Io bsi,
767 OG
Print name: T Steve Young Date: 8-7-17 Plan review(25%of permit fee):
State surcharge(12%of permit fee): 9.
Authorized signatu
c � TOTAL PERMIT FEE: g-e7/.cv
Print name: Brad Manchester Date: 8-7-17 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_PemtitApp_ELR_ERE.doc Rev 05/21/2013
440-4615T(11/05/COM/WEB
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9538 SW WASHINGTON SQUARE RD H14,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical Limited Energy ELR2017-00175
Inspection Type: Inspector:
198 Low voltage final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor