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Permit (202) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT a COMMUNITY DEVELOPMENT Permit#: ELR2018-00013 TR(jAR C) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/23/2018 Parcel: 2S 113AB00600 Jurisdiction: Tigard Site address: 16195 SW 72ND AVE Project: Option Care Subdivision:COUNCIL VIEW ACRES(LOTS 21-44) Lot: 30 Project Description: Relocating 9 RTU thermostats for TI. Contractor: ALLIANT SYSTEMS LLC Owner: PACIFIC REALTY ASSOCIATES LP 351 NW 12TH AVE ATTN: N PIVEN PORTLAND, OR 97209 15350 SE SEQUOIA PKWY#300 PORTLAND, OR 97224 PHONE: 503-619-4000 PHONE: FAX: 503-230-9238 FEES Description Date Amount Specifics: Restricted Energy Permit 01/23/2018 $75.00 Type of Use: COM 12%State Surcharge-Electrical 01/23/2018 $9.00 Class of Work: ALT Total Number of Systems: 0 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. 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 9 -001-0090. You m obtain a copy of the rules or direct questions to OUNC by calling 503.232,1987 or 1.800.332.2344. Issued By: A(44/444°6- Permittee Signature: 771 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 ', a / FOR oFF10E usE oNLv Receive City of Tigard DateB :d { f i / 13125 SW Hall Blvd.,Tigard,OR 97223 JAN l Plan Review/ Related Permit#: Phone: 503.718.2439 Fax: 503.598.1960 Date/B w a, eady Date/By: Jul-is: H ee Page 2 for Inspection Line: 503.639.4175 T,1-1,.. tF ) s, Supplemental Information TIGARD Internet. www.tigard-or.gov -HAVING � i"y dJeady Date/By: TYPE OF WO U t#.iD li . . -r4 ' PLAN REVIEW `6 Please check all that apply(submit 2 sets of plans w/items checked): ❑New construction }[3 Addition/alteration/replacement 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition D Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. less to ground,or exceeds 14,000 ❑Commercial-use agricultural ❑ 1-and 2-family dwelling 5g3 Commercial/industrial ❑Accessory building amps for all other installations. buildings. D Multi-family 0 Master builder 0 Other: El Fire pump. El Installation of 150 KVA or 0 Emergency system. larger separately derived JOB SITE INFORMATION AND LOCATION `t(� ❑Addition of new motor load of system. Job#: Job site address: up 1 q s 1� --)261--)26 �T p I V'C 10OHP or more. 0"A","E","1-2","1-3", occupancy. ❑Six or more residential units. ❑Recreational vehicle parks. Health-care facilities. 0 Supply voltage for more than City/State/ZIP: �\Iwo,/ O�4 ❑Hazardous locations. Suite/bldg./apt.#: Project name: //��!y�tj� 600 volts nominal. l.� \ x ❑Service or feeder 600 amps or more. Cross street/directions to job site: FEE SCHEDULE Description I Q . I Each I Total New residential single-or multi-family dwelling unit. Lot#: Includes attached garage. 1,000 sq.ft.or less Subdivision: 168.54 4 Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 (with above sq.ft.) At vry C( `v--vu }yeic \o s j`�5 Limited energy,multi-family 75.00 2 "(�� 1 residential(with above sq.ft.) Renewable Energy ❑ See Page 2 0 PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation 200 amps or less 100.70 2 Name: 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 59.36 1125.08 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps Date: 401 amps to 599 amps 168.54 2 Owner signature: Branch circuits—new,alteration,or extension,per panel X APPLICANT 0 CONTACT PERSON A.Fee for branch circuits with Business name: .,p`'v above service or feeder fee, 7.42 2 A���(A�� ��j��.veach branch circuit Contact name: 3 E C-A. L A1.10 B.Fee for branch circuits without service or feeder fee,first 56.18 2 Address: "3 Nw v2,4-A, )A(\J..Q branch circuit Each add'1 branch circuit 7.42 2 City/State/ZIP: V oc•- ce\C`--X /0P— / 9.-1 2,0c1 Miscellaneous(service or feeder not included) Phone: a� �^� Fax: :(5 d3) 2.30 - Q 23cs Each manufactured or modular 67.84 2 O1-l � dwelling,service and/or feeder Email:‘..... .,4 t O .RC Q D &\\Usss.4 -5 .C.b'� Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Sign or outline lighting 67.84 2 Business name: \I'(,t�(� =, j}�"j�/Vl� �,\ Signal circuits)orlimited-energy �j{See Page 2 2 Address: 'J► Nw �2 l'T V-Q panel,alteration,or extension. J`1 "��,,� �1 / � Each additional inspection over allowable in any of the above City/State/ZIP: v o ii arc\ 6 q t lJ Additional inspection(1 hr min) 66.25/hr Phone:(Cj1,7�s) j\CI L43 Fax:( ) Investigation(1 hr min) 90.00/hr Industrial plant(1 hr min) 78.18/hr Email: 6 a t 0 -c,c.,�oAck'NA.— -K'Jt�5. c©Vv^ Inspections for which no fee is 90.00/hr CCB Lic.: `!�J ; Electrlca1?tc.: 3q—(L(} Suprv.Lic.: 3 51 L specifically listed C hr min) \ J y�� }�si�"' "' � ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: C Subtotal: Date: 1—1'-_I tS 0 Plan Review Required(25%of permit fee): Print name: O Es-nu,...)�`� State surcharge(12%of permit fee): TOTAL PERMIT FEE: ,dd Authorized signature:--gS1C" •. 0 This permit application expires if a permit is not obtained within 180 Date: 1-��'1 ' days after it has been accepted as complete. Print nam-:/r L / 1 9 • Number of inspections allowed per permit. I:\BuildingU'� LC_PermitApp_ELR_ERE c Rev 06/17/2015 440-4615T(1 l/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: FEE SCHEDULE Fee for all residential systems combined: $75.00 Description Qty. Each Total y Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 n 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 n 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 n Vacuum Systems* >100 kva—no additional 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 specifically listed(%z hr min) 90.00/hr COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):• Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: I-7 Audio and Stereo Systems ❑ Boiler Controls n Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation HVAC n Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* n Medical ❑ Nurse Calls n Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: a_ *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELCPermitAppELR_ERE.doc Rev 06/17/2015 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 16195 SW 72ND AVE, TIGARD, OR, 97224 Record Type: Record ID: Commercial - Electrical Limited Energy ELR2018-00013 Inspection Type: Inspector: 198 Low voltage final Jeff Grove Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor