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Permit (265) CITY OF TIGARD111 ELECTRICAL RESTRICTED ENERGY PERMIT r ' Permit#: ELR2018-00011 g COMMUNITY DEVELOPMENT 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/18/2018 T[Ca 1 jt.L Parcel: 2S 101 DA00102 Jurisdiction: Tigard Site address: 13221 SW 68TH PKWY 500 Project: Centene Corporation Subdivision: None Lot: None Project Description: HVAC system. Relocation of thermostats. Contractor: OREGON AIRE INC Owner: GK TRIANGLE CORPORATE PARK III L 7715 NE 33RD DR STE A ATTN KBS REALTY ADVISORS PORTLAND, OR 97211 P 0 BOX 28270 SANTA ANA, CA 92709 PHONE: 503-335-2222 PHONE: FAX: 360-423-1978 FEES Description Date Amount Specifics: Restricted Energy Permit 01/18/2018 $75.00 12%State Surcharge-Electrical 01/18/2018 $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. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification enter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a • e rules or. -ct questions to OUNC by calling 503. 2,1987 or .800.332.2344. Issued By: /'i :.66...Air Aill.. 5---- -. _ "ee ignature: -//' d--ee/c -)\ 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 FOR OFFICE USE ONLY City of Tigard Received ,_ —' � DateB �� r � M NM 114 '11 13125 SW Hall Blvd.,Tigard,OR 97223 ct Plan Review - Phone: 503.718.2439 Fax: 503.598 x Related Permit#: �i .. Date/B / Ni►] Inspection Line: 503.639.4175 ''''''' Ready Date/By: ,, See Page 2 for EMI T I G A RD Internet www.tigard-or.gov t Q 1U Notified/Method: Supplemental Information IA A . , , Z .. ,fi ». -YP1ls ®F 0 µ t -is- .x.. .; wx.i4 ,tl,AIt REVIEW " "' " oiii b ro y Please check all that apply(submit 2 sets of plans whtems checked): New construction ®Addition/alteration/r'eR]a9itien 'N ;t „..\-- 14.❑ '+,_It.,i�a r{- t,.,, t •at^� ' ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition 0 Other: ' \ where the available fault current 0 Marinas and boatyards. s CATI,GORY OF rC T �c rIO x y,°. ,, y. ., exceeds 10,000 amps at 150 volts or 0 Floating buildings. " "` less to ground,or exceeds 14,000 0 Commercial-use agricultural ❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building amps for all other nstallations, buildings. 0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or ❑Emergency system. larger separately derived i:. _, ,,:.. x.',' 0.$ ,SITTv`,;1N1?QRN4AV:014;ANI} LOCATIONZ u.�, >, : . . •. ls stem. - ❑Addition of new motor load of Y Job#: Job site address: 13221 SW 68th Parkway 100HP or more. ❑"A","E",°°1-z' "1-3", ❑Six or more residential units. occupancy. City/State/ZIP:Tigard,OR 0 Health-care facilities. 0 Recreational vehicle parks. ❑Hazardous locations. 0 Supply voltage for more than Suite/bldg./apt.#:500 Project name:Centene Corporation ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions toob site:Triangle Corporate Park III � '` j g P .,�... �` � ,�N _ FEE SCH>DI�E .�.'`�, V , Description I Qty. I Each I Total I Y* New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'1500 sq.ft.or portion 33.92 1 Z . .rZDECP1© .QF WOK " � - Limited energy,residential 75.00 2 (with Reloctation of Thermostats to accommodate new wall layouts above sq.ft.) Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 ►tee RO T fI ,E. Z t Z x, . � �.�, a l'f, FER �'� , , ,� � 10_ T` ,'� ,-Et& v Services or feeders installation,alteration,and/or relocation Name:Triangle Corp.Park attn KBS Realty Advisors 200 amps or less 100.70 2 201 amps to 400 amps 133.56 2 Address:PO Box 28270 401 amps to 600 amps 200.34 2 City/State/ZIP:Santa Ana,CA 92709 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 , Branch circuits—new,alteration,or extension, s er panel "� ,� xF._ �xAYP'Ll�` .,�. r..x .., :E aG(�I1`I'<, P-..�,.bN ¢, .. � '`., A.Fee for branch circuits with Business name:Oregon-Aire,Inc above service or feeder fee, 7 42 2 each branch circuit Contact name:Matt Tidwell B.Fee for branch circuits without service or feeder fee,first 56.18 2 Address:7715 NE 33rd Drive,Suite A branch circuit Each add'1 branch circuit 742 2 City/State/ZIP:Portland,OR 97211 Miscellaneous(service or feeder not included) Phone:(503)335-2222 Fax: :(503)335-9977 Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email:mtidwell@oregon-aire.com Reconnect only 67.84 2 4O11 1.„ VI . ,_ . .. Pump or irrigation circle 67.84 2 Business name:Oregon-Aire,Inc. Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energyee Page 2 —h.-i 2 Address:7715 NE 33rd Drive Suite A panel,alteration,or extension. Each additional inspection over allowable in any of the above City/State/ZIP:Portland,OR 97211 Additional inspection(1 hr min) 66.25/hr Phone:(503)335-2222 Fax:(503)335-9977 Investigation(1 hr min) 90.00/hr Industrial plant(1 hr min) 78.18/hr Email:mtidwell@oregon-aire.com X.-1.07 air,:: 3 iii _ Inspections for which no fee is . .:Q specifically listed('/z hr min) 90 00/hr CCB Lic.: 64235 Electrical Lic.• ,- Suprv.Lic.: `73 �/) _ E;E l§"F1CA1� L'FRM1T TFS ,"t Suprv.Electrician signature,required: / Subtotal: 751 Print name: Kevin Cotterill Date: 1/18//2018 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): `/„ TOTAL PERMIT FEE. k(.� Authorized Signature: ,�orf i / This permit application expires if a permit is not o taUUmed within 180 Print name: Matt Tidwell C_ Date: 1/18/2018 days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_ELR_ERE.d0c 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: FER s,Cnl E SIDE�fi I LWORK ONLY:'. �. , crap ,.... .,. * Fee for all residential systems combined: $75.00= Description Qty. Each Total I 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 ❑ 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: ❑ 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(%hr min) CI IVII'I RCIA C �Ir :11 ciAirTir£LE c . 4L FERM, Es x `: c�lu Subtotal(Enter on Page 1). Fee for each commercial system: $75.00 (SEE OAR 918-309-0000) * Number of inspections allowed per permit. Check Type of Work Involved: ❑ Audio and Stereo Systems n 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 n Other: Total number of commercial systems: 1 *No licenses are required. Licenses are required for all other installations L\Building\'ermits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015