Permit (104) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit#: ELR2018-00072
13125 SW Hall Blvd.,Ti Date Issued: 05/22/2018
and OR 97223 503.718.2439
TIC_ r\1i f7 9
Parcel: 2S102AA00600
Jurisdiction: Tigard
Site address: 11940 SW PACIFIC HWY
Project: ALPROP Subdivision: TIGARD HIGHWAY TRACTS Lot: 12
Project Description: HVAC system.
Contractor: HUNTER DAVISSON INC Owner: ALPROP LLC
1800 SE PERSHING ST 4905 SW GRIFFITH DR STE 205
PORTLAND, OR 97202 BEAVERTON, OR 97005
PHONE: 503-542-3628 PHONE:
FAX: 503-542-3654
FEES
Description Date Amount
Specifics: Restricted Energy Permit 05/22/2018 $75.00
Type of Use: COM 12%State Surcharge-Electrical 05/22/2018 $9.00
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 Center. Those rules are set forth in OAR
952-001-0010 through 0 52-001-0090. � u may obtain i-copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued 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' 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 RECEIFOR OFFICE USE ONLY
CI O Tigard Received Permit#: 45' 49,.` .Srx z
111 .-
`5 f g
Date/By: ��r/� rlL/t f!"'C t
't 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 1 r' Date/By: ....c"..-J, 'it -y' Related Permit#: /hoc jitgole
Inspection Line: 503.639.4175 Ready Date/By: loris: H See Page 2 for
Internet: www.tigard-ocgov �/ '' j Supplemental TIGARD ClI A fTIGARDNotified/Method ��/� Su lementallnformation
1.11E OF-"w ,.Cl
A DIVISION' - r . : '?Livy Rolzw,
� �en Please cheek all that apply(submit 2 sets of plans w/items checked):
❑New construction �J Addition/alteration/replacement
0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition 0 Other: where the available fault current ❑Marinas and boatyards.
CATEGOttl','-OF CONSTMICTtON` ' less exceedsto 10,ground000or ampsexceeds at 150 14vo00 ❑lts or ❑Floating buildings.
❑ 1-and 2-family dwelling p Commercial/industrial ❑Accessory building
, ,0agricultural
amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. ❑Installation of 150 KVA or
.30R SITE,INFORMATION AND LOCATION ❑Emergency system. larger separately derived
i P ❑Addition of new motor load of system.
Job#: k8/�a I Job site address: /94/o ,r,,,,, 1 U' c ,9%„q1 100HP or more. ❑"A”,`°E",°°1-2","1-3",
City/State/ZIP: �p C,� ^� U / 0 Six or more residential units. occupancy.
ty / /t ( /eG0 Recreational vehicle parks.
�/0.f` 9Health-care facilities.
1/4J / �j'�i jIU ❑Supply voltage for more than
Suite/bldg./apt.#: Project name: or 9 ❑Hazardous locations. PP Y s
�� ��� men' r ❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: /J-ivbp te-C ,FEES DULE.
Description I Qty. 1 Each 1 Total i
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
(with above sq.ft.) 75.00 2
Low -v*Ziage. /{ � CO4J ro�
J Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy El See Page 2
0 PROPERTY' OwNF,R . ,'� -0 TENANT ' -. Services or feeders installation,alteration,and/or relocation
Name:44pm drape r�, ing 11a q _y�' _, 2f 200 amps or less 100.70 2
1� l/ ,r" f ��L r / 201 amps to 400 amps 133.56 2
Address: '905- Sol/ Gm 77n 3 11/e ,Si1r�2. a D b
— — 401 amps to 600 amps-- -- 200.34 2
City/State/ZIP: 18ea-Ve.r!614/ / 6/e f /UOS 601 amps to 1,000 amps 301.04 2
Phone:(.3.V) L/,.r3_ +'6-o-6 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 i
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
' — alteration,or extension,APh I ICtSNT. „ ,,,,- �. [ +BQIy LA I "J' [t$U15T 1 A.
Fee for circuits new, per pane
,/ �7-' l
Fee branch circuits with
Business name: 11.IwN����- Q i✓�.S oN. 0. above service or feeder fee,
7.42 2
each branch circuit
Contact name: fe��N p—," — B.Fee for branch circuits without
Address: /�V v S-�"' r�^t service or feeder fee,first 56.18 2
�/ / \t branch circuit
City/State/ZIP:,1 r7CQ/VG O� -'q202 Each add'I branch circuit 7.42 2
/' Miscellaneous(service or feeder not included)
Phone:(Sop S7f—76,28' j Fax: :( ) Each manufactured or modular
� 67.84 2
dwelling,service Email:fp Q �t J7 ,ro# t4Jr J G.O/,, Reconnect only
and/or 67.84 2
CONTRe C1 IlY• Pump o irrigation 67.84 2
Business name: rckMe AS 4Iove Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy ❑ See Page 2 l 2
Address: __ panel,alteration,or extension.
City/State/ZIP: Each additional inspection over allowable in any of the above
Additional inspection(1 hr mm) 66.25/hr
Phone:( ) Fax:( ) Investigation(1 hr min) 90.00/hr
Email: Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic./// , Electrical Li :4;26..,'a czEI Suprv.Lie.:6o o / specifically listed(%hr min)
EI:�GTRICAL,PERMIT FEES
Suprv.Electrician signature,required: , —. "t11 : Subtotal: 75
Print name:TA, O0.1//SSON Date:t al./3 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): %4 et
i
Authorized signature: .2_ 1.-r/1 TOTAL PERMIT FEE: ,q`l
This permit application expires if a permit is not obtained within 180
Print name: i 1 x� - A" 7 Date: yat/.�' ' days after it has been accepted as complete.
," * Number of inspections allowed per permit.
1:\Building\Permits\ELC_Permit pK p ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
i
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
Fee for all residential systems combined: $75.00 DescriptionI Qty. I Each Tata]
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 I 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(%hr min)
va ........ .., rte:an'i r .'
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:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
El Data Telecommunication Installation
❑ Fire Alarm Installation
'171
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
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11940 SW PACIFIC HWY, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical Limited Energy ELR2018-00072
Inspection Type: Inspector:
198 Low voltage final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor