Permit (92) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
11 la:. COMMUNITY DEVELOPMENT Permit#: ELR2018-00120
T[GARD GAR13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/06/2018
Parcel: 2S102AD02200
Jurisdiction: Tigard
Site address: 8900 SW BURNHAM ST
Project: Burnham Storage Subdivision: None Lot: None
Project Description: Low voltage for CCTV.
Contractor: PAKA LOW VOLT LLC Owner: BURNHAM BUSINESS&STORAGE LLC
1103 SE 191ST AVE 9500 SW BARBUR BLVD STE 300
VANCOUVER,WA 98683 PORTLAND, OR 97219
PHONE: 503-367-7092 PHONE:
FAX.
FEES
Description Date Amount
Specifics: Restricted Energy Permit 08/06/2018 $75.00
12%State Surcharge-Electrical 08/06/2018 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio&Stereo: 0 Boiler Controls: 0
CCTV: 1 Clock Systems: 0
Data&Telecommunications: 0 Fire Alarm: 0
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 ap•/able 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 fpended for more the 180
days. ATTENTION: Oregon law requires you to follow the rule- -••• -• • the Oregon Utility Notification Center. Those ules are set forth in OAR
952-001-0010 throug952-001-0090. Yo. u, •stain a co.., of the rules or direct,uestions to OUNC by calling 503.232.1987:7;32.2344.
•
Issued B r/- — 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 ,,, FOR OFFICE USE ONLv
,4
City of Tigard _
t g i ,,e Received y ),1
a DateB : D 41 /0 Permit# af ', i
ate
13125 SW Hall Blvd.,Tigard,OR 97223 q' '1 1'Plan Review
Phone: 503.718.2439 A,)VI t Date/ B : Related Permit#:
Email: TigardBuildingPermits@Tigard-or.gov Ready Date/By: _ ® See Page 2 for
T 1 G A R D Inspection Line: 503.639.4175 Internet: www.tigaTd-pr gov Notified/Method: i Supplemental Information
1
TYPE OF WORK VIP 1, PLAN REVIEW
0 New construction 12 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition ❑Other;
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
El1-and 2-family dwelling [`Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
El Other: amps form all other installations. tngs.
❑Multi-family 0 Master builder
0 pump. 0 Installation of 150 KVA or
JOB SITE INFORMATIONAND LOCATION 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address: Actot, eZj .av M S. t. IOOHP or more. ❑"A">"E","1-z",°`I-3",
City/State/ZIP: ` ❑Six or more residential units. occupancy.
1(jpclZb '�`� '7 2230 Recreational vehicle parks.
0 Health-care facilities.
Suite/bldg./apt.#: Project name:Zvi* M S� 0 Hazardous locations. 0 Supply voltage for more than
��`��' ❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: -61.4.74Q ,r,tBTW r-F l-(-/k(( f FEE SCHEDULE
Mak /1 _ Description I Qty. I Each I Total I *
I 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'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
/r / (with above sq.ft.) 75.00 2
vowt �1 Ctnv! Limited energy,multi-family
V residential(with above sq.ft.) 75.00 2
Renewable Energy 0 See Page 2
0 PROPERTY OWNER 0 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:( ) 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
0
APPLICANT` 0 CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: :PYv._ 4 f- } above service or feeder fee,
7.42 2
each branch circuit
Contact name: B.Fee for branch circuits without
Address: service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP: Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: `1)y44L 1_8W VoL-r Gt_L Sign or outline lighting 67.84 2
Address: (� 3 ' E 5: /k_- c( Signalcircuit(s)eron or limited-energy 07
See Page 2 % 2
0 ��(� /��` panel,alteration,or extension. f
Ca yV�,(� Each additional inspection over allowable in any of the above
City/State/ZIP:
w 98(2 83 Additional inspection(1 hr min) 66.25/hr
Phone:(SO 3) 3fc —'�O' c_ ( Investigation(1 hr min) 90.00/hr
`_E.Lvi iz.. Pak a I fl��814 'CO,A,1 Industrial plant(1 hr min) 78.18/hr
Email: 1'1
Inspections for which no fee is 90.00/hr
CCB Lic.: Ot CElectrical Lic.' &A?)L( Suprv.Lic.: ,$ A specifically listed CAhr min)
` ELECTRICAL PERMIT FEES
Suprv.Electrician signature,requi CA.,-
.0"-t.
A.Y Subtotal:
Print name: 5Q�/` ,n(� U
Date: S ' (13 0 Plan Review Required(25%of permit fee):
JState surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE: 7k,,.4
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 10/26/2017 440-4615T(11/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
FEE SC1I
RESIDENTIAL WORK ONLY: .. s
Description *
Fee for all residential systems combined: $75.00I RenewableQty Each Total electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
111Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
El 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 552.26 2
with OAR 918-309-0040)
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
111 Vacuum Systems* >100 kva-no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
111 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(A hr min
COM WORK O 4 iEt E
A
Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00 * Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
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
n Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Prote ive Signaling
Other: e.-67-77
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 10/26/2017
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8900 SW BURNHAM ST, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical Limited Energy ELR2018-00120
Inspection Type: Inspector:
198 Low voltage final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor