Permit (181) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT
Permit#: ELR2018-00161
T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/20/2018
Parcel: 1 S 134AD06200
Jurisdiction: Tigard
Site address: 10565 SW NIMBUS AVE 100
Project: Progressive Subdivision: (KOLL BUSINESS CENTER,TIGARD Lot: A
Project Description: Low voltage for thermostats.
Contractor: LATIMER HVAC LLC Owner: DIETRICH, NANCY BISHOP
11230 SW MORGEN CT ROBINSON, JERRY CHRISTOPHER TRUST
TIGARD, OR 97223 ROBINSON, LYNN ET AL
9701 SE MCLOUGHLIN BLVD
MILWAUKIE, OR 97222
PHONE: 503-290-1085 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Restricted Energy Permit 09/20/2018 $75.00
12%State Surcharge-Electrical 09/20/2018 $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 Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a c•i• o e r• - - •irect questions to OUNC by calling 503.232.1987 0 .800.332.2344.
Issued By: Permittee is - • ••
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 O\L\
CityofTigard / Received )f�j
illq g eC DateBy: ./ /a r . 'ermit#: ,5:4,,,,,,01
(( j r ay . I
a 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ll
Phone: 503.718.2439 Fax: 503.598.19 {(� Date/By: Related Permit#:
T I G A R D Inspection Line: 503.639.4175 C 9 41 ei V Ready Date/By: Jugs: H See Page 2 for
Internet www.tigard-or.gov J 1t`t�� . otified/Method: ',60......, Supplemental Information
TYPE OF WORK . _ 'PLAN REVIEW CO-
0 New construction Addition/alteratioi Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
0 Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑ 1-and 2-family dwelling 4 Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: 0 Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LO CATION ❑Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: 18-133 Job site address:10565 SW Nimbus Ave 100HP or more. ❑"A","E","t-2","1-3",
City/State/ZIP:Tigard,OR 97223 ❑Six or more residential units. occupancy.
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Progressive ❑Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Each I Total 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
thermostat (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
® PROPERTY OWNER -0 TENANT Services or feeders installation,alteration,and/or relocation
Name:KG Investment Properties,LLC 200 amps or less 100.70 2
Address: 10240 SW Nimbus Ave-Suite L3 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Portland,OR 97223 601 amps to 1,000 amps 301.04 2
Phone:(503)869-2111 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: Kf M-A(, 1 ,CQ V� relocation
Owner installation:This nstallation 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
P.11 APPLICANT 0 CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:Latimer HVAC above service or feeder fee,
7.42 2
each branch circuit
Contact name:Clint Latimer B.Fee for branch circuits without
Address: 11230 SW Morgen Ct service or feeder fee,first 56.18 2
g branch circuit
City/State/ZIP:Tigard,OR 97223 Each add'1 branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(971)294-0879 Fax: :( ) Each manufactured or modular 67.84 2
Email:clint@latimerhvac.com dwelling,service and/or feeder
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Latimer HVAC Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
lgoSAddress: 11230 SW Morgen Ct panel,alteration,or extension ee Page 27,,g 2
City/State/ZIP:Tigard,OR 97223 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(971)294-0879 Fax:( ) Investigation(1 hr min) 90.00/hr
�y, Industrial plant(1 hr min) 78.18/hr
Email:Clint@IatimerhvaC.Com
711 f 3i /L'/1 I r Inspections for which no fee is
CCB Lic.: 220839 Electrical Lic.: LHR406 Suprv.Lic.: 1798LEB
specifically listed('A hr min) 90.00/hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: j t il --77--,'
Subtotal:
Print name: Greg Boone Date: 09/19/18 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): C( ;
4/4 Authorized signature: TOTAL PERMIT FEE: , "
- �'� This permit application expires if a permit is not obtained within 180
Print name: Carlie Latlrner ar Date: 09/19/18 days after it has been accepted as complete.
* Number of inspections allowed per permit
I:\Building\Permits\ELC PermitApp ELR_E doc Rev 06/17/2015 ' 440-4615T(11/o5/COM/WEB
Electrical Permit Application—City of Tigard
Page 2.7 Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: se
Fee for all residential systems combined: $75.00RenewableDescription
I Qty.1 Each I Total I
R
3' Renn ewwaable 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:
n 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)
n 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
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed('A hr min)
COMMERCIAL WORK ONLY:
ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00
Subtotal
on Page 1):
y * Number of inspections allowed perr pens permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
n Audio and Stereo Systems
n Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
HVAC
n Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control*
n Medical
n Nurse Calls
Outdoor Landscape Lighting*
n Protective Signaling
n Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I:\Building\Permits\ELCPermitApp_ELR_ERE.doc Rev 06/17/2015