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Permit (127) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT I, COMMUNITY DEVELOPMENT Permit#: ELR2018-00185 Date Issued: 10/18/2018 T(GAR.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S134BC00200 Jurisdiction: Tigard Site address: 12160 SW SCHOLLS FERRY RD Project: Greenway Town Center Subdivision: None Lot: None Project Description: HVAC system. Contractor: HUNTER DAVISSON INC Owner: ATLAS GREENWAY LLC 1800 SE PERSHING ST 333 NW NINTH AVE, STE 1009 PORTLAND, OR 97202 PORTLAND, OR 97209 PHONE: 503-542-3628 PHONE: FAX: 503-542-3654 FEES Description Date Amount Specifics: Restricted Energy Permit 10/18/2018 $75.00 12%State Surcharge-Electrical 10/18/2018 $9.00 Type of Use: COM 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 riles adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. Yo •• •• -'. -co•y of the rules or•irect questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: �_� � - - /� � a 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 r >-- g•—• FOR OFFICE USE ONLY 11 Received IINAMMIN INCity of Tigard Date/B : . �;Ir� s1 13125 SW Hall Blvd.,Tigard,OR 97223 (1�1- 1 g '2 Q 1 Plan Review Related Permit#: I ' Phone: 503.718.2439 Fax: 503.598.1960 '-/ Date/B : Ad -` , 06 4 A Inspection Line: 503.639.4175 ")n)Ready Date/By: El See Page 2 for TIGARD p C11+ �...) " i l f.Y 'Notified/Method: Supplemental Information Internet: www.tigard-or govc-il t d , e I YPIl OF W( ' : .. PLAN REVIEW ❑New construction 174 Addition/alteration/replacement 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 0 Marinas and boatyards. . CATEGORY'OF;CONSTR11JCTI©N '- 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 0 Accessory building amps for all other installations. buildings. 0 Multi-family 0 Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or '40B.SITE.::11 T'OIx111(A Ulwl t 1VD I C ION,. new motorat y derived ❑Emergency syste n larger separ el Ferry Q El Addition of load of system Job#: / 9O I Job site address: /a J 'p .S'W Sc,�e//S FF rr red 100HP or more. ❑"A","E","t-2","t-3'°, Yoccupancy. City/State/ZIP: / ,d 9 /a.o23 0 Six or more residential units. �/\ 0 Health-care facilities. 0 Recreational vehicle parks. '247:,. ❑Hazardous locations 0 Supply voltage for more than Suite/bldg./apt.#: I Project name: �re e ./&Jo..i ^► ( AI't' ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: // N 7 _ YOU q�qr T T .,-- i'."-,,,. EEESCHED:TJI.E• li Description t Qty. I Each 'I 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 v:: n<ESCRtPTION OFWO , ._. , ': Limited energy,residential 75.00 2 .) /`Ci,bGq // 111-1 A fit'Gki' •71 . wehabove,m multi �'/Q D a 0 CoGo MM0 a Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 Igl.1 ROPER'TY OWNS$„ ,' . j .._ , ,�TEI .' ... - Services or feeders installation,alteration,and/or relocation � � L ,}.A 200 amps or less 100.70 2 Name:(,Pp) G t'q,J et?' I�eNP cY/G/s 67,,):IN c�//0/`I 201 amps or 400 amps 133.56 Address: �o o 6Q�q J/��� .�' C _ _ 401 amps to 600 amps I 200.34 -® City/State/ZIP: Mt, l u a ki—/Q o/' 9 7 X22 601 amps to 1,000 amps 301.04 2 Phone:(Sb. ) 8'90 - fo/2 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:.,. , _ , 40. ee or anm54 2 '000 _ , . 1. ,�❑,CONTACT PEisd' ,. .. BArFnhfciruic -cinrceiwts wiittehratton,or extension,per panel Business name: ' above service or feeder fee, NU Nr`1nn 41//.CTp J`I/ �/�C- each branch circuit 7.42 2 Contact name: gVAN %'Q e:-/-, B.Fee for branch circuits without r. service or feeder fee,first 56.18 2 Address: /ac O J / a,c-,�X)//u? J e t branch circuit Q J Each add'I branch circuit 7 42 -© City/State/ZIP: lO t'�°V'f� O/P Q���� Miscellaneous service or feeder not included -3oc I Fax: :( ) Each manufactured or modular 11167.84 -© Phone:(s`p� ) fr dwellin ,service and/or feeder _ Email: C pc /e i r-gvQ�irroN t Gcr/ . Reconnect only 67.84B / ,0:0014-0*.:,'„,,:::, ,. Pump or irrigation circle 1111 67.84 _© Sign or outline lighting 67.84 _© Business name: e Ar 770(/2, Signal circuit(s)or limited-energy ❑ See Page 2 � 2 __ _ Address: panel,alteration,or extension. Each additional inspection over allowable in any of the above City/State/ZIP: Additional inspection(I hr min) 66.25/hr Phone:( ) I Fax:( ) Investigation(1 hr min) 90.00/hr Industrial plant(I hr min) 78.18/hr Email: Inspections for which no fee is e� 90.00/hr CCB Lic.//fa I Electrical Li I.:6,76..,*a cz� Suprv.Lic.:6o o GG s.ecificall listed Y.hr min ELECTRICAL PERMIT';FEES Suprv.Electrician signature,required: ' i, Subtotal: '75,� Print name:-`M Davi SSoN Date: �� ,,,t-- ❑Plan Review Required(25%of permit fee): C`- State surcharge(12%of permit fee): '3,a' Authorized signature: T� TOTAL PERMIT FEE: ") This permit application expires if a permit is not obtained within 180 Print name: /P t Date: /pld . '-/f' days after it has been accepted as complete. yet N v 4 « * Number of inspections allowed per permit. 1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc 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: De Fee for all residential systems combined: $75.00x )' Renewable I Qty. I Each I Total 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 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 ❑ 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(%2 hr min) Subtotal Enteron Page 1): Fee for each commercial system: $75.00 3' ` 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 El Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls El 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