Permit (19) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
r COMMUNITY DEVELOPMENT Permit#: ELR2019-00090
'
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/05/2019
TIGARD Parcel: 1 S 135BA00100
Jurisdiction: Tigard
Site address: 10125 SW WASHINGTON SQUARE RD
Project: Jaguar/Land Rover Subdivision: None Lot: None
Project Description: Low voltage control wiring for new mechanical units.
Contractor: HVAC INC Owner: PPR SQUARE TOO LLC
5188 SE INTERNATIONAL WAY PO BOX 847
MILWAUKIE, OR 97222 CARLSBAD, CA 92018
PHONE: 503-462-4822 PHONE:
FAX: 503-462-6555
FEES
Description Date Amount
Specifics: Restricted Energy Permit 06/05/2019 $75.00
12%State Surcharge-Electrical 06/05/2019 $9.00
Type of Use: COM
Class of Work: NEW
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 11,work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility NotificatignrCelpter. ' Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You •. ••ain a -•• •f the rules or direct questions to OUNC by calling 503 32.p 087 ri1 X800.332.2344.
I
Issued By: //, Permittee Signature: 7� ;y
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 OF I;it I SF ()NI.)
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City of Tigard Lam. IReceived '— ' Permit `. lot >
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/B :1114
Related Permit#
Inspection Line: 503.639.4175 MAY 15 2019 Ready Date/By: Jutis: 65 See Page 2 for
TI G A R D Internet: www.tigard-or.gov Notified/Method: Supplemental Information
CITY OF TIGARn
TYPE OF WO1WJILDING DIVISION PLAN REVIEW
®New construction 0 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.
❑Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
0 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ['Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address:10125 SW Washington Square Rd. 100HP or more. ❑"A","E",`°1-2",°°1-3",
❑Six or more residential units. occupancy.
City/State/ZIP:Tigard,OR 97223
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Jaguar Land Rover 0 Hazardous locations. 0 Supply voltage for more than
0 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'1500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential 75.00 2
low voltage control wiring for new mech units (with above sq.ft.)
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: 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:( ) 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
C. APPLICANT e CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:HVAC,Inc. above service or feeder fee,
7.42 2
each branch circuit
Contact name:Jody DePew B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address:5188 SE International Way branch circuit
City/State/ZIP:Milwaukie,OR 97222 Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503-)462-4822 Fax::(503)462-6555 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:jodyd@hvacincorp.com Reconnect only 67.84 2
, , CONTRACTOR , Pump or irrigation circle 67.84 2
Business name:HVAC,Inc. Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy D See Page 2 2
Address:5188 SE International Way panel,alteration,or extension.
Each additional inspection over allowable in any of the above
City/State/ZIP:same
Additional inspection(1 hr min) 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.: 50897 Electrical Lic.: 26-571CLC Suprv.Lic.: 3796LEB specifically listed(%hr min)
�, ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: 1in1,11tY )/CAA , Subtotal:
Print name: Mike Schmidgall Date: 5/14/19 0 Plan Review Required(25%of permit fee):
Stae surcharge(12%of permit fee):
Authorized signature: P\-'
TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Pr int nt41.c. Judf D„1\ Dnto: c/14/19 .r.ye.itar it h..barn.rraptad as rnmrtata
✓ * Number of inspections allowed per permit.
I:\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:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Fee for all residential systems combined: $75.00 Description I .1 Each ( Total I
3' 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
n G• arage Door Opener* 50.01 to 100 kva 552.26 2
I g p >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
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:
❑ O• ther: Each additional inspection is 66.25/hr
charged at an hourly(I hr min)
Inspections for which no fee is 90.00/hr
specifically listed(1/2 hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Subtotal Enteron Page 1):
Fee for each commercial system: $75.00
3r ' Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ A• udio and Stereo Systems
L Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
n F• ire Alarm Installation
• HVAC
❑ Instrumentation
n Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems: 1
*No licenses are required. Licenses are required for all
other Installations
I:\Building\Permits\ELCPermitApp_ELR ERE.doc Rev 06/17/2015