Permit (171) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit#: ELR2019-00145
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/27/2019
Parcel: 2S 101 DD00500
Jurisdiction: Tigard
Site address: 6755 SW SANDBURG ST
Project: Reece Security Subdivision: SALEM FREEWAY SUBDIVISION Lot: 2
Project Description: Mechanical for TI:(6)new RTU's.
Contractor: HVAC INC Owner: REECE HOLDINGS LLC
5188 SE INTERNATIONAL WAY 25977 SW CANYON CREEK RD, STE E
MILWAUKIE, OR 97222 WILSONVILLE, OR 97070
PHONE: 503-462-4822 PHONE: 503-803-7673
FAX: 503-462-6555
FEES
Description Date Amount
Specifics:
Restricted Energy Permit 08/27/2019 $75.00
Type of Use: COM 12%State Surcharge-Electrical 08/27/2019 $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. TrL•, e rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You ma obtain .. •. •f the r I- • .. R
Issued By: ,,6`��_- _ •ermittee 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 ONLY
City of Tigard w Received
s fw� �i w ��« DateB Irl/� Permit#: , • r s.( C —<��1 L15-
1111
13125 SW Hall Blvd.,Tigard,OR 97223 r: - _„r -� Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : l Related Permit#: .;� ..,‘,/-_ r +
Inspection Line: 503.639.4175 /\Li is 7 201S, Ready Date/By: la See Page 2 or
T I G A R D Internet: www.tigard-or.gov Notified/Method: EMI Supplemental Information
ral.-'., *w. i:Riiai, .' s ;:i i.0 *Ia t!P.i , ,�aYy ; i'I,i 4 ' ��
y "., .i � ;'. y ',t.1 CV = g,A
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ElNew construction ®Addition/altera . '. aceihent' - °',-'+`-r J' 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 ❑Other:
.'"%7,11k, where 1afault current 0 Marinas lazds.
74", 1V ' # �p ,,": exceds1000am at 150 volts or ❑Floatinbud ng
❑ 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 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
faliMtEl, � 1 A ! W l ii `�, . 1 a l 0 Emergency sstem. larger separately derived
AddJob#: Job site address:6755 SW Sandburg 100HSt. ❑10013 P or mortion nee
oo of omotor load of system.
. ❑"A","E","1-2","1-3",
City/State/ZIP:Tigard,OR 97223 0 Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Reese Security 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: �,
z 4Ri 'iii Wt 74-Z _
Description 1 Qty. I Each I Total
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
;7 1 '411i', t ritiihii ,4Ft c 3 9 a,' . f ,ti . *W.V.Lii:W54 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
x 141110'1:::,;'0 }r t " ' ^' '11 " uraMii, M .--!II 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
,76:077=771,1y1 p-3:!::- 1 ',1_ iitrvli Branch circuits—new,alteration,or extension, .er I anel
Business name:HVAC,Inc. above service or feeder7.42 2
each branch circuit
Contact name:Jody DePew B.Fee for branch ,
ut
service or feeder first
Address:5188 SE International Waybranch circuit 2
City/State/ZIP:Milwaukie,OR 97222 Each add'l 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
Email:jodyd@hvacincorp.com dwelling,service and/or feeder
Reconnect only 67.84 2
.kq r! 11in. _e,.A'., ltaIia o , or ' 1111 67.84 2
."-5784 2 ,'
Address:5188 SE International Way
Signal circuit(s)tio)or limited-energyxns0 See Page 2 75;�,t. 2
panel,alteration,or extension.
City/State/ZIP:same Each additional inspection over allowable in any of the above
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.: 26-571CLE. Suprv.Lic.: 3796LEB s.ecificall listed V0 hr min)
Suprv.Electrician signature,required:CrVI/�/ C--){.),\A... r�9
Subtotal: 7y,
Print name: Mike Schmidgall Date: 8/7/19 0 Plan Review Required(25%of permit fee): ---
State surcharge(12%of permit fee): 1_
/44
Authorized signature:
pi,
TOTAL PERMIT FEE: t
This permit application expires if a permit is not obtained within 180
Print name: Jody DePe Date: 8/7/19 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doe 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:
's 1 * i •' z ; ' x I r r
, " `-• m-._; -� ..!l.kt.. °4.."rim, ."-, mr�.o-..�i �. TMm.;»-, r �' E�- w ,'�°�,�, ��i�a ,z.'-';..
Fee for all residential systems combined: $75.00 ReDesnewable t Qty. I Each Y Total
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
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 I
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(V2 hr min)
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
y * 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
❑ 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
1:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015