Permit (138) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
1 ' COMMUNITY DEVELOPMENT Permit#: ELR2019-00171
T t t,A R j 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/09/2019
Parcel: 1S136DD02300
Jurisdiction: TIG
Site address: 11799 SW 69TH AVE
Project: HAMPTON INN&SUITES Subdivision: Lot:
Project Description: Limited energy for fire alarm cabling.
Contractor: PORTER ELECTRIC INC Owner: DVKOCR TIGARD, LLC
7320 NE ST JOHNS RD 1419 W MAIN STREET, SUITE 110
VANCOUVER,WA 98665 BATTLEGROUND,WA 98604
PHONE: 360-574-1366 PHONE: 360-723-0024
FAX: 360-573-3723
FEES
Description Date Amount
Specifics: Restricted Energy Permit 09/09/2019 $150.00
12%State Surcharge-Electrical 09/09/2019 $18.00
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: 2
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 $168.00
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 plan. This permitill expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Ore.•• law re. 'res/ ou to folV, the ules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through 2-001 •0. „u may obt-la cop /.f the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: �ri At ht- •ermittee Signature: ¶IIIcti,t,ti
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 O1L1
City of Tigard ry, Received ZITAgVIIIIIMPINEMEIM
Da
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review:
I Phone: 503.718.2439 Fax: 503.598.1960 11114
S E(� 2019Date/B : Related Permit#:
Inspection Line: 503.639.4175 Ready Date/By: Juris: H See Page 2 for
I I(iA R D Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF Wdlitill.DINU LHVISIONI 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: tr
where the available fault current ❑Mannas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑ 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
JOB Snit INFORMATION AND LOCATION ❑Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#:I(0 S.3► I Job site address: 11799 SW 69th Ave 100HP or more. ❑"A","E","i 2","1-3",
❑Six or more residential units. occupancy.
City/State/ZIP:Tigard Oregon 97223 0 Health-care facilities. 0Recreational
l vehicle parks.
Suite/bldg./apt.#: I Project name:Hampton Inn 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:SW 69th Ave&Clinton St FEE SCHEDULE
Description I.'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'1500 sq.ft.or portion 33.92 1
�+ �T.� 6" l ' i • ' 1; a
Limited energy,residential 75.00 2
Fire Alarm Cabling (with above sq.ft.)
Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
1 r.„
TENANT, Renewable Energy 0 See Page 2
❑ PROPERT`Y OWNER 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
0
APPLICANT ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: above service or feeder fee,
7.42 2
each branch circuit
Contact name: B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address: branch circuit
City/State/ZIP: Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) I Fax: :( ) 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
-- --- — _ _ r--—4--6784 - —_-.-2-- _
Address:7320 NE St Johns Rd Signal circuit(s)or limited-energy ® See Page 2 150 2
panel,alteration,or extension.
City/State/ZIP:Vancouver WA 98665 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(360)574-1366 I Fax:(360)573-3723 Investigation(1 hr min) 90.00/hr
Email:BRobinson@PORTEREIectricInc.Com
/
.7 Industrial plant(1 hr min) 78.18/hr
J Inspections for which no fee is 90.00/hr
CCB Lic.: 4667821(012AI Electrical Lic.:JT7 g -t,Suprv.Lic.: 2909S specifically listed('A hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: /1-z -, "Z.. 0 ' '°,1' Subtotal: 150
Print name: Ken D Boal Date: 9/6/2019 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 18
Authorized signature:/} TOTAL PERMIT FEE: 168.00
`'"�'�� � This permit application expires if a permit is not obtained within 180
Print name: A ���J• Date: 9/6/2019 * days after it has been accepted as complete.
/� Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-46151(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 SC HEDULE
*
Fee for all residential systems combined: $75.00 Description
I Qty. I Each I 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
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(1/2 hr mm)
ELECTRICAL PERMIT PEES
COMMERCIAL WORK ONLY: 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
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems: 2
*No licenses are required. Licenses are required for all
other installations
L\Building\Permits\ELC_PennitApp_ELR_ERE.doe Rev 06/17/2015