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Permit (135) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT Permit#: ELR2019-00184 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/24/2019 Parcel: 2S113 BA00400 Jurisdiction: Tigard Site address: 7632 SW DURHAM RD 300 Project: Banner Bank Subdivision: None Lot: None Project Description: HVAC system. Contractor: HUNTER DAVISSON INC Owner: PORTLAND SW CENTER LLC 1800 SE PERSHING ST BY FELTON PROPERTIES INC PORTLAND, OR 97202 ATTN: FELTON, MATT 520 SW 6TH AVE, STE 610 PORTLAND, OR 97204 PHONE: 503-542-3628 PHONE: FAX: 503-542-3654 FEES Description Date Amount Specifics: Restricted Energy Permit 09/24/2019 $75.00 12%State Surcharge-Electrical 09/24/2019 $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 copy of the rules or direct questions to OUNC by calling 503.2 1987 or 1.800.332. 44. Issued By: Ptrrmittee 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. . lectrical Permit Application FOR OFFICE USE ONLY Received Permit#: J�4I/f(''CV d ' City of Tigard ,RECEIVE 1' Received : q /4 `.�� " `� - I �t Plan Review Related Permit#: I";,�3 -y` lii13125 SW Hall Blvd.,Tigard,OR 97223 DatelB Phone: 503.718.2439 Fax: 503.598.1960 Ready Date/By: 0 See Page 2 for Inspection Line: 503.639.4175 S E P 2 4 2019 Ready d/Ivlethod: 1?1MINI See Page 2 Informationo TIGARD Internet: www.tigard-or.gov TYPE OF WQtt6I+ ,C4,-..TlAfp;. PLAN REVIEW It!!I1 I f• A V I I Please check all that apply(submit 2 sets of plans w/items checked): ❑New construction 5 Addition/alterati�" 0 Service or feeder 400 amps or more 0 Building over three stories. ❑Other: where the available fault current 0 Marinas and boatyards. ❑Demolition exceeds 10,000 amps at 150 volts or ❑Floating buildings. CATEGORY`OF, CpNSTgucTIOPI • • , ' less to ground,or exceeds 14,000 ❑Commercial-use agricultural ❑ 1-and 2-family dwelling Commercial/industrial 0 Accessory building amps for all other installations. buildings. 0 Other 0 Fire pump. 0 Installation of 150 KVA or ❑Multi-family ❑Master builder ❑Emergency system. larger separately derived JOB SYTE;•INFi�RMATIOt AND:I t)CATnIN f" p ❑Addition of new motor load of system. G; ?6?2, Sw �/ttr'ActM A�/ 100HPormore. ❑..A., ..E„ ..1.2,...1-3" Job#: ( I o2�a2 I Job site address: occupancy. I p �7��L/ ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP: rj t;ja Qin. rift"'" 0 Health-care facilities. / 0 Hazardous locations. 0 Supply voltage for more than Pro ect name: ,cl Ur �'E pi��r600 volts nominal. Y ,p Suite/bldg./apt.#: I U 0Service or feeder 600 amps or more. Cross street/directions to job site: grlN'CC :. N ..-r-2: .St1I Q Description I Qty. I Each I Total I * New residential single-or multi-family dwelling unit. I Lot#: Includes attached garage. Subdivision: 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1 Limited energy,residential 75.00 2 D SCTLTLrTiOltl.OF W.(1' with above s'.ft.) Zo residential(with above sq.ft.) N ) 1 S fO q CC OMMtY41 Limited energy,multi-family 75.00 2 (Ai Vol f6 Cf 2• �VC CO .7.�. tJ Renewable Energy 0 See Page 2 F PROPERTY OWNER , - ❑r;'TENNA1 T. Services or feeders installation,alteration,and/or relocation 200 amps or less 100.70 _© Name: rif )Co MM a,cCi a' Co N frc^c rc � Lam"/G 201 amps to 400 amps _Ell 133.56 I �J1 S1�� 200.34 2 Address:,SS 7 3 S 401 amps to 600 amps ---- -_— _-------------- --- - _ 601 amps to 1,000 amps 301.04 2 City/State/ZIP: gr T 1 Q ,.e ,/i 14/4 F8 .y`R Over 1,000 amps or volts 552.26 2 Phone:( 360 )S l3 z/8c�'d' Fax:( ) Temporary services or feeders installation,alteration,and/or relocation Email: 200 am s or less 59.36 1 Owner installation:This installation is being made on property that I own which is not p 129.08 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps401 amps to 599 amps 168.54 2 Owner signature: Date: • • Branch circuits-new,alteration,or extension,per panelne PPLYCANT ❑,CONTACC .PERSOlsI A.Fee for branch circuits with above service or feeder fee, 7 42 2 Business name:/(,N f�r oci1/lA S30r1 TNI C-• each branch circuit R B.Fee for branch circuits without Contact name: Y ci N /oef.,Q/ service or feeder fee,first 56.18 2 ego o s- ,,- branch circuit Address: �S�Q1NQ re'�� Each add'l branch circuit 7.42 2 City/State/ZIP: � Igt.1 C>/1 �0�0 Miscellaneous(service or feeder not included) Each manufactured or modular 67.84 2 Phone:( Sp3) S`/o2-3�a� Fax: ( ) dwelling,service and/or feeder ,1 Reconnect only 67.84 2 Email: CPv t2¢,�@ ��Nt2t cYa�+sS•r/�CpM orcircle ' " Pump irrigation 2 �a; ,:..�-�. r,�;f r;.a�� ...._u�. Stgrt-er�utlins-lighting. 67._84.. Business8 ,f,, Signal circuit(s)or limited-energy See Page 2 / name: j"�UW l�,r - �JISSor1 3r-'C° /r / .anel,alteration,or extension. Address: /goo �� ¢�S h/N ��re�� Each additiona inspection over auowa e m any of tea i ove /� // Additional inspection(1 hr min) 66.25/hr City/State/ZIP: /'pr�CtAIJC� p � Cr 7020 90.00/hr Investigation(1 hr min) Phone:( So3 )) Sya / a'}0v I Fax:( ) Industrial plant(1 hr min) 78.18/hr Email: rpoIQ...td. "n' ' 1tract/'5So"I, -77NC'" Inspections for which no fee is 90.00/hr specifically fisted '/2 hr min) Electrical Lit.:a�,.'a ail Suprv.Lic.: V O /� CCB Lic.�� ,.. EL,,ELECTRICAL.,, , , EEE . i Subtotal: - Suprv.Electrician signature,required: �, Date: i_J 19 0 Plan Review Required(25%of permit fee): Print name: 'M Qal/'SSON State surcharge(12%of permit fee): I TOTAL PERMIT FEE: 2 Authorized signature: b t I This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: /P�,q p/ //�^p�Q Q I Date: `7 40247 * Number of inspections allowed per permit. C\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(I 1/05/COM/WEB