Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
• COMMUNITY DEVELOPMENT Permit#: ELR2020-00020
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/06/2020
Parcel: 25101 DB01000
Jurisdiction: Tigard
Site address: 7080 SW FIR LOOP
Project: 72nd Business Center Subdivision: 72ND BUSINESS CENTER Lot: 12
Project Description: Limited energy for HVAC system for(4)new RTU's.
Contractor: HUNTER DAVISSON INC Owner: FIR LOOP BUILDING LLC
1800 SE PERSHING ST 7080 SW FIR LOOP STE 100
PORTLAND, OR 97202 TIGARD, OR 97223
PHONE: 503-542-3628 PHONE:
FAX: 503-542-3654
FEES
Description Date Amount
Specifics: Restricted Energy Permit 02/06/2020 $75.00
12%State Surcharge-Electrical 02/06/2020 $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: Ore law r uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through 0 52-0 090. may obtain a c y of the rules direct questions to OUNC by calling 503.232 987 or 1.800.33 44.
oatf
Issued By: / "% Permittee Signature: v /iJr
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.
ti lectrical Permit Application ®���` �� FOR OFFICE USE ONLY
City ofTigard RECEIVE Received
g DateBy: A Permit#: EzietRoi,r) a -1.6
` 1114 " 13125 SW Hall Blvd.,Tigard,OR 97223 1 �O2o Plan Review ��y�
Phone: 503.718.2439 Fax: 503.598.1960 JAN 2 Date/By: Related Permit#: F-G2Zb�Ltit1�
TIGARD inspection Line: 503.639.4175 TIGARD Ready Date/By: Ions�.,_ ® See Page 2 for
0 Internet: www.tigard-or.gov CITY OF Notified/Method: /`�7y Supplemental Information
111-111-C44
nIVISION
TYPE OF WORIC ''FLAN REVIEW
❑New construction al Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more ❑Building over three stories.
❑ Demolition ❑Other: where the available fault current 0 Marinas and boatyards.
CATEGORY'OF'CONSTRUCTION exceeds 10,000 amps at I50 volts or 0 Floating buildings.
❑ I-and 2-family dwelling M Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE,INFORMATION AND LOCATION ❑Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#:
93 I Job site address: .'"?0 d20 s'�/ F'r° �pp ❑"
A" "E„ "1-2""1-3",
� 100HP or more.
� / ❑Six or more residential units. occupancy.
`O
City/State/ZIP: rl/aN c O, 77,2A 3 ❑Health-care facilities. ❑Recreational vehicle parks.
/ e ❑Hazardous locations ❑Supply voltage for more than
Suite/bldg./apt.#: I Project name:7`,9�rd Bj�q+ e� ,4 ,0;(41 600 volts nominal.
.1 `) ❑Service or feeder 600 amps or more.
Cross street/directions to job site: r^ jra a ,FEF<SCL EDLILE,,•
`1 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'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
(with above sq.ft.) 75.00 2
LdIA) (/oltq e, A/VAC. carlfr0�S -cal- 9 New Limited energy,multi-family
r residential(with above sq.ft.) 75.00 2
rO J'1' fJ �� �vtM�%, Renewable Energy ❑ See Page 2
CI:I'ROPERTV OW It' I I ,,,,, , „D° NAN'L ?- Services or feeders installation,alteration,and/or relocation
Name: RR,ciSi Ch. 4 C LA it es LL C 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Address: A go)( 17/.92,1/p
— 401 an_m_to 600 amps 200.34 2
City/State/ZIP: t,r-f cat, 0 / 7a 442 601 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
Branch circuits—new,alteration,or extension,per panel
•«e 1,1.CANT, : = ❑ CO AC'C''MR$OS1 .. A.Fee for branch circuits with
Business name:RIAN'te.S'" Avis J01`) 2,4 C above service or feeder fee, 7.42 2
i each branch circuit
Contact name:.QN !/`7 , B.Fee for branch circuits without
a / , service or feeder fee,first 56.18 2
Address: /80o �, 4c`,54i/.J3 sf�,z, branch circuit
City/State/ZIP:�r�/ C/ et 7'42 `> Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( j )Sy2 36� Fax: :( ) Each manufactured or modular 67.84 2
dwelli�� ��r Reconnect only
and/or feeder
Email: Q2. ct1/1s3 6jj. Div\ Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: As- ,'c,l/e., Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energylifi See Page 2 2
Address: panel,alteration,or extension.
City/State/ZIP: Each additional inspection over allowable in any of the above
Additional inspection(I 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.://6`fa Electrical Li .:al; a aeI Suprv.Lic.:60 p /� specifically fisted(''/2 fiCTRIr mm)
ELECAL.rc'RMIT.,FEES
Suprv.Electrician signature,required: Subtotal:
Print name:, Av,SSON Date: / .//"/9' 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: ��0.N b� Date:/ j� days after it has been accepted as complete.
"'-'t Number of inspections allowed per permit.
l:\Building\'ermits\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
g PP
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Description I Qty. I Each I Total I *
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: s 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:
n Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
n Garage Door Opener* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
n V• acuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
n O• ther: Each additional inspection is 66.25/hr
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(V2 hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00Subto allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
n Audio and Stereo Systems
❑ Boiler Controls
n C• lock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
HVAC
n Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
n M• edical
❑ N• urse Calls
n O• utdoor Landscape Lighting*
❑ Protective Signaling
n Other:
Total number of commercial systems: /
*No licenses are required. Licenses are required for all
other installations
I:\Building\Permits\ELCPermitApp_ELR_ERE.doc Rev 06/17/2015