Permit CITY OF TIGARDli
ELECTRICAL RESTRICTED ENERGY PERMIT
■. COMMUNITY DEVELOPMENT Permit#: ELR2020-00026
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/18/2020
Parcel: 1 S134BC00200
Jurisdiction: Tigard
Site address: 12162 SW SCHOLLS FERRY RD
Project: Greenway Town Center Subdivision: None Lot: None
Project Description: Limited energy for HVAC.
Contractor: HUNTER DAVISSON INC Owner: ATLAS GREENWAY LLC
1800 SE PERSHING ST 808 SW ALDER ST STE 200
PORTLAND, OR 97202 PORTLAND, OR 97205
PHONE: 503-542-3628 PHONE:
FAX: 503-542-3654
FEES
Description Date Amount
Specifics: Restricted Energy Permit 02/18/2020 $75.00
12%State Surcharge-Electrical 02/18/2020 $9.00
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: 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 follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 9 -001-0090. You m obtain a co 4he u' i,rdirect-questions.taQUNC by calling 503.23z.1987 or 1.80 2.2344.
Issued By: Permittee 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 Receid
Date/B: ,a ty- A� Pennit#: ,/ 0-. 0.24., _
'4 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review T
g J�fj
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Relt�iWl•#i � " -oQaw
Inspection Line: 503.639.4175 Ready Date/By: Juris: Ei See Page 2 for
TI GARD Notified/Method: Supplemental Information
Internet: www.tigard-or.gov
TYPE OF WORK PLAN REVIEW,;- ; '
❑New construction V 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.
0 Demolition ❑Other: where the available fault current 0 Marinas and boatyards.
CATEGORY°(3F CO(•1STRUCTION .`` exceeds 10,000 amps at 150 volts or 0 Floating buildings.
El 1 and 2-family dwelling Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-ttse agricultural
amps for all other installations. buildings.
❑ Multi-family ❑Master builder ❑ Other: 0 Fire pump. 0 Installation of 150 KVA or
,7Q SI7E,INFi(3Rl�fAIIOII'AND LOCATION ^. ❑Emergencysystem. larger separately derived
c" 1 ❑Addition of new motor load of system.
/l 3$� 14Rl62 S yv S,A.its 12Tr /��/, A,> ..E„ ..1_2„"1 3'•
Job#: Job site address: 100HP or more. ❑"
� 1 Q ❑Six or more residential units. occupancy.
City/State/ZIP: / .-r 0,0 d c, "7 5 2 3 ❑Health-care facilities. ❑Recreational vehicle parks.
❑Hazardous locations. 0 Supply voltage for more than
Suite/bldg./apt.#: I Project name:�jre sZn/ /c�y 7oL Jnl CAN ¢ 600 volts nominal.
❑Service or feeder 600 amps or more.
Cross street/directions to job site: Ec,)0,,rcj �o>JeS V,, FEE SC1IEDj,1i.E , -;'
Description I Qty. I Each 1 Total
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 l
DESCRIPTION• dE,WO1 ,,; .',''''If',.",.."' Limited energy,residential 75.00 2
-} f (with above sq.ft.)
Lalm ✓;Sec�l,9q., /IVAC Cor�lt`o(J'' TOr 3 �ai`i Limited energy,multi-family 75.00 2
�1 residential(with above sq.ft.)
rt yS Pot c 1\ 0 iv C o r/. Renewable Energy 0 See Page 2
�.1 1Xj PROPERTY OWNER ( 0 TENANT Services or feeders installation,alteration,and/or relocation
Name:(RQP) , r6 to l'd r f v ^N ai zme,ft 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Address: /
��� vow �� �� -rTr6t,—/- sit, 401 amps to 600 amps 200.34 2
City/State/ZIP: 0 rft1copd CC 9'`'a a.c 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: amps to 599 amps alteration,or extension,68. panel 2
401 1
; {f Branch circuits new, ra' n, Qer
�,el�F' ,I'AIVT" t. CO`NTAG"I', :'-'!"1,( A.Fee for branch circuits with
Business name: PI AN c_,l V iSS oN 6 N G• above service or feeder fee, 7.42 2
eact/ck / 1 Feeh branch circuit
Contact name: R B. for branch circuits without
service or feeder fee,first 56.18 2
Address: /ra O SE /c q J r4;/4 rr,e,* branch circuit
City/State/ZIP:,-1Lrx,J4 ole J q`7a)2 d02 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(Sa3)Sya--.? Z? I Fax: :( ) Each manufactured or modular 67.84 2
/ 1 b dwelling,service and/or feeder
Email: Cpt3�zQ:to h6,Af eCOl'gVISSUNk COM Reconnect only 67.84 2
CONTRACTOR Iv Pump or irrigation circle 67.84 2
Business name: //wvi2C_ Pc V%SS0N 7--^f c . Sign or outline lighting 67.84 2
J 1� Signal circuit(s)or limited-energy See Page 2 / 2
Address: /d'o_o ,S� Pe,CS�iiN .r1�22� panel,alteration,or extension. Ai
City/State/ZIP: ®® �'Cctn(� O ��a Uo� Each additional inspection over allowable in any of the above
Y /Qt Additional inspection(1 hr min) 66.25/hr
Phone:(s'3)sy2--3w2d I Fax:( ) Investigation(1 hr min) 90.00/hr
�} / -� r Industrial plant(1 hr min) 78.18/hr
Email: �eD IQR,-te hoA ter-ec.c 1/i s-sr1 , C.-ti M Inspections for which no fee is
/ specifically listed(Yz hr min) 90.00/hr
CCB Lic.///2 I Electrical Li .:a� a czii Suprv.Lic.:6j v p ZED'
ELECTR)(CAL;1PRRMIT;FEES
Suprv.Electrician signature,required: A Subtotal:
Print name:-`M O,iVt,rSDN Date:a2-Iy 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: E 2— TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Q Date: `/y' days after it has been accepted as complete.
/Q/aN !���tQZr 02 * Number of inspections allowed per permit.
l:\Building\Permits\ELC_PennitApp_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 ne a Qty. eaen Total
Renewable electrical energy systems:
Check Type of Work Involved: s kva or less 100 70 2
5.01 to 15 kva 133.56 2
n Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
n B• urglar 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
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
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
nO• ther: Each additional inspection is
charged at an hourly(1 hr min) 6625/hr 1
Inspections for which no fee is 90.00/hr
specifically listed(%hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Subtotal(Enter on Page 1):
$75,00
Fee for each commercial system: * Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
n Audio and Stereo Systems
n Boiler Controls
❑ Clock Systems
ri D• ata Telecommunication Installation
❑ Fire Alarm Installation
HVAC
n Instrumentation
n Intercom and Paging Systems
ri L• andscape Irrigation Control*
❑ M• edical
n Nurse Calls
❑ Outdoor Landscape Lighting*
n Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
1\Building\Permits\ELCPermitAppELR_ERE.doc Rev 06/17/2015