Permit (2) ., CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
' 4 . COMMUNITY DEVELOPMENT Permit#: ELR2020-00018
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02l18/2020
Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9619 SW WASHINGTON SQUARE RD M06
Project: Pottery Barn Subdivision: None Lot: None
Project Description: Low voltage wiring and T-stats.
Contractor: AMERICAN HEATING INC Owner: PPR WASHINGTON SQUARE LLC
5035 SE 24TH AVE PO BOX 847
PORTLAND, OR 97202-4765 CARLSBAD, CA 92018
PHONE: 503-239-4600 PHONE:
FAX: 503-239-7038
FEES
Description Date Amount
Specifics: Restricted Energy Permit 02/14/2020 $75.00
12%State Surcharge-Electrical 02/14/2020 $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 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 ma .obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: tom. Permittee Signature: ` C�1��[�/ IJIC_J �l
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.
Inspections Required for Permit No.: t i 020.20 0 00/g
IVR Code Type Permit Description IVR Code Type Permit Description
01 BUP Building—structural 07 SIT Site Work
02 ELC Electrical 08 SWR Sewer Connection _
03 ELR Restricted Energy 09 FPS Fire Protection _
04 MEC Mechanical 10 RER Re-Roof
05 MST Master—residential combination I CMS Commercial Manufact. Structure
06 PLM Plumbing 12 SFM Single-Family Manufact. Structure
I Req'd Code Inspection Description I Req'd Code Inspection Description
Building(structural) Inspections Electrical Inspections
205 Footing 105 Underground/slab cover
210 Foundation walls 110 Temporary electrical service
215 Footing drain 115 Electrical service
220 Slab 120 Electrical rough-in
225 Post/beam structural 125 Wall cover
230 Underfloor insulation 130 Ceiling cover
240 Exterior shearwall 135 Low voltage rough-in
242 Interior shearwall 140 Sign installation
245 Firewall 145 A/C or heating unit circuit
250 Roof nailing 150 Hot tub/spa/pool
255 Wtr proofing basement walls 195 Misc.inspection
260 Tilt-up panel 198 Low voltage final
265 Masonry 199 Electrical final
270 Reinforcing steel(rebar)
275 Framing Mechanical Inspections
280 Insulation 605 Post/beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough-in
289 Approach/sidewalk 620 Hydronic piping
295 Misc. inspection 625 Duct work
299 Final inspection 630 Fire damper
635 Smoke detector shutdown
Fire Protection System Inspections 640 Exhaust hood
901 Sprinler supply lines 645 Grease duct test
905 Sprinkler underfloor/slab 695 Misc.inspection
906 Flush test 699 Mechanical final
907 Sprinkler hydro test
910 Sprinkler rough-in/test Plumbing Inspections
915 Fire alarm rough-in 305 Plumbing underslab
920 Suppression trip test 310 Crawl drain
995 Misc. inspection 312 Backwater valve
998 Mann final 315 Post/beam plumbing
999 Sprinkler final 320 Plumbing rough-in
322 Shower pan
Site Work Inspections 330 Water service
405 Excavation 335 Rain drain
410 Fill 340 Storm sewer
415 Grading 345 Culvert/catch basin
495 Misc Inspection 350 Septic tank
499 Final Inspection 395 Misc.inspection
399 Plumbing final
Sanity Sewer Inspections
505 Sanitary sewer
Erosion Control Inspections 585 Misc. inspection
750 Initial erosion control 599 Final inspection
752 LIDA on-site facility inspection
755 Regular erosion control Manufactured Structure Inspections
797 Final LIDA inspection 810 MFG-Structure set-up
798 Final erosion control 899 MFG-Structure final
1:\Building\Forms\Inspection Cards\AOP Insp Card By Case\InspCard_A11_03i816.docc
•Electrical Permit Applicati...,-x,.->wL - FOR OFFICE USE ONLY- .
City of Tigard 2p20 Received • .
• 13125 SW Hall Blvd.,Tigard,OR 9722E 4 Plan Review
y /=_ G —. �0 0/�
1 C Phone: 503.718.2439 Fax 503.598.1 6 F -'- eAK. Date/B : Other Permit
.�69Jr1 ..�
T I GAR D Inspection Line: 503.639.4175 .- +.••,= n Date Ready/By: kris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK Pi:AN REVIEW
Please cheek all that apply(subm,t z sets�f plans uccm,checked bclou)
E New construction E Addition/alteration/replacement
0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition ❑ Other: where the available fault current ❑Marinas and boatyards.
°-'"" Q P.y CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less to ground,or exceeds 14,000 0 Commercial-use agricultural
❑ 1-and 2-family dwelling ®Conunerciallindustrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family 0 Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
ID Emergency system. larger separately derived system.
# ! 1 #' a "1 # # ❑Addition of new motor load of 0"A","E","1-2","1-3"
100HP or more, occupancy.
Job no.: Job site address:9619 SW Washington Square Rd
❑Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP:Tigard,OR 97223 Cl Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.:COIA Project name:Pottery Barn 0 Service or feeder 600 amps or more.
Cross street/directions to job site: Description Qty. Fen Total
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4
Tax map/parcel no.: Ea.add'1500 sq.ft.or portion 33.92 1
Limited energ
y,residential
i i ii ii i,e ,..-,�,,, _.-, - 75.00 2
DSCRIP'I t (with above sq.ft.)
' ' ' "' Limited energy,multi-family
low voltage wiring and T-stats residential(with above sq fi) 75.00 2
Renewable Energy ❑`.See Page:2
Services or feeders installation,alteration,and/or relocation
Q !' TY OWNER � L - -TTANT_ , 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
Address: 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation,alteration,and/or
Phone:( ) Fax:( ) relocation
200 amps or less 59.36 1
Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168s4 2
Owner signature: _ Date: Branch circuits—new,alteration,or extension,per panel
® CON'Fx1CI tERSONI A.Fee for branch circuits with- - - above service or feeder fee, 7.42 2
Business name:American Heating Inc. each branch circuit
B.Fee for branch circuits without
Contact name:Amanda Bostic service or feeder fee,first 56.18 2
branch circuit
Address:5035 SE 24'Ave. Each add'I branch circuit 7.42 2
City/State/ZIP:Portland,OR.,97202 Miscellaneous(service or feeder not included)
Each manufactured or modular
Phone:(503)239-4600 Fax: :(503)239-7038 dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
E-mail:a.bostic@americanheating.net Pump or irrigation circle 67.84 2
f "- t.:a : . Sign or outline lighting 67.84 2
Business name:American Heating Inc. Signal circuit(s)or limited-energy 1 See 1
panel,alteration,or extension. Page 2 2
Address:Amanda Bostic Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
City/State/ZIP:Portland,OR.,97202 Investigation(1 hr min) 66 25/hr
Phone:(503)2394600 Fax:(503)239-7038 Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 33135 Electrical Lic.: 26993CRE Suprv.Lic.: 2640LEB snecificall listed 'Ahrmin
Suprv.Electrician signature,required r t" . Subtotal:
Print name: T Steve Young Date: 9/17/19 Plan review(25%of permit fee):
///nnnlll �!1 �T��e� State surcharge(12%of permit fee):
Authorized signaturea�4466 CC TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Amanda Bostic Date: 9/17/19 days after it has been accepted as complete.
e Number of inspections allowed per permit.
I:,BuiIding\Peroits'E1.C_PennitApp_ELR ERE.doc Rev 05/21/2013 440-4615T(11/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
� == FED SCtlbT3LE _ 71
Fee for all residential systems combined $75.00 Description en. I Fee I Total ' I
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01to15kva 133.56 2
n Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
ElBurglar Alarm Wind generation systems in excess of 25 kva:
25.01 to 50 kva 301.04 2
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance with 552.26 2
ElHeating,Ventilation and Air Conditioning OAR 918-309-0040)
System* Solar generation systems in excess of 25 kva:
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
charged at an hourly(1 hr min) 66.25!hr 1
Inspections for which no fee is 90.00/hr
s ificall listed %hr min)
MIT
FEES
Fee for each commercial system $75.00 Subtotal
(SEE OAR 918-309-0000) Plan review,if required(25%of permit fee):
State surcharge(12%of permit fee):
Check Type of Work Involved: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
❑ Audio and Stereo Systems days after it has been accepted as complete.
Number of inspections allowed per permit.
❑ 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:
*No licenses are required. Licenses are required
for all other installations
I1BuildisgTernits&ELC_PerndtApp_ELR_ERE.doc Rev 05/21/2013