Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
1111 COMMUNITY DEVELOPMENT Permit#: ELR2020-00001
Date Issued: 01/02/2020
T lc;±1 H fJ 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S135A601003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 308
Project: Variant Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Limited energy for HVAC for TI.
Contractor: HUNTER DAVISSON INC Owner: LINCOLN CENTER LLC
1800 SE PERSHING ST BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97202 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 503-542-3628 PHONE: 503-412-4844
FAX: 503-542-3654
FEES
Description Date Amount
Specifics: Restricted Energy Permit 01/02/2020 $75.00
12%State Surcharge-Electrical 01/02/2020 $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 p it 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 quires you to f How th rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952- 1 090. u may t in a c of the es or direct questions to OUNC by calling 503.23 987 or 1.800 .2344.
a ®
Issued By: / / V Permittee Signature: 2 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 503.639.4176 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 Received ��j ..
,� DateB : �r�'W. ... ',_ `,10 00
■ 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review �`
■ Phone: 503.718.2439 Fax: 503.198.1960 Date/B : e-eVio --06
1'1GAAD Inspection Line: 503.639.4175 Ready Date/By: to see Page 2 for
e Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑New construction J 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.
ElDemolition Other:
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑ 1-and 2-family dwelling ' Commercial/industrial El building less to ground,or exceeds 14,000 0commercial-use agricultural
�j
amps for all other installations. buildings.
❑Multi-family
0 Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: /1''6 i Job site address: /O2S p SKI G f p 1/ Q I ❑Addition of new motor load of system.
QR.1'r��{ /CC/ IOOFIP or more. ❑••A, •'E•• •'I_2" "1_3"
City/State/ZIP: 7 arc/ aR 97da J ❑Six or more residential units. occupancy.
t ❑Health-care facilities.
❑Recreational vehicle parks.
Q �� / ❑Hazardous locations. 0 Supply voltage for more than
Sul ldg.lapt.#: 6a7 Project name: L/nJ Gu�nl BlA/r iN 600 volts nominaL
❑Service or feeder 600 amps or more.
Cross street/directions to job site: FEE SCHEDULE
Description I OtY. I Each I Total I *
New residential single-or multi-family dwelling unit.
Subdivision: 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 I
DESCRIPTION OF WORK Limited energy,
t. residential 75.00 2
/e D Q�O CC -1 flt Q,c/U p S 1y,tS /-,0
O r-�f GC oMmo//nt - (with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
T.7,
Renewable Energy ❑ See Page 2
1I PROPERTY OWNER 0 TENANT g
-1. -} Services or feeders installation,alteration,and/or relocation
Name: C�o ,) de
in CS2/!/ ./JSt-L.Vi//o.N _/�-• 200 amps or less 100.70 2
Address: ,Q.O 9 is Sr^/ /oS t R Ave, / 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 7-(.401.let I'i N o , -26,4 a 601 amps to 1,000 amps 301.04 2
Phone:(_cp?) ' ' >- o2vZ 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
fa
APPLICANT ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: gtdi.ij - ,,Pc.,,V/SS() S/.I L, above service or feeder fee, 7.42 2
i each branch circuit
Contact name: Ey�N '/ c '/ ' B.Fee for branch circuits without
service or feeder fee,first
Address: ,S}- S , C 56.18 2
� G 2T' N .� /f✓Z� branch circuit
City/State/ZIP: fOS c OR 97 Each add'I branch circuit 7.42 2
Phone:(spa )Sy ���� Fax::( ) Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
CP J�•e� / dwelling,service and/or feeder
Email:
/ LNetd�QU� ISSa,J ,.--„A.,,‘ Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: �,1^,e S 4�L JQ A Sign or outline lighting 67.84 2
I Signal circuit(s)or limited-energy
Address: panel,alteration,or extension. / ee Page 2 2
City/State/ZIP: Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:( ) Fax:( ) Investigation(I hr min) 90.00/hr
Email: Industrial plant(I hr min) 78.18/hr
/ Inspections for which no fee is 90.00/hr
/O CCB Lic.: i ,2 Electrical Lie.:, 6/" Suprv.Lie.:6®0 LEA specifically listed('/,hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name: U l M Yq llfss Date: /a-/e7-/9 0 Plan Review Required(25%of permit fee):
6 State surcharge(12%of permit fee):
Authorized signature: I /I/4/
TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within IRO
Print name: 40,,.) t i Date: 42- r%2-J 9 days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:1Building\Permits\ELC_PernitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/OSICOM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Description I Qty. I Each I Total
Fee for all residential systems combined: $75.00 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:
El Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
El Garage Door Opener* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
El Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
El 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
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(Yx hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
SubtoFee for each commercials stem: $75.00 allowed l
permnter t.o Page 1):
y ' Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
n Boiler Controls
n C• lock Systems
❑ Data Telecommunication Installation
n F• ire Alarm Installation
HVAC
❑ Instrumentation
El Intercom and Paging Systems
❑ Landscape Irrigation Control*
n M• edical
❑ Nurse Calls
El Outdoor Landscape Lighting*
n Protective Signaling
❑ Other:
Total number of commercial systems: /
*No licenses are required. Licenses are required for all
other installations
l:\BuiIding\Permits1ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015