Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
III t;' COMMUNITY DEVELOPMENT Permit #: ELR2011 -00121
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/26/2011
Parcel: 1 S134AA01800
Jurisdiction: Tigard
Site address: 10240 SW NIMBUS AVE L4
Project: Scholls Business Center Subdivision: SCHOLLS BUSINESS CENTER Lot:
Project Description: HVAC system.
Contractor: REITMEIER MECHANICAL Owner: HANSON, RONALD D
19570 SW 90TH CT ROBINSON, CONSTANCE A
TUALATIN, OR 97062 ROBINSON, CHESTER TRUST ET AL
KENNEWICK, WA 99331
PHONE: 503 - 603 -0205 PHONE:
FAX: 503 - 603 -0150
FEES
Description Date Amount
Specifics: Restricted Energy Permit 05/26/2011 $75.00
12% State Surcharge - Electrical 05/26/2011 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: N Fire Alarm: N
HVAC: Y Instrumentation: N
Intercom /Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N 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 c• oft . - • • uestions to OUNC by calling 503.232.1987 or 1.800.332.2344.
r _
Issued By Vii Permittee Signature: 7 " � orlve o
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 ' !'Eew57 permit No.: L (i � 7T' i 0i / -.Y� I �-i
13125 S W Hall Blvd, Tigard, OR 97223 . f
Phone: 503.718.2439 Fax: 503.598.1960 � \ Date /By: Other Permit <QZ
TIGARD Inspection Line: 503.639.4175 ` c . 0 Date Ready /By: Juris. El See Page 2 for
Internet: www.tigard '� �+ O . ottfied/Method: Tr& Supplemental Information
,..,., . a • <., -
PL AN -REVIEW
� ' - L e TYPE�O ;; `'�
New construction •. � � �� -° " Addition /al�te on /r c m � �� , � s � �� , � _< __ `W _ _ ° _k . <i � -sue � ,.��.� , , � �� 3.$3 .t lt, . , ` .: _
❑ ® eet (v Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Demolition ❑ Other: C\* w Service e r re boatyards.
stories.
Demol
,..: > a 1 `* ._i ". . ; ,r ....:.. ...:.:K ace ds 10,000 a
anp fault current 150 vos or ❑ Floating Marinas
buildings.
CATEGORY , O CONSTRUC,TIO
less to ground, or exceeds 14,000 0 Commercial-use agricultural
❑ I- and 2- family dwelling ® Commercial /industrial Ll Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or
r - - , „ ❑ Emergency system larger separately derived system.
JOB S
- 5 ITE�INFORMATI;O , AND ,LOGATION•� " ^ 0 Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: 10240 SW Nimbus Ave. 100141 or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard, OR 97223 ❑ health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: L -4 Project name: Sch gd -L n0 1 . ❑ Service or feeder 600 amps or more.
$ t g s „�E. . SCHEDULE t .;
Cross street/directions to job site: e � Description 1 Qty. i Fee. I Total " I *
�'
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
75.00 2
Low voltage control wiring D
g ES GRIE�TTON WORK' 3 '''4';-:,,',i'.: (weh above ft)
- family 75.00 2
n, -� - ^._ � -. _. � " Limited energy, multi -family
residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 100.70 2
; a-- - "- .; ':iWY. " ", .. 5 &',,
`® ' PROP 'J OWNER „ .Yi'` , '- °,
. eix'•>> .. ®k T ENA ,; ` NT' n• , \ , - - {' "" 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200 34 2
Name: KG Investment Management LLC
601 amps to 1,000 amps 301.04 2
Address: 10240 SW Nimbus Ave. Over 1,000 amps or volts 552.26 2
City/State/ZIP: Portland, OR 97223 Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits — new, alteration, or extension, •er panel
Owner signature: Date: A. Fee for branch circuits with
feeder f
®` APP.LICANT ® -, CONTA CT. PER ANN a% a h b ran c h c or �e fee 7 42 2
.:.: � ..: each branch circus
Business name: Reitmeier Mechanical B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: Matt Rogers branch circuit
Each add'I branch circuit 7.42 2
Address: 19570 SW 90th Court Miscellaneous (service or feeder not included)
City /State /ZIP: Tualatin, OR 97062 Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: (503) 603 - 0205 Fax: : (503) 603 - 0150 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail: matt .rogers @reitmeiermechanical.com Sign or outline lighting 67.84 2
-; > _: :. ', i r . CONTRA
,. -. .-..,: -_ .,a. _ _ ,. . — ,, T_ ., Signal c irc u it( s ) or limited-energy -
f �
Business name: Reitmeier Mechanical panel, alteration, or extension. ( Paget 2
Each additional inspection over allowable in any of the above
Address: 19570 SW 90 Court Additional inspection (1 hr min) 66.25/ hr
City /State /ZIP: Tualatin, OR 97062 Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 603 - 0205 Fax: (503) 603 - 0150 Inspections for which no fee is 90.00 / hr
specifically listed (% hr min)
CCB Lie.: 153770 Electrical Lic.:3t - 86 ( Suprv. Lie.: 11LEB • ;;:: ic,,, ` .. :, ::- E1EGTRICAL_,PERNiiT'. FEE&.; ; 7';;.'<` z;
Suprv. Electrician signature, required: Subtotal: `75"
9
- Plan review (25% of permit fee):
Print name: Jeff Jensen Date: 5/26/11 State surcharge (12% of permit fee): q cif
�� TOTAL PERMIT FEE: ■ Authorized signature: �������� �`
This permit application expires if a permit is not o tamed within 180
r days after it has been accepted as complete.
Print name: Matthew Rogers Date: 5/26/11 * Number of inspections allowed per permit.
I:\Building\Permits\ELC- PermitApp doe 07/01/10 440- 4615T(11 /05 /COM/WEB