Loading...
Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT Permit #: ELR2011 -00144 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/22/2011 Parcel: 2S113AB00500 Jurisdiction: TIGARD Site address: 16083 SW UPPER BOONES FERRY RD 105 Project: Metro Multifamily Housing Association Subdivision: FANNO CREEK ACRE TRACTS Lot: PT 37, F Project Description: HVAC system. Contractor: OREGON HEATING & AIR CONDITIONING Owner: G &S FC LLC PO BOX 241 16083 SW UPPER BOONES FERRY RD, DUNDEE, OR 97115 STE TIGARD, OR 97224 PHONE: 503 - 691 -9699 PHONE: FAX: 503 - 691 -8556 FEES Description Date Amount Specifics: Restricted Energy Permit 06/22/2011 $75.00 12% State Surcharge - Electrical 06/22/2011 $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 • 001 -0090. You may obt -'• - • • • - rul-. = •i ect questions to OUNC by calling 503.7 or 1.800.332.2344. Issued By: «� �� Permittee Signature: 4� � 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:OMCI. ()SE ONLY e . ©/ City of Tigard PECS VE lw 13125 SW Hall $lvd., Tigard, OR 97223 �;;- I ±1, hr her pem,it: ✓ '' . 1 = • Phone: 503.639.4171 Fax: 503.598.1960 : I/ t' I G RD Inspection Line: 503.639,4175 JUN 2 .1 2011 D Ready /By- Z. See Pete 2 for Internet: www.tigard- or.gov Notified/Method : BIMAIII supplemental Information • TYPE OF Wr a . _ ' RD PLAN REVIEW ❑ New construction Addition /alteration "T'" • • :PI VISION Please check all that apply (submit 2 sets of plans w /items checked below) ❑ Service or feeder 400 amps or more ❑ Building over three stones. ❑ Demolition ❑ Other: where the available fault current 9 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less so ground, or exceeds 15,000 ❑ Coinmercial -use agricultural ❑ I- and 2- family dwelling An Commercial /industrial ❑ Accessory building amps for all other installations buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 kVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. n ❑ Addition of new motor load of 9 ` °A ", "E". "1 -2" "1-3" Job no.: / / -01 SY Job site address: / CO Oi 3 ($t..) , A • r trig 100KP or more. occupancy. ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State /ZIP: • © H azard care facilities. ❑ Supply voltage for more than r ❑ Hazardous locations. 600 volts nominal. Suite/bldg./apt. no.: y Project name: (- -i i ❑ Service or feeder' 600 amps or more. FEE SCHEDULE Cross street/direct ens to - job site: Detcriptien 1 co. 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 M 4 Ea. add') 500 so. ft. or portion 33.92 2 Tax map /parcel no.: Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq, ft.) Limited energy, multi - family 75.00 2 1j. s�_•L_ w residential (With above sq. ft.) u r v I L/ T� Services or feeders installation, alteration, and /or relocation • 200 amps or less 100.70 2 ❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2 . 401 amps to 600 amps 200.34 2 Name: _ _ 601 amps to 1,000 amps 301,04 . 2 Address: • Over 1,000 amps or volts 552.26 2 ' City/State/ZIP ' • Temporary services or feeders installation, alteration, and /or relocation Phone: ( ) Fax: ( ) • 200 amps of less 59.36 1 20.1 amps.to 400 amps 8 125.0 2 Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447. 449, 670. and 701. Branch circuits - new, alteration, or extension, per panel . Owner signature: Date: A. Fee for branch circuits with above service or feeder fee 0 APPLICANT 1 0 CONTACT PERSON fee, '7.42 2 ' each branch circuit _ — Business name: / ?_ ._ . _. B. Fee for branch circuits wirhouf lVU4 service or feeder fee, first 56.18 2 Contact name: branch circuit Each add'l branch circuit 7.42 2 Address: „�i C6 Miseeilaneo service or feeder not included) Ci / State /ZIP: �v - Each manufactured or modular 67.84 2 ty dwelling, service and /or feeder _ • Phone: ( ) Fax: ( ) Reconnect only 67.84 2 l f� Pump or irrigation circle 67.84 2 d� / 4E' .!) , ..- .. _ Sign or outline lighting 67.84 2 ' C NTRACrOIt Signal circuit(s) or limited - energy / -'7 Business name: 4 r. _V 14 panel, alteration, or extension. f Page 2 < 5 } 2 Each additional inspection over allowable in any of the above Address: ✓j -} O 7 3 4// Additional inspection (1 hr min) 66.25/ he Investigation (1 hr min) 66.251 hr City /State /ZIP: .e'` Q 7/ L Industrial plant (1 hr min) 78.18 /hr Phone:( 03)U/e) / — '7 &q Fax:603) ' 7d inspections for which no fee is 90.00!hr "`"''��"'������ -���� specifically listed ('VS hr min) CCB ',ie.:Val a L 1 Electrical Lic.:L, d /0 Suprv. Lic-l JJ. ELECTRICAL PERMIT FEES �. Vim- Subtotal; • f Suprv. Electrician signature, required: -- . • Plan review (25% of permit fee): 1 Dat State surcharge (12% of permit fee): 1 Print name: r ^, , 411111 . W r ' TOTAL PERMIT FEE: �� Authorized signature, - ,� • ` i This permit application expires it a permit is not obtnine lain 180 f / days after it has been accepted as complete. Print name: /:. �- �97 1 Date: 6 - . r- 6 ,, • Number of inspections allowed. per permit. I:Suilding \Permite\ELC- Pennitapp.doc 07/01/10 440 - 45157(11 /COMNIBS 60/ TO 30dd 9NIld3H NO93i'i0 9958- t69 -E05 ST:VI ZTOi; /2/99 • Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined $75.00 Check Type of Work Involved: E Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* US eating, • • nation a..d Air •nclitioning stem* • n Vacuum Systems* ❑ Other: - -... .- COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems • ❑ Boiler Controls Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation XHVAC n Instrumentation .n Intercom and Paging Systems H Landscape Irrigation Control* E Medical ❑ Nurse Calls • n Outdoor Landscape Lighting* ❑ Protective Signaling I Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i.18Uildi, _C- PermitApp.dsc 07 /al /IS E0 /Z0 39Vd ONI1d3H NO9a10 9958 -T69 -895 SI :VT TTOZ /7/90