Loading...
Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT �1 COMMUNITY DEVELOPMENT Permit #: ELR2011 -00151 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/28/2011 Parcel: 1 S 126CA00100 Jurisdiction: Tigard Site address: 9225 SW HALL BLVD F Project: Ideal Image Subdivision: FAIRVIEW PLACE CONDO Lot: 20 Project Description: HVAC system. Contractor: OREGON HEATING & AIR CONDITIONING Owner: GREENBURG CORNERS LLC PO BOX 241 BY MENASHE, R BARRY DUNDEE, OR 97115 621 SW ALDER, SUITE 605 PORTLAND, OR 97205 PHONE: 503 - 691 -9699 PHONE: FAX: 503 - 691 -8556 FEES Description Date Amount Specifics: Restricted Energy Permit 06/28/2011 $75.00 12% State Surcharge - Electrical 06/28/2011 $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 9 - 001 -0090. You may obtain a co• of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. _ .. Issued By: /_ , tr!' , ice ! _ 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. RECEIVED Electrical Permit Application FOR C FI E USE ONLY City g of Tigard JUN 2 8 2011 Receive Date/n 011 d IN " . 13125 SW I-lall Blvd., Tigard, OR 97223 GA� Plan Review Phone: 503.639.4171 Fax: 503.598.19 ®i l >< OF ta n Rev O ther Permit: /�> G 4, / U OAP D Inspection Line: 503.639.4175 BUILDING DIVISIO , Date Ready /By: See pe • • 2 for Internet www.tigard- or.gov Notified/Method: �, Supplemental information TYPE OF WORK El New construction 14•4 Addition /alteration /replacement Please check all that apply (submit 2 sets of plans wlitems checked below): ❑ Service or feeder 400 amps or more • 0 Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. tee. to groond, or eareedc 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling A •mmercial /industrial ❑ Accessory building amps for all other installations. buildings, ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or ❑ Emergency system larger separately derived system. JOB Si'CI IhIEORM #TION AND LOCATION ❑ Addition of new motor load of p "A• "E", "14" "1 -3" I' I001dp or more. occupancy. Job no -: 11-- b Job site address; 'r - ❑ $i or more residential units." © Recreational ve7iisle parks. + d ❑ Health-care facilities, ❑ Supply voltage for more than r "! : -1 /A•r ❑ Hezlydous locations. 600 volts nominal. J Suite/bldg. /apt. no - 1` Project name: .4.M.WILIMINI ❑ Service or feeder 600 amps or more. PEE SCHEDULE Cross street/directions to job site: vest ri• non IIL •Y''M=MMI © New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no,: 1,000 sq. h. or less MI 168.54 gl Ea. add'I 500 sq. ft, Or portion 33.92 EMIR Tax map /parcel no.: Limited energy, residential MN DESCRIPTION OF WORK with above s.. ft. 75.00 Limited energy, multi- family 75.00 II residential with above sq. ft.) I.. , :. a. Services or feeders installation, alteration, and /or relocation 200 amps or loss M. 100. MIME El PROPERTY OVNNRR ❑ TENANT 201 amps to 400 amps 11.1 1 33.56 MIME . 401 amps to 600 amps MI 200.34 . El Name: 601,amps to 1,000 amps MI 301.04 . B Address: • • Over 1,000 amps or volts • Temporary services or feeders installation, � alteration, . City /State /ZIP: relocation Phone: ( ) Fax: ( ) • 200 amps or less El 59,36 �a 20.1 amps to 400 amps 125.08 . Owner installation: This installation is being made on property that I own which is not 4 amps to 599 amps 16864 MENU intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. grsuch circuits — re v, alteration, or extension, .er i snail Owner signature: - Date: A. Fee for branch circuits with .w CONTACT PERSON above service or feeder ft e, ■ 7.42 MI ID APPLICANT each branch circuit B. Fee or branch circuits without Business name: IL: 0 ca M 0 W 4 service or feeder fee, first 56.1 e all COritact name branch circuit • 1_ INII=011 U Address: , • i Miscellaneous (service or feeder not included) Each manufactured or modular 1.I City /State /ZIP: dwellin • service and/or feeder • Phone: ( ) Reconnect only 1.11 67.84 � Pump or irrigation circle 13 umsfirf• l.Q 1 • / . Sign or outline lighting IMI 67.84 ME© CO • CTOIt Signal circuit(s) Or limited - energy panel alteration, or extension. In Pace 2 _ Business name: 0 / i f • A / / 1 e 4 Each additional ins i ec#ion over allowable in an of the above Address: (J-I� 4 Addition5l inspection (I hr min) 66.25/ hr MEI `,F' � � �+ 66.25 / hr City /State /ZIP: I r r 7 ii s— hr min) 78.18/hr III Phone: ! g1---gk " Fax: 563) te, 117,- Inspections for which no fee is 90.00 / br II .. . a. cificafv listed h hr min) CCB Lic.: - a(,2 Electrical Lic. :L _ . 140 Suprv. Lic.:) 11 Subtotal; Suprv. Electrician signature, required: i• Plan review (25% of permit fee): Oats; State surcharge (12% of permit fee): r i • • • / TOTAL PERMIT FEE: 4 11121 / 2211 Authorized signature: ,, / Phis permit application expires if a permit is not obtained =bin 180 /� ' „, 1 / 1.' days after it has been accepted as complete. 1 / • / r Date: / " Number of inspections allowed. per permit. l:\Buildingtermir4 LC- PerreitApp.900 07/01/10 440.4615T(11 /05 /COM /WEa E0 /T0 3Sdd ONIId3H NOJ3ZIO 9598— T69 —£09 T9 :60 TTOZ /LZ /90 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: • Pee for all residential systems combined........ $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* n Burglar Alarm ❑ Garage Door Opener* Eng, Ventilatiota and Air Conditioning System* • ❑ acuum 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 j Boiler Controls • ❑ Clock Systems ❑ Data Telecommunication Installation Li Fire Al. allation E AC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: f *No licenses are required. Licenses are required for all other installations 1 Building \Pefmita\ELC- PermitApp.doe 07/01/10 80 /Z0 39 d ENIPO3H N09380 9998 -169 -605 T9 :60 TTOZ /LZ /90