Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2013 -00064
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/19/2013
Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9759 SW WASHINGTON SQUARE RD D05
Project: The Art of Shaving Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108
Project Description: (1) low voltage for HVAC thermostat wiring
Contractor: SUNLIGHT ELECTRIC INC Owner: PPR WASHINGTON SQUARE LLC
2800 NE 65TH AVE SUITE B PO BOX 847
VANCOUVER, WA 98661 CARLSBAD, CA 92018
PHONE: 360 - 772 -3877 PHONE:
FAX: 360 - 694 -9728
FEES
Description Date Amount
Specifics: Restricted Energy Permit 03/19/2013 $75.00
12% State Surcharge - Electrical 03/19/2013 $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 OA 952-001-0090. You may
�- ay � oobtaiina � copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
(o 2.234 [ 4.. �7/�
Issued By: i� 'lif/)�.C�f ` fT / I Permittee Signature: (/ri - �' PL C P( d
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 App lication F UR ( H.l.1( I.. l tit. (,0,1,)
City of Tigard plicationRECEINrE
D Received
Date/Sy. 1 ( 9 I A
4 ---- 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Painit No.g1.,,tt 2 0 ( 3
a
11 toff-
" Phone: 503.718.2439 Fax: 503.598.191 AR 19 2013 Date/By:
• -) Other Pamit otix) J A -00/ 4'6
Inspection Line: 503.639.4175 Date Ready/fly; .turis) ,, 21 See Page 1 for
Aiti_
Internet: www.tigard-or.gov . Notified/hfabort Ga 0 • Supplemental Information
t .. OF TIGAIM . . . ..
• . .. -,..- .. - :.... . . ... _.'LltPE OF .,.' i ti sl fl n ivisiON. , , ..i ' . . .. : ..... , . . ' - . ' - -:, ...' - :spw,, :' :..::::-...,:
o New construction XAdditionialgri )! Y-4 Miran Please cheek all tine apply (submitl sets of plans wfitems checked beiow):
°Service or feeder 400 amps or more °Betiding over three stories.
0 Demolition 0 Other: .
. where the available &oh current °Marinas and boatyards.
rATw1oRy OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 13 Floating trendless.
less to ground, or exceeds 14,000 Cl Commadal-ose agricultural
0 1- and 2-family dwelling Conunmeialrmdusttial 0 Accessory building farms for all caw installations. buildings.
0 Multi-family 0 Master builder 1 0 Other: 1:IFire purnp. 0 bstallation of 75 KVA or
0 Emergency system. larger separately derived system.
JOB SITE INFORMATION AN) LOCATION IDAddition dam motor load crf 0"A", ir, "1-2", "1-3",
Job no.: • ' I Job site address: 535 ' $ (A) Wa.14111415, LI 100HP or more.
.
0 Six or mere residential units occupancy.
0 Recreational vehicle pada.
City/State/Z1P: 1- 4 - 0 tt. . 3'0 °Heal
6tat-fr- e 12.0(- - th-case facilities. 0 r
0 Hamudrms !amnions. Simply voltage fo more than
600 volts nominaL
Suite/bldg/apt no.: 051 Project name: 1 CI Service er itcder 600 amps or more.
. . FEE SCHEDULE
Cross street/directions to job site: Desert:4ton i Cur, I Fee. I Taal I •
New resIdendal Angle; or muld-Ibmily dwelling unit.
• Includes attached garage. •
Subdivision: ‘ '
'
I Lot no.: 1,000 sq. ft. °rims 168.54 , 4
Ea. addl 500 sq. ft. or portion 33.92 1
Tax map/parcel no.: Limited energy, residential
75.00 2
• . - DESCRIPTION OF WORE„ • ..
. • (with above sq. ft.)
• . •
Limited energy, multi-family
75.00 2
T iii/ PI*. r ; - — 4 V74 C- • residential (with above sq. ft)
Services or feeders installation alteration, and/or relocation
. 200 amps or less 100.70 2
1
0 PROPERTY OWNER • • . I • I ' 0 TENANT ' 201 amps to 400 amps 133.56 2
Name:
ts c _74 le-+ 0 S lelii4L 4 'd It 401 amps to 600 amps
601 amps to 1,000 amps 200.34
301.04 2
2
Address: Over 1,000 amps or volts 552.26 2
• Temporary services or feeders installation, alteration, and/or
City/State/ZIP: • relocation
Phone: ( ) I Fax: ( ; ) 200 amps or leo 59.36 I
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 168.54 2
Branch circuits— new, alteration, or extension, per panel
Owner signature: Date: A. Fee for breach circuits with
0 APPLICANT . I . • .i 0 CONTACT PERSON , above service or feeder fee,
each branch circuit 7.42 2
• .
Business name: B. Fee for branch circuits without
•
• service or feeder fee, firm
Contact name: branch circuit 56.18 2
• Each add'I branch circuit 7.42 2
Address:
Miscellaneous (service or feeder not included)
City/State/ZIP: -
. • Each manufactured or modular
•
dwelling, service and/or feeder
67.84 2
Phone: ( ) I Fax : ( ) ' Reconnect oniy 67.84 2
E-mail: •
. Pump or irrigation circle . 67.84 2
•
• •
• CONTRACTOR ; • . • Signal circnit(a) or limited-energy
• • • Sign or outline lighting 67.84
Business name: % S A • 144 t74 gt a . ..1 , panel, alteration, or extension. Page 2 • '* 2
.5 .2
ti IL Each additional inspection over allowable in any of the above
Address:
2 go a (1 /r/g e 7 4....., 2 _ - 11 . 8 Additional inspecfion (1 hr min) , 6625/ hr •
. Investigation (I br min) 6625/ hr
City/State/ZIP: Vat- tel c o tx tz-e t . . . ' 1.4/4 . %.5) e ? 4 67 Industrial plant (1 hr rnin) •
78.18/ hr
Phone: (36a 5/f— 7:57e I Fax: sCo) s2c..... 966 0 ' Inspections for which no fee is • 90.00/ hr
specifically listed eh br min)
CCB Lie.: /12,c4i,..9 I Electrical Lie.: CZ30 I Suprv. Lic.: / 7 90/ s ! ' . ' ELECTRICAL PERMIT FEES • :
.• - ‘
Supra. Electrician signature, required:21 : i) . „.4e,, t i . Subtotal: 74"
Plan review (259tiof penult 1130 '
Print name:Ch cs " T ......... 1 I Date: 0 , a State surcharge (12% of permit fme) S
.1
Authorized signature. . TOTAL PHRM:IT FEE 81/
, . This permit application expires Ifs permit is not obtained within 180
Print name: Date: days after it has ban accepted as complete.
. • Number of inspections allowed per pennit.
1....." !
1:1EhibitzePerrnits1ELC-PerailiApp. 07/01/10' 440-4615T(11/04/COMAVEB 4 kg C)+9 •
Electrical Permit Application - City of Tigard
Page 2.- Supplemental Information
LIMITED ENERGY PERMIT FEES:
l i € (1, 7t:;' i; i,' � , i " xt Y F" 3I ' ,;, i TIT 7 . �
a»•.:..•+ a ?e 8ifz. �.". �� i���jld! i�.�� a te �. ' tiri � -' „
Fee for all residential systems combined........ $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
n Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
if 10- �f9f -. .ir � :.' S, : r: Iti p ` ... � j i.�:ricd; - ii 4, -y- • •Cf
l l i-' 'd J .� lam/ "F �Irl lt`: � l- s.:..:ti ir• •�i ..
'. ��rn11c"r -se . w: as r.: e:..' 4=;;:. �, �r; s1�a ; %Y`:.:::::``F'x�n�.�!;•. {� i�'�::rw�
Fee for each commercial $75.00
system
(SEE OAR 918 309 - 0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
n Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
p Fire Alarm Installation
HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
n Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1:1Bui1diig1P milalELC- PomilApp.doc 07/01/10
TO: TIGARD
F A FAX NUMBER: (503) 598 -1960
FROM: YEGOR S.
Sunlight Electric Inc. FAX NUMBER: (360) 326 -9660
2800 NE 65th AVE
Suite #B.
DATE: 3/19/2013 3:24 PM
r7 REGARDING: PERMIT APPLICATION
iii
()..........111 PHONE NUMBER FOR FOLLOW -UP:
(360) 518 -7589
COMMENTS:
PLEASE PROCESS PERMIT ASAP.
Fax a copy of the permit to: 360 -326 -9660.
THANK YOU!