Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
11111 — "
1 ' COMMUNITY DEVELOPMENT Permit#: ELR2015-00198
T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/28/2015
Parcel: 1 S126DC03300
Jurisdiction: Tigard
Site address: 9900 SW GREENBURG RD
Project: Columbia Business Center Subdivision: LEHMANN ACRE TRACT Lot: 4-5
Project Description: Low voltage for HVAC
Contractor: HUNTER DAVISSON INC Owner: ATHERTON REALTY PARTNERSHIP
1800 SE PERSHING ST 2100 S WOLF
PORTLAND,OR 97202 DES PLAINES, IL 60018
PHONE: 503-542-3628 PHONE:
FAX: 503-542-3654
FEES
Description Date Amount
Specifics: Restricted Energy Permit 09/28/2015 $75.00
12%State Surcharge-Electrical 09/28/2015 $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: 0 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 $84.00
Other Desc: Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. AT ON: Orego aw re• 'res you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-00 010 through OAR 952-•• •'90. •u may obtain a copy of the rules or direct questions to OUNC by callin•W'21987 or 1.800.332.2344.
I ued By: Permittee • ' o✓.dwitiMi
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale,lease or rent.
OWNER'S SIGNATURE: Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Electrical Permit Application FOR OFFICE USE.ONLN
City of Tigard Received .9. c /s , • Permit No.: et
1,42...94----en( q
114 • 13125 SW Hall Blvd., OR 97223 Plan
Review
.,Tigard,
: 4 Phone: 503.718.2439 Fax: 503.598.1960
11 Date/13y: 0
niten3Reiew
yv:
Other Permit: •
TIGARD Inspection Line: 503.639.4175 Date Ready/By: Luria &I See Page 2 for
Internet: www.tigard-.or.gov Notified/Method: Supplemental Information
tvi4C.6ii780-ifik:'..•-; i.:: •:.• :•:,E.:'.':.--,-.-'1 H,;,--5-MaRK:Warpg4144/10VVAI-raiiiM$ago005,-q.
D New construction Addition/alteration/replacement
Please check all that apply(submit 2 sets of plans w/items checked below):
IA
0 Service or feeder 400 amps or more El Building over three stories.
D Demolition D Other: where the available fault current 13 Marinas and boatyards.
...,,,_
(..!VIEGORy OF CONS exceeds 10,000 amps at 150 volts or El Floating buildings.
, FRIA I ION. , . . •
less to ground,or exceeds 14,000 El Commercial-use agricultural
0 1-and 2-family dwelling RI Comm.,cial/industrial r]Accessory building amps for all other installations. buildings.
D Multi-family 0 Master builder []()IIIL-r. 0 Fire pump. 0 Installation of 150 KVA or
-........,5,,moc6,,iw,,Av,s 0 Emergency system. larger separately derived system.
;:...._• ' :.',r':. •r:''''‘1()111 A ‘.1, .,, •,„,., !t„..,..41,t M.144,..,9cf:.,....;f..,PP' ,i*AMPS:,,Atalit* El Addition of new motor load of 0"A","13""1-2""1-3",
100HP or more. occupancy.
Job no.: 1 62.0 6 1 Job site address: oigt 0 0 SW Gr Inur id
.r...e." 3 0 Six or mom residential units. El Recreational vehicle parks.
City/State/ZIP: izi El Fktli El
al -cato facilities. . Supply voltage for more than
1 i y„r i OIL CI-4-1.1:73 0 Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: ID Service or feeder 600 amps or more
Project name: COVoli eon,nct4 ctrAyt, &Tv _ „,, ...., : ..,....:...,•:-.-..,,4-,,,..,-,..:•• •.•,,, -,-.•-:.J ,•-••,....y: ,tr
7,..tig:VV:•:'''..'''''.'".' ' ..;:041.010.AVOMPAF•00)**4
Cross street/directions to job site: i• DI)C f '11 .. Deseriptioa I Qty. l Fee, 1 . 'Total— f "
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'l 500 sq.ft.or portion 33.92 I
Tax map/parcel no.:
Limited energy,residential
75.00 2
MEW,:4C:411,:-'..;:4=INFat No 1.7'"t-ilirlif,i7 IMIT'i;Iii:,,ANNIsilit'Afirektg,4§; (with above act"')
' — ' — Limited energy,multi-family
75,00 2
residential(with above sq.ft.)
D vstorog.4 o,"4. reftwz 0(J Con hi,1, (....41,. o p 3 moLd vt,s i,,y)
-;,Reifeiviiwuritegy.:,,,f,,v.: :.3:.,:.:,,,:4;:::i ;.,t1,,,,,s-:00!iiko:2,::.:..••,. . .:.
Services or feeders installation,alteration,and/or relocation
200 n or less
100.70 2 •
,.,1.,,,v,d"AZ.1.6•1.- ',1--,.if't, ,...,..-:',',':',^. . .'e.lInhAlt.rol .:" 4-S.4.. ::*-5.:,:,,.i*',0',,,*.t, ',•:,,,,:,,,A.,:■'..:.,:'.%;:'?.,').:":N'.-.=4-.Mc-,,i,
201 amps to 400 amps 133.56 2
Name: LI' rat,v. j mevc1 Li
401 amps to 600 amps 200.34 2
Address: zoo sy,4 m.14_ 601 amps to 1,000 amps 301.04 2 si, stus,e, Ina
Over 1,000 amps or volts 552.26 2
City/State/ZIP: pa r I.1,4 a 0 P. 9,1101 Temporary services or feeders installation,alteration,and/or
Phone:(603) evil.. 1-124 I Fax:( ) relocation
200 amps or less 59.36 1
Owner installation:This installation is being made on properly 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
Owner signature: Date: Branch circuits-new,alteration,or extension, er panel
F.,,g1,s-P,Rtt_if011tin,a,II,..';',T44.;•0111;a11.14610.:8Xilartrarldiftiktii,r0Wie A.Fee for branch circuits with .
,yeAR,F,Awi.,,,,,,,0 „...-no.,,,=,- -,, ..,..-,144. 3.,,-,4?..:,$hal§.v.:;::;NA'04:-....w:;,:e ..-.,,,•.-,T-r..,.- --w...........:,,go...,..,R,,,14.,,st above service or feeder fee,
742 2
each branch circuit
Business name: 14, 0„6„...t)0.4.,,son4 t,4
B.Fee for branch circuits without
service or feeder fee,first
Contact name: puma 4,.,,, ,A,
branch circuit 56.18 2
•
Address: Igoo se 1' l, S4-
•e" on Each add'l branch circuit _ 7.42 2
Miscellaneous(service or feeder not included)
City/State/ZIP: tar4.ka, I Ur....e otTurt.
Each manufactured or modular
lie't i 67.84 2
Phone.(r.An ) 91.1..5‘oct I Fax::( ) dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail: ak,,,,,,,,Ave. kw, . 710.1ops,....c.,."11., Pump or irrigation circle 67.84 2
4.101MMAIPOSAWNSO 7.:4.*-....' 4kiraigaMingingnikali Sign or outline lighting 67.84 2
Business name: on-1e- p...MSc's%, trsc.. panel,alteration,or extension. ,X, Page 2 7.‘-ct6) 1
2 i
Address: 1400 66 Perirt Si" Each additional inspection overaBowable in any of the above
Additional inspection(1 hr min) 66.25/hr
CitY/State/ZTP: ro a,.IA I
'peso Og citlIO
t Investigation(1 hr min) 66.25/hr
Phone:(sp.&) sm.t_16/1 ct TFax:( ) 1.11 Industrial plant(1 hr mln) 78.18/hr
i , ,1 L4/ /0,1 1 Inspections for which no fee is
90.00/hr
CCB Lic.: 1(a rt. Electrical Lie.:A-1/V041--Suprv.Lie.: 11-713 L,,,3 specifically listed 05 hr min)
italOgfaff$.001104U*000'40;$:.: :''.,.''...,--...-,,..•;:i.'
Suprv.Electrician signature,requiret-7: ....x.... 9c „Va--- '-a7...„,-.be
Subtotal:
' -... —_
, .----. Plan review(25%of permit fee):
Print name:----tri -...., e.\., I ate:
r" . V(. ....fta . 't- .--1 State surcharge(12%of permit fee): ci.6'a
Authorized signature: TOTAL PERMIT FEE: q 4/. 00
This permit application expires if a permit is not obtained within 180
Print name: I Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
IABuilding\Pennits\ELC_PennitApp_ELR 13RE.doc Rev 05(2112013 440-4615T01/05/COIWWEB
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Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
, ESIDEIITTAL WORK ONLY Fk's...!tl a,rL) ..H. a . ..F;*
Fee for all residential systems combined ... $75.00 Deurtptlon I Qty. I Fee I T ^otsl I ..
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 to25 kva 200.34 2
Wind generation systems in excess of 25 kva: _
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance with 552.26 2
OAR 918-309-0040)
❑ Heating,Ventilation and Air Conditioning
Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
❑ 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 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed('A hr mm)
[.COVIMJRVAX L 07WO M.Y.`.I.4 #:3 .`rz i�..w,.s X 51 ?i of ;-i; .,.Y.'!ogg , ICAL JrA.'/R1YAlYjL Es.,.#. .a ,
Fee for each commercial system $75.00 Subtotal:
(SEE OAR 918-309-0000) Plan review,if required(25%of permit fee):
State surcharge(12%of permit fee):
Check Type of Work Involved: TOTAL PERMIT
This permit application expires if a permit is not obtained within 180
❑ Audio and Stereo Systems days after it has been accepted as complete.
Number of inspections allowed per permit.
❑ Boiler Controls
•
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
tRj HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
\BuildingW ermitslELC_PomdtApp_ELR_ERE.doe Rev.05/21/2013