Permit (11) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
11111 u
1. COMMUNITY DEVELOPMENT Permit#: ELR2016-00121
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/18/2016
T Ic�r1 .J_f g Parcel: 1S136CD01500
Jurisdiction: Tigard
Site address: 11660 SW PACIFIC HWY
Project: Tigard Bowl Subdivision: None Lot: None
Project Description: CCTV system.
Contractor: HECKTEC TECHNICAL LLC Owner: POWERS PEARL LLC
3484 HILLSIDE CT 11660 SW PACIFIC HWY
HUBBARD, OR 97032 TIGARD, OR 97223
PHONE: 503-572-1938 PHONE:
FAX: 503-982-4823
FEES
Description Date Amount
Specifics: Restricted Energy Permit 05/18/2016 $75.00
12%State Surcharge-Electrical 05/18/2016 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio&Stereo: 0 Boiler Controls: 0
CCTV: 1 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 -I 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, • if work is -uspended for more the 180
days. ATTEN N: egon law requires you to follow the rules adopted by the Oregon Utility Notification Cs• er. Those ules - : set forth in OAR
952-001- 0 through OA 95 - 1-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2 .1987 4,r 1.801 33'.234,
I sued By: /� Permittee Signature: AA, iAtA
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 1.0Roulic I l 1-.ON 1.l
City of Tigard HECEIVED Received
, Ill 13125 SW Hall Blvd.,Tigard,OR 972V,AY 1 8 2016
Ill Date/B : 5- e
Plan Review 7ila rffil •••111fflfil.
Related Permit#:
: I Phone: 503.718.2439 Fax: 503.598.196 Date/B :
Inspection Line: 503.639.4175 Ready Dale By: FENN lid See Page 2 for
I II, \RD CITY OF TIGARD -
Internet: www.tigard-or.gov Notified/Method: Supplemental information
, TypE gitakiNG DIVISION . PLAN REVIEW -
El New construction ,E3 Addition/alteration/replace ent Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition gi Other: .., C itki-1 it".e.-S" where the available fault current 0 Marinas and boatyards.
CATEOORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
. , , ,
0 1-and 2-family dwelling IRCommercial/industrial 0 Accessory building less to ground,or exceeds 14.000 0 Commercial-use agricultural
amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or ,
JOB SITE INFORMATION AND-LOCATION 4 A 0 Emergency system, larger separately derived
,
0 Addition of new motor load of system.
Job#: Job site address: / („605,1 rcAc.A.v.t\ tivi c 100HP or more.
1
City/State/ZIP:
/ liQr-ci 0
0 Health-care facilities..Six or more residential units.
occupancy.
0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: t A ck, i 0 Hazardous locations. 0 Supply voltage for more than
Cross street/directions to job site: r 0 Service or feeder 600 amps or more. 600 volts nominal.
FEE SCHEDULE
Description I Qty. I Each I Total I *
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.ft or less 168.54 , 4
Tax map/parcel#:
Ea.addi 500 sq.ft or portion 33.92
DESCRIPTION OF WORK Limited energy,residential .
75.00 2
e.:
(with above sq.fl.)(7 ,7). ?lc,"-i Limited energy,multi-family
75.00 2
residential(v,ith above sq.ft.)
Renewable Energy 0 See Page 2
0 PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less . 100.70 7
Address: 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 , 2
Owner signature: Date: 401 amps to 599 amps 168.54 7
Branch circuits-new,alteration,or extension,per panel
0 APPLICANT 0 CONTACT PERSON
A.Fee for branch circuits with
Business
-
Business name: (-ter I e Av\.,cc,. 1
above service or feeder fee,
each branch circuit 7.42 7
Contact name: B.Fee for branch circuits without
eb Ulte^ ftcf.- , service or feeder fee,first
Address: C 6 cl Cc bw.iiitc.. 1,--)) branch circuit 56.18 2
cisk-- 7 2(.23 Each add*1 branch circuit 7.42
Miscellaneous(service or feeder not included) I
City/State/ZIP:
Phone: (5b3) 5t-7.z. , 41.1 I Fax: :( ) Each manufactured or modular
67.84 2
dwelling,service and/or feeder
Email: live.c1(.-ttQYASif\.. cbtAr. Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: /42K. "Thri\IN\C-Ck t Sign or outline lighting 67.84 7
Signal circuit(s)or limited-energy
Address: ei \\ panel,alteration,or extension. 0 See Page 2 k 2
Each additional inspection over allowable in any of the above
City/State/ZIP:
Additional inspection(1 hr min) 66.25/hr
Phone:( ) Fax:( ) Investigation(1 hr min) 90.00/hr
Email: Industrial plant(1 hr mm ) 78.18/hr
Inspections for which no fee is
90.00/hr
CCB Lie.: /67.3iii Electrical Lie
Print name: .Ifir6 L S prv. Lic.: specifically listed(1/2 hr min)
ELECTRICAL PERMIT'FEES
4
Suprv. Electrician *gnature,required: Subtotal:
I
1
NJ.%)1\ kt-C- Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
TOTAL PERMIT FEE: f8V.aC)
Authorized signat .
Print name: ,----
Z"-- DateS/6,-/( .. This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
* Number of inspections allowed per permit.
1 I.Building Permits PLC ermitApp Flit.ER do Res 06 17 2515 440-461 T(I I 05 COM WEB
,
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RE l TL4I 1W ONLY:
FEE Qty. ,
Description r Each Total 1
Fee fo all residential systems combined: $75.00 Renewable electrical energy systems:
h t• t Involved:
5 kva or less ]00.70 2
Check Ty f Work
5.01 to 15 kva 133.56 2
n Audio and : eo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 ksa 301.04 2
50.01 to 100 kva 552.26 2
❑ Garage Door sener* >100 kva(fee in accordance 552.26 2
❑ _ with OAR 918-309-0040)
Heatin! entilation and Air Conditioni Solar generation systems in excess of 25 kva:
Sys y *
Each additional kva over 25 7.42 3
❑ acuum Systems* >100 kva-no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
Other: CLaV, 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 CA hr min)
COMMERCIAL'rWORK ONLY: ELec CAL RMrT lis'
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
* Number of inspections allowed per penult.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
n Audio and Stereo Systems
❑ Boiler Controls
n Clock Systems
ri D• ata Telecommunication Installation
Ti F• ire Alarm Installation
n HVAC
❑ Instrumentation
Ti Intercom and Paging Systems
Ti Landscape Irrigation Control*
Ti Medical
n Nurse Calls
n Outdoor Landscape Lighting*
❑ Protective Signaling
Other: CC--Tilr
Total number of commercial systems: t.
*No licenses are required. Licenses are required for all
other installations
1:Building Permits II.0 PermitApp ELR_ERt dos Res 06 17 2015
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11660 SW PACIFIC HWY, TIGARD, OR, 97223
Commercial - Electrical Limited Energy
198 Low voltage final
PASS - No C of O
ELR2016-00121
Jeff Grove
Violation Summary:
Inspector Contractor