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Permit (51) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT SII.. COMMUNITY DEVELOPMENT Permit#: ELR2016 00119 T(CS A R.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/16/2016 Parcel: 1 S 1260000300 Jurisdiction: Tigard Site address: 9516 SW WASHINGTON SQUARE RD H05 Project: Ben Bridge Jewelers Subdivision: None Lot: None Project Description: Audio and stereo system. Contractor: MUZAK LLC Owner: PPR WASHINGTON SQUARE LLC 3318 LAKEMONT BLVD PO BOX 847 FOURT MILL, SC 29708 CARLSBAD, CA 92018 PHONE: 803-554-2594 PHONE: FAX: 503-252-1109 FEES Description Date Amount Specifics: Restricted Energy Permit 05/16/2016 $75.00 12%State Surcharge-Electrical 05/16/2016 $9.00 Type of Use: COM Class of Work: ALT Total Number of Systems: 1 Audio&Stereo: 1 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. 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 952-001-0090. Yo .• ••rrules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. r Issued By: 49-1-10214,06-- -tPermittee Signature: �. '-'t 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 City Application /� Q �y •J o f Tigard jr C1X1Date/Byct/�Q IIP Permit#: +001/Lf 114 4 13125 SW Hall Blvd.,Tigard,OR 97223 fJPlan Review ■ Phone: 503.718.2439 Fax: 503.598.1960Date/By: Related Permit#: Inspection Line: 503.639.4175 1 a 2016 Ready Date/By: Juris. 0 See Page 2 for 1 i .,A R D Internet: www.tigard-or.gov op 1 u (� ''Notified/Method: 7 Supplemental Information +` TYPE OF WORK e "�'�O'1+11,�MjI'( PLAN REVIEW ❑New construction ®Addition/alteration/replaCCt leenr ��1� tn Please check all that apply(submit 2 sets of plans w/ites checked): IL r'�1 i 1S El Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition ❑Other: � where the available fault current 0 Marinas and boatyards. , ' Ry.. C+N4"litV 'ON ,.'< - exceeds 10,000 amps at 150 volts or 0 Floating buildings. ❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or JOR SITEINFQRMA AND LOCATION . ❑Emergency system. larger separately derived ❑Addition Job#: 1 Job site addreSQ RD IO0HP W WASHINGTON Hof new motor load of system. or more. ❑"A","E","1-2","1-3", City/State/ZIP:TIGARD OREGON 97223 0 Six or more residential units, occupancy. 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Q 5 1 Project name:BEN BRIDGE JEWELERS 0 Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: t,,4,76.e MP,'ii FEE SIE: ISLE Description I Qty. i Each I Total I " New residential single-or multi-family dwelling unit. Subdivision: I Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1 DES flON O=,WDBK Limited energy,residential LOW VOLTAGE SOUIND SYSTEM (with above sq.ft.) 75.00 2 Limited energy,multi-family 75.00 2 residential(with above sq.ft.) • Renewable Energy 0 See Page 2 EII11F7;444'1 O N . , _ 1� , _ L AI74': ,- Services or feeders installation,alteration,and/or relocation Name: 200 amps or less 100.70 2 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:( ) I 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 2 Branch circuits—new,alteration,or extension,per panel 'd l - © ' PFRt!1 A.Fee for branch circuits with Business name:MUZAK LLC above service or feeder fee, 7.42 2 each branch circuit Contact name:BILL HIGGINS B.Fee for branch circuits without `Address:3318 LAKEMONT BLVD service or feeder fee,first 56.18 2 '57 branch circuit City/State/ZIP:FT MILL SC 29708 Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(803)554-2594 Fax: :( ) Each manufactured or modular 67.84 2 dwelliEmail:BILL.HIGGINS@MOODMEDIA.COM Reconnectne, oservice and/or feeder only 67.84 2 CONTRA TOR _ _ „,,, Pump or irrigation circle 67.84 2 Business name:MUZAKLLC Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy ® See Page 2 75 2 Address:3318 LAKEMONT BLVD panel,alteration,or extension. City/State/ZIP:FT MILL SC 29708 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(803)554-2594 Fax:( ) Investigation(1 hr min) 90.00/hr Email:BILL.HIGGINS@MOODMEDIA.COM Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: 142760 Electrical Lic.: 26-1055CL E Suprv.Lic.: 3980LEA ,Y``1/j 7specifically listed(V2 hr mm) \,„9......,..--C.D..4.Q____e, -7r ELEC FR1CAL 1 RMIT ES-Suprv.Electrician signature,required: ` aN1 �- Subtotal: 75 Print name: JEAN GALE Date: sl, (,,i& 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): 9 Authorized signature: TOTAL PERMIT FEE: 84 This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. * Number of inspections allowed per permit. 1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-46151(11/05/COM/WEB ,Electrical Permit Application—City of Tigard or Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: Fee for all residential systems combined: $75.00 Description Qty• Eachr°tai y 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 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 kva(fee in accordance with OAR 915-309-0040) 552.26 I 2 El 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 I charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed Sh hr mm) Subtotal(Enter on Page 1). 75 Fee for each commercial system: $75.00 * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: Audio and Stereo Systems El Boiler Controls El Clock Systems ❑ Data Telecommunication Installation El Fire Alarm Installation ❑ HVAC El Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* D Medical El Nurse Calls ❑ Outdoor Landscape Lighting* El Protective Signaling 0 . LOW VOL _ _ _ - TEM To number of commercial systems: 1 *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 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 9516 SW WASHINGTON SQUARE RD H05, TIGARD, OR, 97223 Commercial - Electrical Limited Energy 198 Low voltage ﬁnal PASS - No C of O ELR2016-00119 Jeff Grove Violation Summary: Inspector Contractor