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Permit (175) IIIICITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT ' COMMUNITY DEVELOPMENT Permit#: ELR2016-00262 13125 SW Hall Blvd.,Ti Date Issued: 11/17/2016 T[C , .T and OR 97223 503.718.2439 9 Parcel: 2S102AD03000 Jurisdiction: Tigard Site address: 12850 SW ASH AVE Project: Burnham&Ash Apartments Subdivision: BURNHAM TRACT Lot: 5 Project Description: Building 1 -Low voltage for irrigation controller Contractor: TEUFEL NURSERY INC Owner: PREMIUM PROPERTY-TIGARD LLC 7431 NW EVERGREEN PARKWAY STE 200 1015 NW 11TH AVE., STE 243 HILLSBORO, OR 97124 PORTLAND, OR 97209 PHONE: 503-646-1111 PHONE: 503-226-1972 FAX: 503-646-1112 FEES Description Date Amount Specifics: Restricted Energy Permit 11/17/2016 $75.00 12%State Surcharge-Electrical 11/17/2016 Type of Use: COM 9 $9.00 Class of Work: ALT Total Number of Systems: 1 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: 1 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 thr R 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: C—�(`/�—Glrl��'�( ______ ), Permittee Signature: L-- —c.¢F ! 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. lllll Electrical Permit A lication City of TigardFOR OFFICE USE ONLY 13125 SW Hall Blvd.,Tigard,OR 97223 Received ■ Phone: 503.718.2439 Fax: 503.598.1960 DDate/B : �� Permit#: Inspection:503. 1 503.63Pate/B iew i 11 l I G A R p Ready : Related Permit#: Internet www.bgard-or.gov Ready Date/By: �Aa-o/5=0Dlg x tx Notified/Method ® See Pegent 2 for 1 Ctgi j !t`uZ-ztati Supplemental Information ®New construction `� ��3��� ��, � 0 Addition/alteration/replacement that ppl su 1. checked):): 0 Demolition Please check all apply 0 OtherPP Y(submit 2 sets of plans w/items checked ❑Service or feeder 400 amps or more 5$35:47,--37N4 at74.44,UW hrµ 40 where the available fault current 0Madnng over three stories. 0 1-and 2-family dwelling 0 Commercial/industrial ° exceeds 10,000 ampsat 150 volts or Mannas and boatyards. ❑ 1-anMulti-family2-fa ❑Accessory buildingless to Floating buildings. cry C� ,i��� 0 Master builder ground,or exceeds 14,000 ❑Commercial-use a iculhtral ®Other:Mixed Use ampsireform all other installations. �'� '�' ��'�+� '— ��� buildings. tOi gk k 0 Fire pump. Job#:81608 ❑Installation 150 KVA or Job site address: 12850 SW Ash Ave#���� *����- ,��,W,'� ❑Emergency system. ❑Addition of oew motor load of larger separately derived City/State/ZIP:Tigard,OR 97223 I oOHP or more. system. 0"A","E","1-2","1-3", Suite/bldg./apt.#: it ❑Six or more residential units. occupancy. Burnham&Ash Apartments Health-care facilities. ❑Recreational vehicle parks. Cross street/directions to job site: ❑Hazardous locations. ❑Supply voltage for more than Project name:B ❑Service or feeder 600 amps or more. teg,�t, t ** 600 volts nominal i'-4 t, - s fr'F.rip iy'` **- � t a t�-�Y-j p Subdivision: nescri,00n ®mow; at y CO New residential single-or multi-family dwelling unit.Total Tax map/parcel#: Lot#: Includes attached garage. u3 1,000 sq.ft.or less f ` i I , : fib*R ;`u j a 4 j, *�`�� Ea.ited en00 sq.ft.or portion 168.54 4 Landscape&irrigation ^� Limited ener 1111 33.92 �© CO ! gy,residential with above s..ft ■ 75.00 -© Limited energy,= multi-family 1111 pl ® iu 3 residential(with above s..4) 75.00 M© A' �• enewable Ener: ServiRces or feeders installation,alter tion,and/or rel Address: 200 amps or less - 201 amps to 400 amps 100.70 _© City/State/ZIP: 133.56 _© 401 amps to 600 amps - Phone:City/Sin ( ) 601 amps to 1,000 amps 200.34 _© Over 1,000 amps or volts - 30152604 mu - 55226 _© Owner installation:This installation is being made on property that I own which is not 200 amps or Temporary s1111 rvices or feeders installation,alteration,and/or intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. relocation Owner signature: 201 amps to 400 ampsNMI 59 36 _© "`"�� ��® u• � Date: 401 amps to 599 amps � 125.08 11111111111 � � a[®� �,, �� *u�� n� O � +�r„� 168.54 "_ ' �� Branch circuits—new,alteration,or extension—i--i.er .ane. Business name:Teufel Nursery,Inc. A.Fee for branch circuits fee, Contact name:Kelly Dalpoggettoabove service or feeder fee,each branch circuitAddress:7431 NW Evergreen Parkwa B.Fee for branch circuits without service or feeder fee,first City/Sta / IP:Hillsboro,OR 97124 branch circuitIII56.18 Phone:(503)646.1111 y,Ste 200Each add'1 branch circuit © Fax: :(503)646.1112 Miscellaneous service or feeder notclod®_© Email:KellyD@Teufel.com Each manufactured or modular ■ � �, .` dwellin_,sere eand/orfeeder 6784 Mlle is '�Q�� �' V �* i� ��+��i �� f��` °",�t�y w+�x t r. Reconnect only 111111 Business name:Teufel Nursery,Inc. �� � � � , 67.84 �© Pump or irrigation circle - Sign or outline lighting 67 84 _© Address:7431 NW Evergren Parkway,Ste 200 - Signal t(s)or limited-energy 67.84 �© r.► City/State/ZIP:Hillsboro,OR 97124 Saner,alteration,or extension. ® See Page 2 Mil Each additional ins.ection over allowable in any of the above Phone:(503)646.1111 Additional inspection(1 hr min) 66.25/hr Fax:(503)646.1112 . Email:Ke11yD@TeufeLcom Investigation(1 hr min) 11111 Industrial plant which min) 90��� CCB Lic.: 41669 c� - 31n F1Prtrical I ' Inspections for no fee is ■ -----_�.: LCB 5133b 7inr�� r Suprv.Electrician signature,required: s• clficall listed %hr min 90 00/hr -. kit Print name: Date: Subtotal: . e0 Plan Review Required(25%of permit fee): — Authorized signature:.. APAry State surcharge(12%of permit fee): r Print name: ,' TOTAL PERMIT FEE: �-J MGMMM. Date: This permit application expires if a permit is not obtained within 18 I:\BuildingWermits:ELC_PermitA ELR �` days after it has been accepted as complete. B PP_ _ERE.doc Rev 06/17'. * Number of inspections allowed per permit. ' 440-4615T(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: . P i It �� ;.t' -444- 4%r vp Fee for all residential systems combined: $75.00 Description —EachI Renewable electrical energy systems: I Total Check Type of Work Involved: 5 kva or less 100.70 2 Audio and Stereo Systems* 5.01 to 15 kva 133.56 2 15.01 to 25 kva 200.34 2 Burglar Alarm Wind generation systems in excess of 25 kva: 25.01 to 50 kva 301.04 2 Garage Door Opener* 50.01 to 100 kva 552.26 2 ❑ >100 kva(fee in accordance Heating,Ventilation and Air Conditioning with OAR 918-309-0040) 552 26 2 System* Solar generation systems in excess of 25 kva: 3 Each additional kva over 25 7.42 I Vacuum Systems* I ❑ >100 kva—no additional charge 0.0 3 ❑ Other: Each additional inspection over allowable in any of the above: Each additional inspection is charged at an hourly(1 hr min) 66.25/hr 1 Inspections for which no fee is specifically listed(%2 hr min) 90 00/hr `��'{�"�"�-���;R�{'�'i" p -�4��-„s a r:=,�' - IIt'� it -.*E i` W1:44-Vie Fee for each commercial system: $75.00 (SEE OAR 918-309-0000) Subtotal(Enter on Page 1): * Number of inspections allowed per permit. Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ 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 I:13undingTermits\ELC_PermitApp ELR ERE.doc Rev 06/17/2015