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Permit (115) • CITY OF TIGARD ELECTRICAL PERMIT Per COMMUNITY DEVELOPMENT mit: ELC2018-00308 Date T 4 ;,t i'(_a 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Issued: 06/06/2018 Parcel: 251060001401 Jurisdiction: Tigard Site address: 13265 SW 169TH AVE Project: River Terrace East Apartments,Building D Subdivision: RIVER TERRACE EAST Lot: None Project Description: Building D: Electrical for new 12 unit apartment building. 10/17/2018: REPRINT permit to change electrical contractor. Contractor. ALAMEDA ELECTRIC Owner. POLYGON WLH,LLC 3415 NE 44TH 703 BROADWAY ST,SUITE 510 PORTLAND,OR 97213 VANCOUVER,WA 98660 PHONE: 503-319-2192 PHONE: 360-695-7700 FAX: FEES Quantity Description Date Amount 1244 sf Permit Fee-Elect(SF or 1st 06/06/2018 $202.46 Specifics: MF dwelling unit) 1114 Each Addi Unit(Multi-Family) 06/06/2018 $1,113.53 Type of Use: MF 1 ea Limited Energy 06/06/2018 $75.00 Class of Work: NEW 1 ea Services or Feeders-200 06/06/2018 $100.70 Type of Const: amps or less Occupancy Grp: 30 crt Branch Circuits w/Purchase 06/06/2018 $222.60 Service or Feeder 1 ea Plan Review Electriclal 06/06/2018 $428.57 1 ea 12%State Surcharge- 06/06/2018 $205.71 • Electrical 45 Misc Administration Fee 10/17/2018 $45.00 Total $2.393.57 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 al other applicable law. Ali 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: 0 gon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 throw O R 952-001-00 0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.�s Issued By: ` C� (, Permittee Signature: C:)/t//t/ 1'8./aG/C '9720�V 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 503.839.4176 by 7:00 a.m.for the next available Inspection data. 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 J A h� 14 2019 I()It t)FF lc 1. 1 Vit.()\I.r. City of Tigard Received Date/By13125 SW 11x11 Blvd..Tigard,OR 9722 . ) Plan Review Phone' 503:718.2439 Rive 503.59813160 . *. x`i Data MIMI Inspection Line' 503.639.4175 Ready Daici ly NM 0 Set Page 2 for Internet: www.tigard-or.govt;�i Notificd+Method: SupplemeatalInformation m � �ia '' +..';7,,y.-44.!.-., 'I) e ,�KFilet N 4. .,..x zikJ '" ex. . 1.f*661:,. f i : .Ls a , ®New construction 0 Addition/alteralion/replacement Please check all that apply(submit 2 sets of plans wfnems checked). 0 Service or feeder 400 amps or more 0 Building over three pones 0 Demolition 0 Other: where the available fault current 0 Mannas and boatyards . : rtl :•,,,..,,,--7,,',,':=1, -:.;-,-..,,i :,1:4,4' rJ CTj{ :;; %,. 3' 'i o:.`- exceeds 10,000 amps at 1 SO volts or 0 Floating buildings. Q 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building legs to ground,or exceeds 14,000 ❑Commercial-vise agricultural amps for all other installations buildings. gi Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or klis i ,';*- s;t 'v T7 jn i.l .Y.as` .!. .t Ai l',�-tSc.IX11/1D s. ',".—r'' '.4.:::4.'. 6,.. ©Emergency system' larger separately derived ''l 2(0 ) \' ^9 ` ve ❑Addition of new meta load of system Job#: Job site address: Vl iootiPamore. City/State/ZIP:. S rLv 0 o a/ oi l l- ❑Six or more residential units Cl Health-care facilities . ❑oaup�c) Recreation al vehicle parks Suite/bldg./apt.#: Project name: �)V.eb revVo(t, ❑Hazardouslocations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: ::-.:1 `r ?"a' ,r1 'w Description Qq. I Each Total New residential single-or multi-family dwelling unit. Subdivision: pi vevT-e rrake) 1 Lot#:t3,16(.1 D Includes attached garage. Tax map/parcel#: 1,000 ser•ft.or less 168,54 4 t`a 4 ,. ' ; .ate, tis j t e ®�'.a , ": Ea.add'I SOO sq.t.or portion 33.92 1 T P / +� 'A l Limited energy,residential 7500 2 �� lJ�� _� (with above sq.t.) la /44 ` a►t.C.Iet - Limited energy,multi-family 75.00 2 *-,¢^"� A f", + u ` u , !:�/ '�%v 14 s. �. :;B a residential(with abo%e sq.ft•) Name:ADVL Land Holdings,LLC Renewable Energy 0 See Page 2 Address:7600 E Doubletree Ranch Road Services or feeders installation.alteration,and/or relocation 200 amps or less 100,70 2 City/State/ZIP:Scottsdale,AZ 85258 Phone:(602)694-4031 Fax:( ) 201 amps to 400 amps 133.56 2 Email: 401 amps to 600 amps 200.34 2 Owner installation:This installation is being made on property that I own which is not 601 amps to 1,000 amps 301.04 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. " Over 1,000 amps or volts 552.26 2 Owner signature: Date: ^a'?",:,!,;......;-:.... 0.3..? ,u_ - Temporary services r feeders installation,alteration,and/or . d. ' rF f t.r- `: `i ia_ „=: ., . 1i .4:4,`i° z "v:' relocation Business name: Ya I o A W 1( LID. 200 amps or less 59.36 1 Contact name: 1 1 r G201 amps to 400 amps 125.08 2 Address:: 5i1A ,7 69 y-06 i t'/ u- 5-f-L S ID 401 amps to 599 amps 168.54 2 City/State/ZIP:Vancouver,WA 98660 Branch circuits—new,alteration,or extension,per panel Phone:(360)695-7700 Fax::(360)693-4442 A.Fee for branch circuits with above service or feeder fee, 7.42 r Email:rrermt t9VLkttiV1I I P01 tI 6 A I 1 ii I 1 . eachbranchcrcuit ` H.Fee forbranch circuits wuhoui ,.u' ... T o a 3'' 7. "'-::::73: 711 -7v "`ate - ,-- service or fceder fee,first 56.18 2 . Business name:alameda electric abranch circuit Each add'I branch circuit 7.42 2 Address:3415 ne 44th �r v11 �,df� /.e 7 e2.-/3 EachMiscellaneous(served or m oru feeder not included) Cl /StatlZlP:> Q, pJz Each manufactured or modular 67..84 2 dwelling,service andior feeder Phone:(503)3192192 Fax:( ) , Reconnect only l 67.84 - Email:solarpdx@me.com Pump or irrigation circle 67.84 2 CCB Lic.: 199188 Electrical Lic.: c923 Suprv.Lic.: if f7/...5 Sign or outline lighting 67.84 2 Suprv.Electrician signature,required: Signal circuit(s)or limited-energy ❑ Ste page 2 Print name: /C r k. /2,00,./C Date: .. 1 .I a. l f td-. panel,alteration,or extension g Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25'hi Authorized signature: I Print name: /....e.'Z..:::eie_.----4r." Dat 1 ��' ' Investigation(1 hr min) 90.00;hr 1,6aaiMea lsoW c PernotApp.RIA_ER80a Rev 0617/2015 04615111lFO K'OM'NR'B l 1 Mf rd dA 0 l CITY OF TIGARD ELECTRICAL PERMIT a COMMUNITY DEVELOPMENT Permit#: ELC2018-00308 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/06/2018 T t c,"� "O g Parcel: 2S1060001401 Jurisdiction: Tigard Site address: 13265 SW 169TH AVE Project: River Terrace East Apartments,Building D Subdivision: RIVER TERRACE EAST Lot: None Project Description: Building D: Electrical for new 12 unit apartment building. 10/17/2018: REPRINT permit to change electrical contractor. Contractor: ALAMEDA ELECTRIC Owner: POLYGON WLH, LLC 3415 NE 44TH 703 BROADWAY ST,SUITE 510 PORTLAND,OR 97213 VANCOUVER,WA 98660 PHONE: 503-319-2192 PHONE: 360-695-7700 FAX: FEES Quantity Description Date Amount 1244 sf Permit Fee-Elect(SF or 1st 06/06/2018 $202.46 Specifics: MF dwelling unit) 1114 Each Add'I Unit(Multi-Family) 06/06/2018 $1,113.53 Type of Use: MF 1 ea Limited Energy 06/06/2018 $75.00 Class of Work: NEW 1 ea Services or Feeders-200 06/06/2018 $100.70 Type of Const: amps or less Occupancy Grp: 30 crt Branch Circuits w/Purchase 06/06/2018 $222.60 Service or Feeder 1 ea Plan Review Electricial 06/06/2018 $428.57 1 ea 12%State Surcharge- 06/06/2018 $205.71 Electrical 45 Misc Administration Fee 10/17/2018 $45.00 Total $2,393.57 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 throug 0 R 952-001-00 0. 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: Z�'� Permittee Signature: �� r7'y/9/'6/(',9�0�V 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. REC / �F Electrical Permit Application FOR OFFICE USE ONLY i)C I ' i i 0 1 Received City of Tigard Date/B : , 7 /, •� r . II 0 13125 SW Hall Blvd.,Tigard,OR 9722 € 1 k f i ,, : I Plan Review 0 Phone: 503.718.2439 Fax: 503.598.19,61 '• ,s ',t i--, Date/B : Related Permit#: Inspection Line: 503.639.4175mi; r, «. c r ady Date/By: Juris: ® See Page 2 for T I G A R D 01,1 1 =11, ,P 1 1 :'I1:.�' otified/Method: Supplemental Information Internet: www.tigard-or.gov s_. ; PP %.---.,-.. . .Pel'L! OF;WORK .V,t . .ry `rs� as, ? Et, ..s .WT.V4N' W�:�.> tl,..:y.fa' ? s,; -i.ai ®New construction 0 Addition/alteration/replacement 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. ❑Demolition 0 Other: where the available fault current 0 Marinas and boatyards. CATEGORY-OF-CONSTRUCTI.ON , ' ' exceeds 10,000 amps at 150 volts or 0 Floating buildings. ® 1-and 2-family dwelling 0 Commercial/industrial 0 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: ❑Fire pump. 0 Installation of 150 KVA or _ JOB S1TE`INPORMA'ON AND L_OCATION 0 Emergency system. larger separately derived Job site address: A/ [� ❑Addition of new motor load of system. Job#: (S k,5 SW 1(pq-n.1 Pru-E., lOOHe or more. ❑"A»,"E","1-2","1-3" City/State/ZIP:Tigard,OR 97224 0 Six or more residential units. occupancy. 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: 1'3(10 EP+tc' ( OO ) ❑Hazardous ocations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: :TEE;SCHEDIJLE _ 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.add'l 500 sq.It or portion 33.92 I DESCRIPTION OF.`WORIC Limited energy,residential TLC 20t1 (O308' (with above sq.ft.) 75.00 2 Limited energy,multi-family 75.00 2 5v.) t-srH E(EG ( "- vy-o._G residential(with above sq.ft.) Renewable Energy ❑ See Page 2 A® PROPER OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation ' Name: PI�YL. LA N 4 .;01.20,105 1 (,LG 200 amps or less 100.70 2 Address:---1(000e 1Dbvl.P�(,6�Eta A-ne t�t'Rc c 201 amps to 400 amps 133,56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: (E.ps I5p(401..61 A.. S'5 Z5 e) 601 amps to 1,000 amps 301.04 2 Phone:(.p,U2 (AA tiO3\ 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 Ei APPLICANT ❑ ;CONTACT PERSON A.Fee for branch circuits with Business name:Polygon WLH,LLC above service or feeder fee, 7 42 2 each branch circuit Contact name:Jolene Smith B.Fee for branch circuits without service or Address:703 Broadway St,Ste.510 ' branch t circa der fee,first 56.18 2 City/State/ZIP:Vancouver,WA 98660 Each add'l branch circuit 7,42 2 Miscellaneous(service or feeder not included) Phone:(360)695-7700 Fax::(360)693-4442 Each manufactured or modular 67.84 2 Email:permitsubmittals@polygonhomes.com - dwelling,service and/or feeder Reconnect only 67.84 2 .., CONTRACTOR Pump or irrigation circle 67.84 2 Business name:alameda electric Sign or outline lighting 67.84 2 — Signal circuit(s)or limited-energy ❑ See Page 2 2 Address:3415 ne 44th panel,alteration,or extension. Each additional inspection over allowable in any of the above City/State/ZIP:Ewa A,,-✓r ldtv'L/Ip/z /',1 7' •/3 Additional inspection(1 hr min) 66.25/hr . Phone:(503)3192192 Fax:( ) Investigation(1 hr min) 90.00/hr Industrial plant(1 hr min) 78.18/hr Email:solarpdx@me.com Inspections for which no fee is 90.00/hr CCB Lic.: 199188 Electrical Lic.: c923 Suprv.Lic.: '/f7/$ s>:ecifically listed(/hr min) - ELECTRICAL'..PERMIT;FEES Suprv.Electrician signature,required: _ Subtotal: Print name: kik /�p�. Date: LO /?/ 1Z' 0 Plan Review Required(25%of permit fee): — State surcharge(12%of permit fee): • Authorized signature TOTAL PERMIT FEE: er.:3 This permit application expires if a permit is not obtained within 180 I` Print name: ✓ Date��/��f($ days after it has been accepted as complete. l ; Number of inspections allowed per permit. I:\Building\Pemuts\ELC PermitApp ELR ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB CITY OF TIGARDIN ELECTRICAL PERMIT • 's COMMUNITY DEVELOPMENT Permit#: ELC2018-00308 Date Issued: 06/06/2018 T f C.All'1.) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S1060001401 Jurisdiction: Tigard Site address: 13265 SW 169TH AVE Project: River Terrace East Apartments,Building D Subdivision: RIVER TERRACE EAST Lot: None Project Description: Building D: Electrical for new 12 unit apartment building. Contractor: THREE PHASE ELECTRIC Owner: POLYGON WLH, LLC 11490 SE JENNIFER ST 703 BROADWAY ST, SUITE 510 CLACKAMAS,OR 97015 VANCOUVER,WA 98660 PHONE: 503-760-8522 PHONE: 360-695-7700 FAX: 503-762-1823 FEES Quantity Description Date Amount 1244 sf Permit Fee-Elect(SF or 1st 06/06/2018 $202.46 Specifics: MF dwelling unit) 1114 Each Add'I Unit(Multi-Family) 06/06/2018 $1,113.53 Type of Use: MF 1 ea Limited Energy 06/06/2018 $75.00 Class of Work: NEW 1 ea Services or Feeders-200 06/06/2018 $100.70 Type of Const: amps or less 30 crt Branch Circuits w/Purchase 06/06/2018 $222.60 Occupancy Grp: Service or Feeder 1 ea Plan Review Electricial 06/06/2018 $428.57 1 ea 12%State Surcharge- 06/06/2018 $205.71 Electrical Total $2,348.57 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 -001-0090. You m obtain a copy oft or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. t Issued By: ,..e..--(, Permittee Signature: 5t c _, 7i/"G� r 1 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 RECEIV 1012 orrlCE 1 SU.ON1_1 !� ceived City of Tigard S' %• Permit — h Date/By: /%/ e •'% sze �� el 30,9 • 13125 SW Hall Blvd.,Tigard,OR 97223 ( )pl plan Revied4 / MAY L U elated Perm Phone: 503.718.2439 Fax: 503.598.1960 Date/By: �/ j , et/ .-e©e7..J Inspection Line: 503.639.4175 yyC. Ready Date/By; ./ Ips mic: f 1 See Page 2 for ('I C A R I7 Internet: www.tigard-or,gov CITY 3.✓f ' ��lotified/Method:� / ary/ Supplemental Information BUILDING DIVISION TYPE OF WORK '/�IrJ/L l✓1G tea.-FLAN REVIEW ®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): ®Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings. ❑ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural am® ❑Fire Multi-family 0 Master builder 0 Other: nbustdings. Fire s for all other installations.pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived Job#: Job site address: /3A /„C f / 0 Addition of new motor load of system. 4 5-s-to /&j f,Z 100HP or more. ❑«A„«E„ «1 2„ al 3„ City/State/ZIP:Tigard,OR 97224 ®Six or more residential units. occupancy. ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name:River Terrace East %�J�//" 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:Roy Rogers FEE SCHEDULE Description l Qty. I Each 4 Total New residential single-or multi-family dwelling unit. Subdivision:River Terrace East BLDG D Lot#: Includes attached garage. 1,000 sq.ft.or less 1 168.54 168.54 4 Tax map/parcel#: Ea.add'l 500 sq.ft.or portion / 33.92 I 3 ,i#.- 1 DESCRIPTION OF WORK — New 12-unit building (j itdVi7—�J !��/rf 3/ _ d , V4. '/... �G( 14-0/-74-:-- // /�/6.18 �� �� Limited energy,multi-family I 75.00 75.00 2 Largest unit=1244 square feet f/)10,7'j 2 residential(with above sq.ft.) ✓✓ �� �/lam �U� Renewable Energy 0 See Page 2 El PROPERTY OWNER - 0 TENANT • Services or feeders installation,alteration,and/or relocation Name:Polygon WLH,LLC 200 amps or less 1 100.70 100.70 2 Address:703 Broadway st Suite 510 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:Vancouver WA 98660 601 amps to 1,000 amps 301.04 2 Phone:(360)695-7700 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 I 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 El APPLICANT 0 CONTACT PERSON Branch circuits—new,alteration,or extension, .er panel A.Fee for branch circuits with Business name:Polygon WLH, LLC above service or feeder fee, 30 7A2 222.60 2 each branch circuit Contact name:Nichole Thorpe B.Fee for branch circuits without service or feeder fee,first 56.18 2 Address:703 Broadway St Suite 510 branch circuit City/State/ZIP:Vancouver,WA 98660 Each add'!branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(360)695-7700 Fax: :(360)693-4442 Each manufactured or modular 67.84 2 Email:Nichole.Thor a of onhomes.com dwelling,service and/or feeder p @p yg Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name:Three Phase Electric Sign or outline lighting 67.84 2 Address: 11490 Se Jennifer St Signalnel, leer tiont(s)or!extension. Page alteration,or extension. ® See Pa e 2 75.00 2 City/State/ZIP: Clackamas,OR 97015 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(503)908-8058 Fax:(503)762-1823 Investigation(1 hr min) 90.00/hr Email:permits@threephaseelectric.com Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: 162368 Electrical Lic.: 3-332C Suprv.Lic.: 3398S specifically listed(1/2 hr min) � ELECTRICAL PERMIT FEES it)Suprv.Electrician signature,required: .e., wzbtf.,rtit,.. Subtotal: 116. Print name: Dennis Welch Date: 05/03/2018 ®Plan Review Required(25%of permit fee): 2 8 e LState surcharge(12%of permit fee): 1 0 Authorized signature: 12,„/„..,_A TOTAL PERMIT FEE: 529. 12,„/„..,_A This permit application expires if a permit is not obtained within 180 Print name: Robert Lane Date: 05/03/2018 days after it has been accepted as complete. * Number of inspections allowed per permit. I:1Building\Retinas\ELC_PennitApp_ELR_ERE.doc Rev 06/17/2015 440-46I5T(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Description Qty. Each Total j �' Renewable for all residential systems combined: $75.00 Ren wewable electrical energy systems: Check Type of Work Involved: 5 kva or less 10030 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: E Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 [1 Garage Door Opener* >100 kva(fee in accordance 552.26 2 with OAR 918-309-0040) H Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 LI 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 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed('A hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00Subtotal(Enter on Page 1): s Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: n Audio and Stereo Systems LI Boiler Controls n Clock Systems Fi Data Telecommunication Installation n Fire Alarm Installation n HVAC n Instrumentation C Intercom and Paging Systems ❑ Landscape Irrigation Control* (— Medical ❑ Nurse Calls LI Outdoor Landscape Lighting* ❑ Protective Signaling n Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015