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Permit (69) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT : • COMMUNITY DEVELOPMENT Permit#: ELR2018-00207 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/27/2018 T t i; h.r 9 Parcel: 2S101BCO2800 Jurisdiction: Tigard Site address: 8250 SW HUNZIKER RD C Project: Horizon Distributors Subdivision: 1990-082 PARTITION PLAT Lot: 1 Project Description: Installing CCTV. Contractor: AVID TECHNOLOGIES LLC Owner: SEVERSON, ROBIN 0 LIVING TRUST 6804 SE HENRY ST 29404 SW HEATER RD PORTLAND, OR 97206 SHERWOOD, OR 97140 PHONE: 503-349-8308 PHONE: FAX: FEES Description Date Amount Specifics: Restricted Energy Permit 11/27/2018 $75.00 12%State Surcharge-Electrical 11/27/2018 $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. ATTENTION: Oregon law requires y, 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 ay obtain a co.,of the rules o/•irect questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: i f a_ LLfA Permittee Signature: Y 19 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. FSI. 0y1.1 R ,r- Gay of Tigard , `EI_•E!ie ' �� /�`SHall Blvd.,Tigard,OR 97223w Phone: 503.718.2439 N O V 2 7 2018 Date/By: Related Permit#: Email: TigardBuildingPermits@Tigard-or.gov �+ Ready Date/By: Juris: ® See Page 2 for 1 I('A R I) Inspection Line: 503.639.4175 Internet: w ZiYail i r. b AR� Notified Method: Supplemental Information TYPE OF WORK BUILDINGDIVISI PLAN REVIEW n New construction ❑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 CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. 0 1-and 2-family dwelling g Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural 0 Multi-family 0 Master builder ❑Other: 0 ampsrfor all other installations. Inbustallation pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived NI2 iI G b ❑Addition of new motor load of system. Job#: Job site address: 62,50 r. 100HP or more. ❑«A» «E„ <`1-2" "1-3„ City/State/ZIP: eA-f.p 8 Q 7 3 0 Six or more residential units. occupancy. I 2 Z 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: C Project name: 1:1 0 Hazardous locations. 0 Supply voltage for more than u 0 Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: /lain Z Ok 41 rfrtkallivs S _ 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.add'1500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 I N6 1PC1--L /V (with above sq.ft) IV Limited energy,multi-family 75.00 2 residential(with aF,we 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 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:( ) 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 APPLICANT ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel A.Fee for branch circuits with Business name: 0/4 7 ( or a u1 Bul above service or feeder fee, / 'v each branch circuit 7.42 2 Contact name: B.Fee for branch circuits without b service or feeder fee,first Address: gZ5 j4jydzif1 . IGj ', branch circuit 56.18 2 City/State/ZIP: '-fch A ele 9 7223 Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: kip -resrikolt,otxia Lic, Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy �g(�� 2 2 Address: 68 / ,et f rJT. panel,alteration,or extension. 12Page City/State/ZIP: PSD tS C���� Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:623 ) 3-pi 11 Investigation(1 hr min) 90.00/hr ( (l / / Industrial plant(1 hr min) 78.18/hr Email: Pa(l'L � (V 1 (72-0 0 Inspections for which no fee is 90.00/hr CCB Lic.: 1 qg (Uo 2. Electrical Lic.: CLe 3tAy Suprv.Lic.112gL f f 4- specifically listed(%hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: C 1,.m hC r-7.-- C Subtotal: Print name: Date: 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: c�'� This permit application expires if a permit is not obtained within 180 Print name: l ouva, Date: 1(-71-it days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_ELRERE.doc Rev 10/26/2017 440-4615T(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 Fee for all residential systems combined: $75.00 Renewable I RenewaaQty. Each I Total I ble electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 El 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 n Garage Door Opener* >100 kva(fee in accordance 552.26 2 with OAR 918-309-0040) 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('/hr min) COMMERCIAL WORK ONLY. ELECTRICAL PERMIT;VILER ' Subtotal(Enter on Page 1): 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 ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation El HVAC El Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* El Medical El Nurse Calls El Outdoor Landscape Lighting* El Protective Signaling Other: CC(' 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 10/26/2017 Electrical Permit ApplicEiCD �,�; ,„ � ,� I �� ('ity of Tigard NOVReceived • i 11?ti tiN Itnll Blvd.3, ml.OR u7?�t 2 7 2018 79ate/o � ��_ J '� ' 4 .^ R. flan Rev I (lean int mi 2439 CITY OF TICARD liste/B • I m»,I T tgon113ut1+IflgPsrmdtYtt TU na }�t�? {��'1!\/ Ready 1btNRy: NMI Sm Pane 4lor 1 `' 'I '' In'p non Linc CO3 b3d141 74'' crtttt`e tV nv Notified/Method: Supplemental Information TYPE OF WORK S. , ; :r. a ..a l s,- . ~15 Ncw coma- ctitm 0 Addition/alteration/replacement rleaucheck all that apply{wDm }sets ofphis w/i chocked): El Ikmtutlition ❑Other ❑Service or!ceder 400 amps or more 13Building over three storks. where the avaibbk Luh cancel r)Marines and boatyards. CATEGORY OF CONS7t1 UCTiON exceeds 10,000 amps id 150 volts or 0 Floating buddm s. ❑ 1•and 2-family dwelling ®('ommercial/industrial 0 Accessory building fess in ground.or exceeds 14.000 p Commercb4we aVield oral ❑Mulli-!amid} 0 Master builder 0 Other: 0Eirepmpor theritahlbtamts. InnhbuildIats. pump, ❑lostalhtion of 150 KVA or JOB Slit I. t ' t`. MO Locavd1't4 13 Emergency system. tamer separately derived_ Joh site address: 5'a 0 Addition or new motor load of tot,N. p �" MJit32ii"x�F• 6r. 1001more. ❑"A","E","1-2;"13". • City-Stale/ZIP, '�)t»�YY e R g 7 2 Z 3 0 Six or more ros,dental snits. Oc My. —, 1 oHeald pre Frcilities. Cl Recreational vehicle park!. Suitc/bldg,/apt.#. Project name: 114)-- 5th-. ❑Hmrdotu locations. El Supply voltage brtnoee thee 1n ib� ❑Semice or feeder 600 stops orMOIL 600 volts nomiuil. /7z LL Cross street/directions to job site: r i idrt44 70 New realdential aimgia sr meld-family dwelling unit. Subdivision: J Lao: Includes attached praga 1,000 aq.ft.or lees 168.54 Tax map/parcel#: EL El . a :.-5444. ,, 3-: zee? '"' fr'i,. r`:s'- Al.,'" ..>,', ...;�.: "f: Limited lenerg),. olgolt portion n 33.92 �© reiidenNal . 75.00 —© IJbti l CG with above:..A Limited energy.muhi-ferny ■ 75.00 MI© residential with above • R. al FR t' " �." ,. v i t,1' Yt..:"iR'•..r..k y �:!� 1i.... M. t3tlrvdta or t ■ r -- feeders imwlls& *kende a■d/er r ocedon Name: 200 amps or less 100.70 2 Address201 amps to 400 amps 13336 2 City/Staie'ZIP: 401 amps to 600 amps 1111111 200.34 _© 607 amps to 1,000 amps Nil301.04 1111111© Phone:( ) Over 1,000 amps or volts 552.26 2 Email: Temporary as rhos or feeders lmuMlatimm,alteration,and/or rdocathea Owner installation:This installation is being made on property that 1 own which is not 200 or less 5936 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670.and 701. 201 apps to 400 amps _ 125.08 Ell Owner signature: c _�� 399 16834 2 401 imms „,., 4; .� ' Brandt ...._ -7�ftxt*;,+'k ..:.'i'�S �'.�1'i'wa4rinY N �a �t V'C'� 7 d r)",,..,,0,:',J.,,", � � -Dues alteration,or land A Fee for blanch wants with Business name: Na1zorJ 061-R 06knabove service or feeder fee, Contact name: each brooch circuit 7A2 2 B.Fee for branch circuits without Address: Sz$b A/14Z 111 et t&fs. twice or feeder foe,tient Sb 18 2 branch circuit City/State/Z1P: AGARDd'Q 97223 Each add'1 branch circuit 7.42 2 M Phone:( ) 1 dlameons(service or feeder sat Isdeded) Each manufactured or modular Email: dwelling,acrvice and/or feeder 67.84 2 BusinessReconnect only 67.84 >:'71( l.» "• _ -..' �.,:9..4. ,.. . .. Pumper 67.84 2 circle 2 name: rk\i10 `( lt,,)u)4it5 Lir. Sign or outline lighting 67.84 1 2 Address: 6604 65-j,el ST. signal maws)or limited-enagy Met ahetatice,or mansion. IKBee rare 2 2 City/State/ZIP: PJ o EV 97 Eisell addlioaat 1Dspectios over teowsble in asp of the above Phone: ty) 3' hl5 Additional inspection(►br min) 66.25/hr Email: luvestMation(1 hr min) 90.00/hr /tom 1 /..LC) industrial plant(1 hr min) 78.18/hr • CCB Lie.: 19g(p p Z J Electrical Lic.: Suprv. e t _ gid K br min inspections for which no ke u y � Li �t',���Lf � ,. 9oao/hr Suprv.Electrician signature,required: _"l..i''L 1� : A]` , 4:'•. tt3>'.! Print name: Subtotal: D liYvf Data t _2.7.. (tit C1Plain Review Required(25%of permit fee): Authorized signature s > e(12%ofpeeredfee) TOTAL PERMIT FEB: Print name: T r (, yr Tads permit es We permit is not ebtased'Ibis 1$ Date: f after ft Me bees accepiad m complete. I. aYermadaC_tenwopp ELR_BRN4oc Rev 10/244019 • Number of laepectioee stowed per paretic 4404615Tt 11AS'COMJWmi City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 8250 SW HUNZIKER RD C, TIGARD, OR, 97223 Record Type: Record ID: Commercial - Electrical Limited Energy ELR2018-00207 Inspection Type: Inspector: 198 Low voltage final Jeff Grove Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor