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Permit (10) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT Permit#: ELR2019-00007 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/08/2019 Parcel: 1 S 1260000300 Jurisdiction: Tigard Site address: 9577 SW WASHINGTON SQUARE RD B07 Project: Morphe Subdivision: None Lot: None Project Description: HVAC system. Contractor: HVAC INC Owner: PPR WASHINGTON SQUARE LLC 5188 SE INTERNATIONAL WAY PO BOX 847 MILWAUKIE, OR 97222 CARLSBAD, CA 92018 PHONE: 503-462-4822 PHONE: FAX: 503-462-6555 FEES Description Date Amount Specifics: Restricted Energy Permit 01/08/2019 $75.00 12%State Surcharge-Electrical 01/08/2019 $9.00 Type of Use: COM 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: 1 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. You may obtain a co• .- rules or direct questions to OUNC by calling 503.232.1987 or A^r�.8Q0.32.2344. 'l Issued By: Permittee Signature: 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 Applications FOR OFFICE USE ONLY City of Tigard Received _ IIII 'I Date `13125 SW Hall Blvd.,Tigard,OR 97223 �A I /Q i J Plan Revie Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#: .7_,:i. %- T I GARD Inspection Line: 503.639.4175 ,,pp TY OF � �"� :ady Date/By: Juris: 0 See Page 2 for y� Internet www.tigard-or.gov �.+t N t,a vi, ied/Method: Supplemental Information :rte.=°' o�a T...= "!" 1 --_:,,,,‘F,,4,' i�� r� i9 '' HM'",4 p y�l"�' �yibly(rr,� � S� �(ufl�j��+f ._� � ��,y�a ��,,'�alG r IG, l��'�b�?�=_� �!�i�� o 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. 0 Demolition ❑Other: where the available fault current 0 Marinas and boatyards. _ ' r tDGtk1i _ r ��t,i _. exceeds 10,000 amps at 150 volts or 0 Floating buildings. El1-and 2-family dwelling ®Commercial/industrial0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural ngs. ❑Multi-family 0 Master builder 0 Other: ❑amps for all other installations. Inbustallation pump. ❑Installation of 150 KVA or r, = 113(4:61t.,-r -�i +}1 _' 0.I 1" iT d rmigr s ❑Emergency system. larger separately derived � � ❑Addition of new motor load of system. Job#: Job site address:9585 SW WASHINGTON SQUARE RD 100HP or more. ❑"A","E","1-z","1-3", City/State/ZIP:TIGARD,OR 97223 ❑Six or more residential units. occupancy. 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#:B07 Project name:MORPHE 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: e. LAC 17)171:74t/ Ii ilu � r y;1 Description Qty. Each I Total I * New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 168.54 4 i � g i Ea.add'l 500 sq.ft.or portion 33.92 1 ,3 a - r�;,G or ,,'.. d� 'O1 "'m ydy � �, - r (] , Limited energy,residential LOW VOLTAGE CONTROLS FOR NEW MECH UNITS (with above sq.ft.) 75.00 2 Limited energy,multi-family 75.00 2 residential(with above sq.ft.) ar ��9a Renewable Energy 0 See Page 2 W ��',11;,-'- °` ''_ '' 1° t 361 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:( ) 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 ) ��a 90 ��s � r°R to ,m Branch circuits—new,alteration,or extension,per panel , tm 1_ N'1 to A��'' ligi i.� ►,;i d ,AL O A.Fee for branch circuits with Business name:HVAC,INC. above service or feeder fee, 7.42 2 each branch circuit Contact name:JODY DEPEW B.Fee for branch circuits without Address:5188 SE INTERNATIONAL WAY beor feeder fee,first branch circuit 56.18 2 City/State/ZIP:MILWAUKIE,OR 97222 Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(503)462-4822 Fax: :(503)462-6555 Each manufactured or modular 67.84 2 Email:jodyd@hvacincorp.com dwelling,service and/or feeder Reconnect only 67.84 2 4 ___ "£ t .. CT©1i ia a, .. ,s , , " Pump or irrigation circle 67.84 2 Business name:HVAC,INC. Sign or outline lighting 67.842 Address:SAME AS ABOVE Signal circuit(s)or limited-energy 0 See Page 2 rV 2 panel,alteration,or extension. �3 i City/State/ZIP: Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:( ) Fax:( ) Investigation(1 hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: 50897 Electrical Lic.: 26-571 CLIA- Suprv.Lic.: 3796LEB s! cifically listed(%hr min) Suprv.Electrician signature,required:d� e , '' � " �n — �f� �'}��, Subtotal: �5r "::•1-1 Print name: MIKE SCHMIDGALL Date: 1/8/19 0 Plan Review Required(25%of permit fee): r f State surcharge(12%of permit fee): 1,w Jl/ TOTAL PERMIT FEE: e( Authorized signature: `���111ccc�/`Yr This permit application expires if a permit is not obtained within 180 Print name: JODY D Date: 1/8/19 days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: cook r � � w 41001111,11101,. 1 SEN ° iiO L 3 11111i'� IIS r��, vzr� '' l�) �"� Description Qty. I Each I Total I * Fee for all residential systems combined: $75.00 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 552.26 2 with OAR 918-309-0040) ❑ 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 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(Y2 hr min) WI 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 ❑ 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:\Building\Permits\ELC_PermitAppELR_ERE.doc Rev 06/17/2015 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9577 SW WASHINGTON SQUARE RD B07, TIGARD, OR, 97223 Record Type: Record ID: Commercial - Electrical Limited Energy ELR2019-00007 Inspection Type: Inspector: 198 Low voltage final Jeff Grove Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor