Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit#: ELR2019-00047
13125 SW Hall Blvd.,Ti and OR 97223 503.718.2439 Date Issued: 03/12/2019
TiC rl1 D9
Parcel: 2S113BA00400
Jurisdiction: Tigard
Site address: 7632 SW DURHAM RD 120
Project: Heritage Bank Subdivision: None Lot: None
Project Description: Relocating(3)DDC thermostats to accommodate TI.
Contractor: HUNTER DAVISSON INC Owner: PORTLAND SW CENTER LLC
1800 SE PERSHING ST BY FELTON PROPERTIES INC
PORTLAND, OR 97202 ATTN: FELTON, MATT
520 SW 6TH AVE, STE 610
PORTLAND, OR 97204
PHONE: 503-542-3628 PHONE:
FAX: 503-542-3654
FEES
Description Date Amount
Specifics: Restricted Energy Permit 03/12/2019 $75.00
12%State Surcharge-Electrical 03/12/2019 $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: 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-•01-0090. You may obtain a cosy of the ru-s or direct•uestions to OUNC by calling 503.32.1987 or 1.800, 2.2344.
Issued By: *A. , /IL/A.//�.- ' Permittee Signature: uj-
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.
f::., c Sh 7
rte,
Electrical Permit Application.
' FOR OFFICE USE ONLY11
�}
City of Tigard t/t,7 1 2 Lo 9 Re ee ved 24/NMP t . / / /' 2
- " 13125 SW Hall Blvd.,Tigard,OR 91221 Plan Review
Phone: 503.718.2439 Fax: 503.198-.49:60 at DateB : r. MO
Inspection Line: 503.639.4175 t_,,,'' t. Ready Date/By: Juris: El See Page 2 for
TIGARD I✓'1 .-,'asl Notified/Method: Supplemental Information
,a Internet: www.tigard-ocgov
Please check all that apply(submit 2 sets of plans w/items checked):
❑New construction V Addition/alteration/replacement ❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
CA'TEGor
�Y'bF �� �FUI?) _ � � mal-t�se gn ultural
exceeds 10 000 amps at 150 volts Floating buildings.
less to ground,or exceeds 14,000 ❑Commer ' a "c
0 1-and 2-family dwelling 441 Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi family 0 Master builder 0 Other: 0 Fire pump. 0 InstaIargalletron of 1y 150 KVA or
, ❑Emergency system.
4sit 811 Irl'4i mATION W,L.. axl<g,,
,p ❑Addition of new motor load of system.epa' f derived
Job# /'100p I Job site address:76?2 ..5-IA/ 2.4 rk /'c/ 1001-IP or more. ❑"A "E"•"1-'-"•"1-3",
o t� ❑Six or more residential units.
occupancy.
City/State/ZIP: --r. ,rd o/e ( /,2OS El Health-care facilities. ❑Recreational vehicle parks.
J .j. ❑Hazardous locations ❑Supply voltage for more than
Suite/bldg./apt.#: Project name: ri•e1 e, o r/ CeN/g j� 600 volts nominal
p q y _❑Servce or feeder 600 amps or more
V .81141 fQ,S EEE SCHEDULE ii
Cross street/directions to job site:/�QCr��AQ e B — �•?• /�O - o' 1
`J �Descnption I Qly. I Each I Total
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'1500 sq.ft.or portion 33.92 1
Limited energy,residential
lee.10 .,3 ESCR�''R�Ui�t�bP �r3; . .,.,'�.. ��. 75.00 2
l O,PceM 57� „ _. .. . (with abovesq.ft.)
t' O s ib Limited ener multi-family75.00 2
AC
cM M OQ�L/_i 7 T1:
residential(with above sq.ft.)
( ,[ _ Renewable Energy ❑ See Page 2
75 PROr'EI fi'Y.OWLVER , c, ❑.. Services or feeders installation,alteration,and/or relocation
Name:/Q f� Co N�r Glp IT .1;4c,
N(, • 200 amps or less 100.70 2
l/�2�,C.O/It/1'!ef Uei G
201 amps to 400 amps 133.56 2
Address: SS7.3 S. /s+ CAT'G e — 200.34 2
401 amps to 600 amps
City/State/ZIP: "'d cid w9 Qcf6 7 OZ
601 amps to 1,000 amps 301.04 2
Phone:((3‘o) 13 - y s�/6�t
/ 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
�11'`P>I.,itAt41 ,,,,, „)._.... Q tOl!1'1<ke ix.o is,t A.Fee for branch circuits with
Business name:/444N-fir-40al j//SSO/4 -2-N Cabove service or feeder fee, 7 42 2
each branch circuit
Contact name:���/ �t�'t i
B.Fee for branch circuits without
service or feeder fee,first 56.18 2
• branch circuit
Address: A..°�C G' Ars At Ali 0 r f� Each add'1 branch circuit 7.42 2
City/State/ZIP:��- qoQ� !C /�U Miscellaneous(service or feeder not included)
Phone:(pa)via— ??2 I Fax: :( ) Each manufactured or modular 67.84 2
„ dwelling,service and/or feeder
Email: /DO��� t��N{J7 ercic4(IISrO/J• '- M. Reconnect only 67.84 2
! CONRACI O[Z, ? Pump or irrigation circle 67.84 2
Business name: Sevvi Q- IAs AO�le// Sign or outline lighting 67.84 2
' Signal circuit(s)or limited-energy See Page 2 2
Address: panel,alteration,or extension.
Each additional inspection over allowable in any of the above
City/State/ZIP: Additional inspection(1 hr min) 66.25/hr
Phone:( ) Fax:( ) Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email: Inspections for which no fee is 90.00/hr
��/a I •as a ccei Suprv.Lic.:60 0 LEE spectficallylisted(%:hr min)
CCB Lic.: Electrical Li i
,.E;E�caR._PI>z>�Rz'.FEEs . ,
Suprv.Electrician signature,required: Subtotal:
' Print name:� Date: 0 Plan Review Required(25%of permit fee):
�J`M ��ll//SSON State surcharge(12%of permit fee):
Jt TOTAL PERMIT FEE:
Authorized signature: L
This permit application expires if a permit is not obtained within 180
Print name: /� Date:3-7/_/9 days after it has been accepted as complete.
�Q N ��i� / : Number of inspections allowed per permit.
l:\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:
� 9i a tri Description I Qty. Each I Total I
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
5 kva or less 100.70 2
Check Type of Work Involved:
5.01to15kva 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
El 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
specificallylisted V2 hr min
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
El Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
El Outdoor Landscape Lighting*
❑ Protective Signaling
El 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