Permit Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Description is. Each. Total ti-
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
2
Check Type of Work Involved: 5 kva or less I00,70
5.01 to 15 kva 133.56 2
0 Audio and Stereo Systems* 15.01 to25 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* Ino kva(fez in accordance
with OAR 918-309-0040) 552,26 2
® 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 02) 3
Each additional inspection over allowable in any of the above:
0 Each additional inspection is
Other: 66,25/hr 1
charged at an hourly(1 hr mint
Inspections for which no fee is 90,00.hr
specilically listed(Yi hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal r nr r to1' ge 1):
(SEE OAR 918-309-0000) un erot i,,spectians�li�,etil pep r;rn.
Check Type of Work Involved:
❑ Audio and Stereo Systems
n Boiler Controls
n Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
• HVAC
❑ Instrumentation
n Intercom and Paging Systems
O Landscape Irrigation Control*
111 Medical
LI Nurse Calls
;❑ Outdoor Landscape Lighting*
n Protective Signaling
n Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
E?.L uikt g:Pa nr;istfi t•:'. Penr:ilAppF€..Ri t'.=..dec ROY 06/17;2015
Building Permit Submittal
Original Submittal Date: g102-elf
Site Plans: #
Building Plans:
Building Permit#: i - nter building permit#above.
Workflow Routing: Planning Engineering rmit Coordinator Building
Workflow Sign-off: ► Sign-off for Planning(include notes rom planning review)
Route Application Documents: ►; Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes: IF /
By Permit Technician: I I/� ____ Date.
E neering Review
rlDelope at building pad: 04
[Mr^ Conditions "Met"prior to issuance of building permit
EV
If/Easements (encroachments)per engineering conditions of approval and plat140(
[ u
Water Quality/Quantity Facility: / f
Assess Water Quality Fee in-lieu: ❑ Yes "No /0//4/1/'
Assess Water Quantity Fee in-lieu: ❑ Yes g No
LIDA Facility on lot: ❑ Yes r No
❑ Final Plat Recorded: Zile? l /eo' o, (6:V-p
74.
❑ NOT Approved by Engineering: Date:
Notes:
Lk/Approved by Engineering: _ Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
Approved, NOT Released: fa 47% jw Jtkua:I. 4i{
—Date: /2g )tf
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
vision Notice 3: Date Sent to Applicant:
SDC Fees Entered: Wash Co Trans Dev Tax: TrYes ❑ N/A
Tigard Trans SDC: LYes ❑ N/A
Parks SDC: Lt3' Yes ❑ NLA
LIDA ❑ YesN/A
OK to Issue Permit
Approved by Permit Coordinator: Date: `g14��1
I:\Building\Forms\BldgPermitRvw_RES_022819.docx