Permit ELECTRICAL RESTRICTED ENERGY PERMIT
` COMMUNITY DEVELOPMENT Permit #: ELR2010 -00071
4:160:13' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/21/2010
Parcel: 1 S 135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 900
Subdivision: LINCOLN TOWER Lot: 0
Project: NW Mortgage Expansion
Project Description: Low voltage for fire alarm.
FEES
Owner:
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555 Restricted Energy Permit 05/21/2010 $67.84
CALIFORNIA ST 49TH FL 12% State Surcharge - Electrical 05/21/2010 $8.14
PHONE:
Contractor:
CAPITOL ELECTRIC CO INC
11401 NE MARX STREET
PORTLAND, OR 97220
PHONE: 503- 255 -9488
FAX: 503- 257 -7121
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: N Fire Alarm: Y
HVAC: N Instrumentation: N Total $75.98
Intercom /Paging: N Landscape /Irrigation: N
Required Items and Reports (Conditions)
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N
Other Desc:
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 -0100. You may obtain a co of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued B ��G iL� _ -�1 .. _ �!� Permittee Signature: cJ 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 an inspection that business day.
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
t .
-r FORiOFP€,K U SE ONLY _ '.'1'," " "
� , a o )
Received
City of Tigard �j W Date /By: 7 X 7 fe Permit no.: j / - 6007 /
} } , Ej ' 13125 SW HaII Blvd., Tigard, OR 9722 , r Plan Review
' - I Phone: 503.639.4171 Fax: 503.598.1960 Date /By: Other Permit. Q, n ��
q t )(,l f
(T� Inspection 503.639.4175 .APR 27 2010 Date Ready/By: Juris: ❑ seei'age2ror
a .+ Internet: www.tigard- or.gov (�jf�
Notified /Method: • j V -6 Supplemental Information
CITY OF TIGARD Sif w4 ,_
TYPE OF WORK 3UI.DING DIVISION PLAN REVIEW
❑ New construction U Addition /alteration /repla en en Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Demolition ❑ Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories
CATEGORY OF CONSTRUCTION where the available fault current ❑ Marinas and boatyards
❑ 1- and 2 family dwelling U Commercial /industrial ❑ Accessory building exceeds 10,000 amps at 150 volts or Floating buildings
❑ Multi family ❑ Master Builder ❑ Other less to ground, or exceeds 14,000 Commercial -use agricultural
JOB SITE INFORMATION AND LOCATION amps for all other installations. ❑ buildings
Job no.: 100395 - 45 Job site address: 10260 SW Greenburg Rd. ❑ Fire Pump ❑ Installation of 75 KVA or
❑ Emergency system larger separately derived system.
City /State /ZIP: Tigard, OR 97223 ❑ Addition of new motor load of ❑ 'A ", "E ", "1 - 2 ", "1 - ",
100HP or more. ❑ occupancy
Suite /bldg. /apt. no.: Suite 960 Project name: NW Mortgage T.I.
El six or more residential units El Recreational vehicle parks.
❑ Health -care facilities ❑ Supply voltage for more than
Cross Street/Directions to job site: Lincoln Tower ❑ Hazardous locations ❑ 600 volts nominal.
❑ Service or feeder 600 amps or more
FEE SCHEDULE
Subdivision: Lot no.:
Description I Qty. 1 Fee. I „
'total
Tax map /parcel no.: New residential - single or multi - family dwelling unit.
DESCRIPTION OF WORK Includes attached garage.
Install Fire Alarm Circuit 1000 sq. ft. or less $ 145.15 4
Ea. Add'I 500 sq. ft or portion $ 33.40 1
Lf PROPERTY OWNER 1 Li TENANT Limited energy residential
(with above sq. ft.) S 75.00 2
Name:
Shorenstein Realty Services Limited energy, multi - family
Address: residential (with above sq. ft.) _ 5 75.00 2
Service or feeders installation, alteration, and /or relocation
City /State /ZIP: 200 amps or less S 80.30 2
._ _ _, 201 amps to 400 amps $ 106.85 2
Phone: Fax: 401 amps to 600 amps S 160.60 2
601 amps to 1000 amps $ 240.60 2
Owner installation: This installation is being made on property that 1 own which is not Over 1000 amps or volts S 454.65 2
intended for sale, lease, rent or exchange, according to ORS 447, 449, 670, and 701 Temporary services or feeders installation, alteration, and /or
Owner signature: Date: relocation
200 amps or less $ 66.85 I
❑ APPLICANT 1 Li CONTACT PERSON 201 amps to 400 amps S 100.30 2
Business Name: 401 amps to 600 amps $ 133.75 _ 2
Branch circuits - new, alteration, or extension, per panel
Contact name: A. Fee for branch circuits with
service or feeder fee, each
branch circuit 5 6.65 2
Address:
B. Fee for branch circuits
without service or feeder fee,
City /State /ZIP: first branch circuit 5 46.85 2
Phone: Fax: Each additional branch circuit: S 6.65 2
Miscellaneous (service or feeder not included)
E -mail: Each manufactured or modular
CONTRACTOR dwelling, service and or feeder S 90.90 2
• Reconnect only S 66.85 2
Business Name: CAPITOL ELECTRIC CO., INC. ` (
, _ ^
tl Pump or irrigation circle $ 53.40 2
Contact name: r ___ / ' / Sign or outline lighting 5 53.40 2
• /'�� �/�+vt �l/`�S Signal circuit(s) or limited- /, p'/
.....Address: 11401 NE MARX ST. .LA (- - energy panel, alterations, or CG7• 0 e
extension. Describe: 1 F',. 2 75.00 2
City /State /ZIP: PORTLAND, OR 97220 -1041 Fire Alarm Circuit
Each additional inspection over allowable in any of the above
. Phone: 503 - 255 -9488 Fax: 503 - 255 -1966 Per inspection S 62.50
Investigation per hour (1 hr min) 5 62.50
CCB Lic.: 48748 Electrical Lic.: 26 -496C ISuprv. Lic.: 2865 -S 1611
I UD Industrial plant per hour
$ 73.75
" ---, Suprv. Electrician signature, required: ` ELECTRICAL PERMIT FEES*
/.1_.----/' Subtotal $ / 4 1 g. o>
Print Name: Richard Martin Date: 04/22/10 Plan review (25% of permit fee)
Authorized signature:
State i State surcharge ( 12% of permit fee) $ $.1 fir0r
TOTAL PERMIT FEE $ j4-1f
9
Print Name: Richard Martin Date: 04/22/10 This permit application expires If a permit is not obtained within 180 / 8
days after 11 has been accepted as complete. �ryJ V
* Number of inspections per permit allowed.