Permit ,;; . OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
Z
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 -00181 •
TYGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/1/2008
PARCEL: 1 S135AB -04500
SITE ADDRESS: 10250 SW GREENBURG RD 200 ZONING: C - P
SUBDIVISION: LINCOLN CENTER /LINCOLN BLDG LOT: 001 JURISDICTION: TIG
PROJECT: FOREST CITY
Project Description: Installing (1) low voltage protective signaling system.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL: X
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
SHORENSTEIN REALTY SERVICES HSM ELECTRONIC PROTECTION SERVICES
ONE SW COLUMBIA ST #300 15495 SW SEQUOIA PKWY STE #100
PORTLAND, OR 97258 PORTLAND, OR 97224
Phone: 503 -412 -4800 Contact #: PRI 503- 968 -3353
FAX 503- 968 -3398
Reg #: ELE 37- 1054CLE
FEES LIC 161567
Description Date Amount SUP 941 LEA
[ELPRMT] ELR Permit 7/1/2008 $75.00
[TAX] 12% State Surch 7/1/2008 $9.00 REQUIRED ITEMS AND REPORTS
Reversal - [ELPRMT] E 7/1/2008 - $75.00
Reversal - [TAX] 12% S 7/1/2008 - $9.00
[ELPRMT] ELR Permit 7/1/2008 $75.00
(additional fees not listed here)
Total $84.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
'
Issued By: . Permittee Signature: . C7� /1
4l
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: s10lc.O$- .-- fm4V REQUIRED ON GREEN INSPECTION CARD.
I ✓ • Code 1 Inspection Description I PASS Date I By ✓ Code I Inspection Description PASS Date By
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
•
410 Fill • 110 Temporary electrical service
415 C rading 115 Electrical service
205 Footing 120 Electrical rough -in
805 MFG - Structure grading /footing 125 Wall cover
210 Foundation walls 130 Ceiling cover •
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain • 145 A/C or heating unit circuit
225 Post /beam structural 150 Hot tub /spa /pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors _ 199 Electrical final
•
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry )c 199 Electrical final
270 Reinforcing steel (rebar) \
• 275 Framing
810 MFG- Structure set -up MEC - Mechanical Permit
280 Insulation 605 Post /beam mechanical
285 ^ Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic.piping
899 MFG - Structure final 625 Duct work
498 Grading final 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood •
695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in 305 Plumbingerslab
915 Fire alarm rough -in 310 Crawl drain
920 Suppression trip test •
995 Misc. inspection: 315 Post /beam plumbing
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan
330 Water service
•
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert/catch basin
410 Fill . 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing • • _ 399 Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
I: \ Building \ Forms \InspCazd- AOP- Blank.doc 02/02/07
. JUN-313-21211218 14:42 P. IZI2/03
Electricai rermit Application GE NE° FOR OFFICE USE ONLY
City of Tigard EISIFFY .-- Permit No.: ,.., L __ 87
• it
13125 SW hall Blvd., Tigard, 0B _ - Plan Review
: I Phone: 503.639.4171 Fax: 503 .58.l96,1 2.0 Date/hty: Other Perrnit:
.. .i, ic . ; A R 1 . ) Inspection Line: 503.639.4175 .. Date Ready/By: h..6 El See Page 2 for
Internet; www.tigard-or.gov / *mit) Notrlied/Method; AC Supplemental information
,, .. , ,.. .• , .. . . , , ., .. ... ,..„. : . .,:..:, ,,..,.,,•:.!. , ...... of , tivo ,:, ., : :,,, ,:. ., ,, ,. 7-777
0 New construction Addition/aleM placement Please check all that apply (submit 1 sets of plans w/items checked below):
0 service or feedee 400 amps til' more ID Building over three stories.
0 Demolition Other: where the available fault current 0 Marinas and boatyards,
..•:' ':: ':: i ': ': .' : .:'.: l'' :' ;.!... .:;eitidiji*IciiaiS,ki ,....::: ;,;;,,,,,:, . '... .: , exceeds 10.000 amps at 150 volts or 0 Floating buildings.
less to groun, or u.ceeds 14,000 El Commercial-use agricultural
El 1- and 2-family dwelling Commercial/industrial 0 Accessory building amps for all other installations. buildings.
0 Multi-family Master builder El Other: 0 Fire pump. 0 Installation of 75 KVA or 0 Iirnrganey larzer 5cpardtely derived system.
';:::; '':,:::; ii.,:or •::,..;.,..,,,, :, :::. . 0 Addition of new motor load of
Job no.: 323322/ Job site address: IDQF 0 keilid& 100HP or more,
) El six Of more reside 0 ntial units. occupancy.
Recreational vehicle parks,
fr--
City/State/ZIP: . 4 c) , ,, --,,,. lc,C 0 I lealtli..care racilities.
_4 _ __. 0 1-1;mirdous locations. 0 Supply volLige for numc than
i ,._;.1
600 volts nominal.
Suite/bldg./apt. no.: t Project ... or feeder 600 amps or e: AL iZe — C ' f Ds more.
,,,
Cross street/directions to job site •
41 . 1. :( /6:7- Description I Qty. I Vee. I Toro l •
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. 0. or less 145. I 5 4
1 Ea. add'l 500 sq. 11. or portion 33.40 1
Tax map/parcel no __
Limited energy,. residential
75.00 2
'HL. :::•'. :; ;;: .:, .::::;: ; • (with above sq. 0.)
L.—
Limited energy, multi-family
RLI*C Exicr ttl PAvel_ 01-46,_. 4 0 k , coovica- __ (with above sq, ft-) 75.00 I 2
Services or feeders installation, alteration. and/or relocation
Ni" 14 A/10T i OAN - 5 200 amps or less ! 80.30 1 2
,:'••:. :::.:'::,::::: IN ;1 : i ;' ; .' ; : . : =;',::: : • : :: . '::!;': : L:::(1, 1 044■1 . 1'J'+ ' ':H' : i .: 201 amps to 400 amps : 106.85 1 2
Name: 401 amps 10 600 amps 160.60 2
601 amps to 1.000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation --
Phone: ( ) Fax: ( ) 200 ainps or less
...-- 66.85 1
Owner installation: This installation is being made on properly NM I own whi 201 amps to 400 amps 100.30 2 ch is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 59<) amps 133.75 2
Branch circuits - now, alterstlion, or extension, per panel
OWnCr signature: Date:
--... A. Fcc for branch circuits with
:4001(;1CA/ITH ':':, ::! '.: 1', ..'''Y ' '1:[COilf,kOri..i*rtsorg !; ,.., ; above service or feeder fee,
6.65 2
_ each branch circuit
Business name: ' 14SA9 42C C14, 1-y B. Fee for branch circuits
tvithout service or feeder fee.
Contact name: : v_it) Suyotei2-_- first branch circuit 46.85 2
Address: 1.Se1.9 A ' 1 1 Aki.th, A/C)() Each addl branch circuit
6.65 2
4 '
• Miscellaneous (service or feeder not included)
..._.
City/Statc/ZIP: pa (Cr- c..), ra.. 9 aa A
Each manufactured or modular
90.90 2
dwelling, service
Phone. ( and/Or feeder
.. 31,.. l_ r L :30 , Fa_L6_3 l
(. . ( 11., 2
Oa Reconnect ony —.—..—_,... ...—
66.85 2
E-mail: Pump or irrigation circle 53.40 2
Sign or outline lighting 53, -
40 2
• . . .. • , ,. . : , : • • . • . . .
------
Signal circuit(s) or limited-
Business name; )4_ 0 c) ,....-
energy panel. alteration, or
-
Address: extension. Describe: K Page 2 1 1 i 2
...
City/State/ZIP: Each additional inspection over allowable in any of the above I
Pcr inspection 62.50
Phone: ( ) Fax: ( ) Investigation per hour (i hr min) 62.50
...--.. 1
CCB Li.: 3 icat F.,leetrical I..ic.: /6 (5 Suprv. I,,ic.: Industrial plant per hour 73.75 I
: • • ;... ' • ' ELECTRICAL PERMIT: FEES
Suprv. Electrician signature. required: — subtotal: -7 6 0
,-
Ian review (25% of permit fee):
Print name: f 7-l 0 ..... An 0 , 2 „, + s,.., ,-- Date: / _.-..? ___ P._ ,,, ,.... 1 _______ State surcharge (12% apermit Ice):
"
Authorized signature: ':_______.---------- TOTAL PERMIT FEE: ..-•
lb . * :
s not obtained w thi 180
Print name: 0e__t: ,,,,,, r Date; 4 , 6" /::::: :yj' -'-‘ -
---- 'i - r-4 This permit application pires if a perm
ex i it in
days after it has been accepted 115 complete-
-- ------- • Number of inspections allowed per permit,
I ■1301101aggermitalc-PemiliAea.doc 05/2,3/N 440.4r,1 1'r( i lionicsomiwliEl