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Permit 114 a CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT ' . .a .. COMMUNITY DEVELOPMENT Permit #: ELR2010 -00007 Tl GRD' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 01/15/2010 A Parcel: 1S135AB04500 Jurisdiction: Tigard Site address: 10250 SW GREENBURG RD 300 Subdivision: Lot: 0 Project: Forest City Project Description: Install restricted energy for protective signaling. FEES Owner: LINCOLN CENTER LLC Description Date Amount BY SHORENSTEIN PROPERTIES LLC, 555 Restricted Energy Permit 01/15/2010 $67.84 CALIFORNIA ST 49TH FL 12% State Surcharge - Electrical 01/15/2010 $8.14 PHONE: Contractor: STANLEY CONVERGENT SECURITY SOLUTIONS INC 15495 SW SEQUOIA PKWY STE 100 PHONE: 503 - 968 -3353 FAX: 503- 968 -3398 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: N 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: Y 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 thr gh R 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: ���i�J1JV - 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' g o Q /1p 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. Jan. 15. 2010 3:04PM No. 5804 P. 1 Electrical Permit Application FOR OFFICE USE ONLY City of d n :u»,a _ , Permit No.: E ,, 10 .. oc '� I llhi 13125 SW Hall Tigar Blvd., Tigard, OR 97223 Plan Rev ew Ll I `� �-1 J C • Phone 503.639.4171 Fax: 503.598.1960 D Other ['1C;AKU Inspection Line: 503.639.4175 Date Ready /B 1 l P.I See Page 2 for Internet: www.tigard or gov Noniied/Metlzod l9, 5upptementa1 information ,� a 1 ,:. I ', a x.::.:rs: :::..:s ., .. ,... E [ F .,.., .e - i ss::::s: :: . . 'rE . s..= a a y F. krz EtiEE:i'p�i !l' I'r8i { I {i ..... ....... .. rz=:. -1 �' _'� :., . .v. - - . ...F:.- ... : _ : _.,., ".. ::: .p=s.q -, , , J t =i �- -- .:- :::::::: { rl�. i��4tly�l�, ��ry�ill {Italrzazav:asslmi;mss;�! quiz- a r+ s,al�.i>_��� i ..... ........._ :.._ :: ::::.:: =r t- 1. -�1a r ..........:.... i....: �' �::;' �. nsstill{f{ �� � {Ii�.��::::}Ii14{.�lf� ❑ New construction Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w/items clocked below): ❑ Service or feeder 400 amps Or more ❑ Building over three stories. ❑ Demolition ther: where the available fault current ❑ Marinas and boatyards, xllgli t { { llt111 ffli t rg rt l t �, _t � `= s ---- = l Ft t = =a exceeds 10,000 amps at 150 volts or ❑Floating buildings. - t..r� ;,..{ 1i.1� {,.11 {h i t{z i�z f ir 1 , t V et ri .�• ,,::... „4 : ;:>_ . - 1 - IESS t0 ground. Or exceeds 13,000 ❑Commercial -uac agricultural ❑ 1- and 2- family dwelling F 4 Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ■ [] Multi- family ■ aster builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or +;H i'it , : •-- ._..,, :_ ... „ ❑ Emergency system. larger separately derived system. Id {{ { 1 q it =.: -i's=-°iii:= a i ._'r i :ilki :.j�f { f 1 �. _ � � �_ � >t�IF�t�lt;a��:�t> tit-- a.,��►�i:t�llt�: t::r<:,:::; __ -- <:: >_.: .a:::,. : z..: ::: :: ._* tL' . =ihs lltii;l +� �lLaaiL.i�;ut ,.t. -.� , a.,: r: :�:. :=izl��>:,:..:.:.�....,_. ,.,., ----- .. ❑ Addition of new motor load of ❑ , "E" "1 -2" "1.3". 37) , 1 (C I o 50 6.O p R) Six or more reti occupancy. Joh no.: Q �OtJ lob site address: lJ V 1© V 1 { ❑Six or more residential netts. ❑ Recreational vehicle parks. City /State /ZIP: R't" lA.( (' C, Cj 7 2 3 ❑ Health -care facilities. ❑ Supply voltage for more than }� "x ❑ Hazardous locatmns. 600 vulti nominal. Suite/bldg. /apt- no.: j ,t? Project name: e 8 c 1 ] 7 sans Service Sece feeder 600 amps or more. p �� 7 ` r " 1 fig i El i�'.r: rrr:te. wth�+ la e 1 l,S r'# }�T r ,{y��` .,y,{, � l iili:�- y v: :_ r" •' � , _ r s 9 : �h 1!r a r� r �{ r .l^7�G .31:% lal r o Cross street/directions to job site: naaeeipttoa j o' . 1 x... I Total 1 • New residential single- or multi- fanrilV dwelling unit. __ Includes attached garage. Subdivision: Lot no.: - 1,000 sq. ft. or les 145.15 4 Ea. add'l 500 sq. R or portion 33,40 1 Tax map /parcel no 1 5{ 3 5 8 cat 5 oL onna Limited energy, residential c :r Pr' . r :Niag': tr:s q E q lb' r { " ii " = 75.00 2 . i �4 ii4t1 { � p !. 11th! 8 itth'1 `hz 0 ;1 ,l. "d r F =:, :r = ,r = G= r - r a (with above sq. ft) -, __i € €r` ='' :u=i { Lid fir EC11'd6� ts?le��t t Ss y 1s > htl:: =: =:::2`.'i � i €� r :� t ec�� x Limited energy, multi- family ReLOt. - E Tv1 45( {b 4C S S L.guip tfr Y" ,1,::c'L i o 3 residential (with above sq. ft.) X5.00 2 Services or feeders installation alteration, and/or relocatio 200 amps or loss, 80.30 2 l ( y� _ tI9 - ' K h' a ige t =l�.(I 1 a i , fatia: �� 1 ' I I 1 1 it r }i1 i a ail � aS { E 7 a h l" 201 amps to 400 a . 1 ( .. d..J k 99 v �= - •= --::: _ :< '�� !r , ,.�i,�lij��{' ri d l [� � iMr l I't•� amps 106.85 2 '. ..._ . =.c.:..c:a.ni� . • k ' a:w .,>�.Iua.I.. d'r<a.11 u a .r „h a. ll� s if .....l� ,w�y4 a, b is 6. ttla t fi lux . f�l �1. Name: 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 1 454.65 2 City /State/ZIP: Temporary services or feeders installation, alteration, and/or _ relocation Phone: ( ) Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 40o amps 100.30 2 intended for salt, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2_ Branch circuits - new, alteration, or extension. per panel Owner signature: Date: A. Fee for branch circuits with 1 , r i ..,. M . .. = itra?r4 < T.� _ - _ =- �i..i.t . tr ... ��:::cn::• r::x� try fr ; vs +a� .� ...p ..rrgtlilts"uek'i' } M; si1t 4( a._ :----_ - -::. - :�-,rt��.�t( .. _ „i :Y,;;. -'I i n: ; 1 above service or feeder fee, 1 :,,J 1°.i{'twa ikli.W. . six uG :773c�'Il i....._.., vr�` -rati> _.' _ �raxs{ e 1 _._ ::.,. 1.,{ 1 r , .', . r ti's• ;atta.tdd.:,i. each branch circuit 6.65 2 Business name: '7- ) S B. Fee for branch circuits i 1 without service or feeder fee, Contact name: 51-c u 5 /4-.yd ,_- first branch circuit 46.8:5 2 Address: 1 5 Li9 5 S'o S L0 /4} 9�oo Each iauseous (ser 1 6. �^ 2 !! �"� 1Vfiscellaneous (service or feeder not included) ) City /State/ZIP: p 0 2 Each manufactured or modular ` dwelling, service and /or feeder 90.90 2 Phone: ( 1 )) Ou, 1r' 335 3 Fax:: ( )) °j44 3 a � if Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 ��� ! t 6 ii ........_ '' 1;1"31 +a j�.. �� a,4ll1tt1 t!i i tip; rr ,. �, iL:' 4101x1 { �I 1 { �st`� �f iS ll {t { ii11Is [VE Sign Or outline lighting 53.40 2 Signal circuit(s) or limited - Business name: T AJUL? / u cncrgypanel, alteration: or Address: extension. Describe: V Page 2 I 2 City /State/ZIP: Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50 r I plant per hour 73.75 CCB Lic.: . 7 - Electrical Lic.: Su Lic. 7. _ ,• _. '�" ,L �, �` i:,11{rlutlui ll:11 tliY 1 1 u r: w ' <<I .,. T in r: O . . 1 ,i' :i dwlu.5.... i {ii}!ril . .it' » Suprv. Electrician signature, required: 5 Subtotal:' --I 1 print name: 510 e, A, (e ,5,e _._,. Date: ) -13-710 Plan review (25;0 of permit fee): __. -,..- _...._._ State surcharge (12% of permit fee): Authorized signature. TOTAL PErevt1T FEE: This permit application expires if u permit is not obtained within 180 Print name: u .{.4.) Spid... _ � Date: / "- � ,0 days after ft has been accepted as complete. • Number of inspections allowed per permit. ' 1. 1HuildinglPermiu1Et .C- PermrtApp.doc 05/23/06 � �/� - I n �r 44 � 0- 4