Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
I `1 COMMUNITY DEVELOPMENT Permit #: ELR2011 -00048
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/25/2011
Parcel: 1S135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 400
Project: Bridgewell Resources Subdivision: LINCOLN CENTER /FIVE LINCOLN Lot: 0
Project Description: Data telecommunications system.
Contractor: STONER ELECTRIC Owner: LINCOLN CENTER LLC
1904 SE OCHOCO BY SHORENSTEIN PROPERTIES LLC
MILWAUKIE, OR 97222 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503 - 462 -6500 PHONE:
FAX: 503 - 659 -4968
FEES
Description Date Amount
Specifics: Restricted Energy Permit 02/25/2011 $75.00
12% State Surcharge - Electrical 02/25/2011 $9.00
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: Y Fire Alarm: N
HVAC: N Instrumentation: N
Intercom /Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N 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 O' : • 52- 001 -0090. You may obtain a co. of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. \
Issued By. �L , �_ " - _` Permittee Signature: '+ - �G /, . i -...ALA. 71111111.
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.
Feb. 25. 2011 7:26AM Stoner Electric Group No. 6900 P. 1
Electrical Permit Avolication FOR OFFICE I :til; ONLY
; - City of Tigard .
R6ce 2
- g 13125 SW Hall Blvd., OR 97223
• ' Phone: 503.639A171 . .
, Fax: Tigard,
1111 Pplairltev:iew
Other Pcnwit; i A , I I_ • ( x)1
Inspection Line: 503,639.4175 Date Ready/0y; 13 Sec Page 2 for
I it.:Aici)
Internet: wsv Notified/Method: • saM Supplemental Information
• • . , • ' 1 . , :fiiii:deiietik.,:71:.:,(ce"e:::if:q'..5.Y.W.: 7 7 :'' '.. . PLAN REVIEW ' ,:':' : ";: '
Pleas; chock all that apply (submit a sets of plans w/items checked below):
1=1 New construction Addition/alteratiOn/replaCement .
0 Service or feeder 400 amps or more 0 flvildtog over three stories,
D Demolition 11 Other: where the available fault current 0 Marinas and boatyards.
$:4E,..:
CATEGORY OF CONSTRUCTION ". . ': ', :: .,.7 :'. : . ' exceeds 10.000 amps at 150 v 13 oila or Floating buildings
kii .
,. less to ground, or exceeds 14,000 0 Commercial-we agricultural
0 I Snd 2-family dwellingAi Commercial/industrial 0 Accessory building amps for all other installations. buildings.
11 Multi-family n Master builder U Other; D Fire pump. 0 Installation of 75 KVA or
larger separately derived system.
. ' :; '''44 e' ' ^ - ! ,, . , i ':.:' , • ' ,,-, ,, i ' D Addition ofnew motor load of 0 "A", "E", "1-2", "1-3",
100HP or more. occupancy,
Job no.: /3/ 1,s / Job site address: fliZpo f 6/, 41
D six or more residential units. ID Recreational vehicle parks.
CI Health-care facilitios.
City/State/ZIP: -11 c, 0 , e_, 9 4. ... 0 Supply voltage for more than
7-z
/ Ei Hazardous locations. 600 volts nominal.
4igitibldg./apt. no.: r, L(qj Project statue: de ,e,,,,,,,,,,, n SerVIC6 a/feeder 600 amps or more.
%4:- 7
Cross Street/directions to job site: nerchi0114,1 I Orr. I he. I Tout I •
New residential single- or niniti-family dwelling unit.
Includes attached garage.
—
Subdivision: I Lot n0,: 1,000 sq. fl. or less 168.54 4
Ea, Add' I 500 sq, ft, or portion 33.92
fax map/parcel no.: Limited energy, residential
75.00 2
iltd (with th 4 11 ..)
Limited energy, multi-family
75.00 2
VC; c Cite& /4/6 residential (with above s(4 . ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
111'g1 tAiiVfP97404r: ,:dt] ',:'T 201 amps to 400 amps 131% 2
401 amps to 600 amps 200.34 2
Name:
601 amps Co 1,000 amps 301.04 2
Address; Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
cIt /State/ZIP:
relocation _
Phone: ( ) Fax: ( ) ' 200 amps or less 59.36 1
201 amps to 400 amps 123.08 2
Owner installation: This installation is being made on property that I own which is not
intended for sale, lease, rent. or exchange, according to ORS 447, 449, 670 401 amps 10 599 amps 168.54 2 , and 701.
Wench circuits- new alteration or extenion, r mini
Owner signature; Date: A. Fee for branch circuits with
arat'aeOf : .:::: ';;fr'.",;; ;ft 471Er6OlitAtif iiiikVIP(544< above service feeder fee,
7.42 2
• ' ' isSlE" . ; - • — - . ., , • . . . , ^" 2 'X!'t' :: , e ,1 ":: ,,,, '.'r : • . •--- . ,•-•• . 1 WN :Tr - i:' each branch cucull
Business namd: B. Fee for branch circuits without
service or feeder fee, first
56.10 2
Contact name: branch circuit
Each add'I branch circuit 7.42 2
Address: hliseelianeous (service or terrier not included)
Each manufactured or modular
City/State/ZIP: 67.84 2
dwelling. service and/or feeder
_
Phone; ( ) I Fax; ; ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E-mail;
Sip or outline lighting 67.84 2
! ' , Signal circuit(s) or limited ,
time', alteration, or extension. f PII:e 2 750D 2
Business name: STONER ELECTRIC, INC. Each additional Inspection over allowable in any of the above
Address: 1904 SE OCHOCO Additional inspection (1 hr min) 66.25/ hr
Investigation° hr min) 6625/Iv
City/State/ZIP; MILWAUKIE, OR 97222 Industrial plant (1 hr min) 78.18/ hr
..
Plume: ( 503 Fax: ( 503) 659-4968 Inspections for Which no fee is -
specifically listed ( hr mm) 90,00/ hr
CCB Lic.: 44823 J Electrical Lie.: 26-122C I Suprv. Lie.: 3496S . ' • ELECTRICAL PERMIT FEES .'
.._
Subtotal: 7:5". 0 P
Suprv. Electrician signature, required: m it i ta„.. t) )...1,„
Plan review (25% of permit fee): .. .
Print name: MICHAEL FALCONER Date: Z /1,510 State surcharge (12% of permit fee): yi 0 0
TOTAL PERMIT FEE: 454, 00
Authorized signature:
This permit application expires ifs permit is not obtained within 180
.
days prier it has been accepted Si complete.
Print name; I Date;
* Humber ofirtspectiorta allowed per permit.
TABuildingTennitstELC-PemitApp.doc 07/01/10 44046157(11/05/COMMED
Feb. 25. 2011 7:26AM Stoner Electric Group No. 6900 P. 2
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
-SYDCNrIAL WO 4Y - i
Fee for all residential systems combined .. $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
f 7 OMl1 OCI.AL ` OIT 1Y1 :_ F
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
. ❑ Audio and Stereo Systems
❑ Boller Controls
❑ Clock Systems
Data Telecommunication Installation
❑ ,Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other 1
T
•
otal number of commercial systems: I
*No licenses ate required. Licenses are required
for all other installations
1 :lIIuildinglPermiLAELC- PerratApp doc 07/01/10