Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2011 -00158
•
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/30/2011
Parcel: 1 S 135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD
Project: Three Lincoln Subdivision: LINCOLN THREE Lot: 0
Project Description: Low voltage for fire alarm.
Contractor: ADVANTAGE PROTECTION INC Owner: LINCOLN CENTER LLC
8510 -C EAST MILL PLAIN BLVD BY SHORENSTEIN PROPERTIES LLC
VANCOUVER, WA 98664 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 360- 695 -5072 PHONE:
FAX: 360 - 696 -2901
FEES
Description Date Amount
Specifics: Restricted Energy Permit 06/29/2011 $75.00
12% State Surcharge - Electrical 06/29/2011 $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: N Fire Alarm: y
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 OAR 952 -001- 0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332. . 2 2344.
Issued By: Ck. �• �'�- IXQ�� .4 �Z( (,i Permittee Signature: �' , -1/ 4 /6-
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.
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From :Andrea Rice 08/29/2011 11:19 #211 P.008/013
Electrical Permit Application `° r(l 01 1( F. t s : ()NIA
.
City Received Q of Tigard 4 +� telly. to . ! ! f / j ib Permit No.: E /.... ev / -ie!// U
a 13125 SW Hall Blvd., Tigard, OR ,97223 1 , . " plan Review
2 Phone: 503.7182439 Fax: 503` 3 ' eQ Date/By: Other Permit fr?. /1 e/0
1 l c.n K� Inspection Line: 503.639.4175 �% r Date Ready /By: Allis: 53 See Yage 2 for
Internet: www.tigard-or.gov \v Notified/Method: Supplemental Information
� .
° u 1 '4,44,:'''447...., r d 6 , - B @. : s 3r w '' ^ . ,41-4.(-4-,-,,,,,,,g14,-K„, p"
:::ees,. aeu � � �.:i - ' ��.,`. _ 1'A`3:.:: • .r< � `,.h..., . � 9r'�' . „ r� < .m x a � �L.T:�. �. s
❑ New construction ® Addition/alterati • r W . , ,1 + w Please check all that apply (submit 2 sets of plans w /items checked below):
D Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition ❑ Other: N® • where the available fault current ❑ Marinas and boatyards.
- `"�"� , sue; s - E`� Y y a n `� " .4 is y . : It p at 150 volts or ❑ Floating buildings.
r � o- - - �, exceeds 111,000 am p at
.k, : ° - ,.. `''� "- ++� ` s i. less to ground, or exceeds 14,000 0 Commercial - use agricultural
0 1- and 2- family dwelling IE Commercial /industrial 0 Accesspry building amps for all other installations. buildings.
0 Multi- family 0 Master builder 0 Other: ❑ Fire pump, ❑ Installation of 75 KVA or
^ 0 x o iy a p` e �, r r� - ° ❑ Emergency system. Iarger separately derived system.
.,1; � f1 , a o i<: ', .4° Q Addition of new motor load of 01"A", " -2 „ "
Job no.: Job site address: 10220 SW Greenburg Road` laoFP or more. occupancy,
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: Tigard, OR, 97223 0 Health-care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 'Project name: 3 Lincoln: ❑ Service or feeder 600 amps or more.
Cross street/directions to job site : ?!
J Dgegpdoa Qty. - Fee. Total t
New residential single- or multi - family dwelling wait.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4
Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.92 1
w t , . Limited energy, residential
r� 1 1 � -. r- , ' er s +� JT �rM °e yr" 5¢ v _ c t '' W "= (with above sq, ft.) 75.00 2
Limited energy, multi - family
Fire radio installation to existing equipment residential (with above sq. ft.) 75.00 2
Services or feeders installatio . alteration, and/or relocation
�{ 200 amps or less 100.70 2
� @ `t ? r �t ri .r; ' F R � , 7 a. 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: Lincoln Center LLC 601 amps to 1,000 amps 301.04 2
Address: 555 California St 49 FL Over 1,000 amps or volts 552.26 2
City/ State/ZIP: San Francisco, CA, 94104 Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 I
made on that I own which is not 201 amps to 400 amps 125.08 2
Owner installation: This installation is being property 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A, Fee for branch circuits with
RAF r i t 3 c I , Kx :a . ' each branch a o r f eer fe 7.42 2
Business name: Advantage Protection, Inc. - c w is +r .�, - B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: Jason Keller branch circuit
Each add'l branch circuit 7.42 2
Address: 8510 - C East Mill Plain Blvd Miscellaneous (service or feeder not included)
City /State/ZIP: Vancouver, WA, 98664 dwelling, manufactured service and/or or r feeder 67.84 2
dweIlitig, service and/or feeder
Phone: (360) 695 -5072 I Fax: : (360) 696 -2901 _ Reconnect only 67.84 2
E -mail: j asonkeller®advproinc,com Pump or irrigation circle 67.84 2
Sign or outline lighting 67.84 2
r �' A w t W ;,,.s • , uDs g WW Signal circuit(s) or limited-energy
Business name: Advantage Protection, Inc. panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 8510 - East Mill Plain Blvd Additional inspection (1 hr min) 66.25/ hr
City /State/ZIP: Vancouver, WA, 98664 Investigation (l hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (360) 695 - 5072 I Fax: (360) 696 - 2901 Inspections for which no fee is
specificall listed S'r4 hr min 90 00! hr
CCB Lic.: 114312 Electrical Lic.: 37 672CL�' I Suprv. Lie.: 3217LEA ? x , 1 ,i"e 11� t e; a:u;. .
Subtotal:
Suprv. Electrician signature, required: f , Plan review (25 %ofpermit fee):
Print name: - �y .... Da te: i D��' St ate surcharge (12% of permit fee):
Authorized signature:
TOTAL PERMIT FEE:
L ._ l A:./ d This permit application expires if a permit is not obtained within 180
Print name: "S
e7 days after It has been accepted as complete.
� �� Dater , w Number of inspections allowed per permit
I:\ Buildi °g\Permits \ELC-PemitApp.doc 07/01/10 440.4615T(11/05/COM/ws3
From:Andred Rice 06/29/2011 11:20 #211 P.009/013
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
7t ® ;1::.
. -W«i`.vari .z' rr 7.72
Fee for all residential systems combined $75.00
Check Type of Work Involved:
El Audio and Stereo Systems*
❑ Burg1 r Alarm
❑ Garage Door Opener*
El Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
El Other.
Fee for each commercial $75.00
system
(SEE OAR 918 309 - 0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
/ .1 Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control's
El Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems: 1
*No licenses are required. Licenses are required
for all other installations
I:\ Building \Pemita\ELC -PermitApp,doc 07/01/10