Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2011 -00160
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/30/2011
Parcel: 1S135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD •
Project: Five Lincoln Subdivision: LINCOLN CENTER /FIVE LINCOLN 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 th ugh OAR 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.23 •87 or 1.800.332.2344.
Issued B — ` Permittee Signatur / . '
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.
From: Andrea Rice 06/29/2011 11:21 1t211 P.012/013
Electrical Permit Application l-ORR 01 FA( 'L USE 1) \I.1
City of Tigard : l? Permit
No.: k
1 "
�e,�r / — oal,‘
13125 SW Hall Blvd., Tigard, OR 97223 `�
2 Phone: 503.718.2439 Fax: 503.598.1'i D , _ Other Permit: ,Q a - 4 e of •
Inspection Line. 503.639.4175 L Date .lurk: lZi See Page 2 for
T I C3 nit D Internet: www.tigard-or.gov , � � ._lZ};' Supplemental Information
-0, 1„;..1_,'`, '.: ,�- •s» 7777.-7-7 ss' ° - . 4-;',47,17W,,5,-, * * *. y '�" :m"7
...A.,,.;.. , r ..., -*,. ,, r N- ' :)77 C Me 4 ',P.,, , - + .y .r 4 1;,x , ry 1 lc ' .. rt yt`^'
❑ New construction ® Addition/alteration/replac -. :1'. 0, � 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.
where the available fault current ❑ Marinas and boatyards.
.( , , c ' %.v?°t', . : � , e �� ti ,, , ,, , exceeds lU > 000 amps at 150 volts or ❑ Floating buildings.
❑ 1- and 2- family dwelling ® Commercial/ industrial ❑ Accessq building am so ground, or exceeds ons, ❑ buildings. ing -use • agricultural
ry g amps for all other installations. buildings.
❑ Multi-family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
'" r a e ' e�; e c a �; s .,1 ❑ Emergency system. larger separately derived system.
' �- - „ 2:1 a a s^t , s :%1 ❑ Addition of new motor load of ❑ ..A> separately derived
Job no.: Job site address: 10200 SW Greenburg Road laoBr or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: Tigard, OR, 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous Iocations. 600 volts nominal.
Suite/bldg. /apt. no.: I '.Pro name: 5 Lincoln ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: Description Qty. Fee. Total
New residential single - or multi- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4
Tax map /parcel no.: Ea. add'l 500 sq. ft. or portion 33.92 1
Limited energy, residential
° :w. s R f t W ` k 'a w ; � e it
` -q (with above sq. R.) 75.00 2
; . „n o, .,_-- . ,tee -�. " � A..�., 4 a r« .�� .41 u'al3Lt -a Limited ene Fire rgy, installation equipment ergy, multi - family 75.00 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
�g - 1', x ` . a ; c _ 4 f Afro, �";- " ' 201 amps a` t .a.,.� .,s..s : 51, -. `.. _.p: t: a - '.... aim ?'u Pa to 400 amps 133.56 2 P
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
Temporary services or feeders installation, alteration, and/or
City /State/ZIP: San Francisco, CA, 94104 relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Pee for branch circuits with
'�, a te o a r , above service or feeder fee,
. r � � y���` s. 3 , .« ' N° �s ���.r, r 7.42 2
each branch circuit
Business name: Advantage Protection, Inc. B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: Jason Keller branch circuit
Each add'I branch circuit 7.42 2
Address: 8510 -C East Mill Plain Blvd Miscellaneous (service or feeder not included)
City / State/ZIP: Vancouver, WA, 98664 Each manufactured or modular 67.84 2
dwelling, service and/or feeder
, Phone: (360) 695 I Fax: : (360) 696 - 2901 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E jasonkeller@advproinc.com Sign or outline lighting 67.84 2
a g
:`=.� W sit �a-TX ele:„s,.,,..�r. ***+ 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 abov
Address: 8510 - East Mill Plain Blvd Additional inspection (1 hr min) 66,25/ hr
Investigation (1 hr min) 66.25/ hr
City / State/ZIP: Vancouver, WA, 98664 Industrial plant (1 hr min) 78.18/hr
Phone: (360) 695 -5072 Fax: (360) 696 -2901 Inspections for which no fee is 90.00/ hr
:. cificall listed Is hr min
CCB Lic.: 114312 Electrical Lic.: 37-67 _ CL E Suprv. Lic.: 3217LEA K, ?4? ^ E �i t5`a a s -,, i
Subtotal:
Suprv. Electrician signature, required: b Plan review (25% of permit fee):
Print name: C S N s . Date: /q /�� State surcharge (12% of permit fee):
TOTAL PERMIT FEE:
Authorized signature: This permit application expires if a permit is not obtained within 180
p days after It has been accepted as complete.
Print name: 3 A 3 L.. y \ ` `/ v Date: t7 0 1 1 \ • Number of inspections allowed per permit.
I:\ BuildingWermlts \ELC- PesmitApp.doc 07/01/10 440-4615Tp1 /05/COM/WS3
From: Andrea Rice 06/29/2011 11:21 1#211 P.0131013
Electrical Permit Application - City of Tigard
Page 2- Supplemental Information
LIMITED ENERGY PERMIT FEES:
MINWONAPAWYNWAMNIETra AVM
Fee for all residential systems combined $75.00
Check Type of Work Involved:
I=1 Audio and Stereo Systems*
O Burglar Alarm
0 Garage Door Opener*
D Heating, Ventilation and Air Conditioning System*
El Vacuum Systems* .
o Other:
Vi-0
Fee for each commercial $75.00
system
(SEE OAR 918
Check Type of Work Involved:
El Audio and Stereo Systems
El Boiler Controls
El Clock Systems
Data Telecommunication Installation
Fire Alarm Installation
O HVAC
D Instrumentation
O Intercom and Paging Systems
0 Landscape Irrigation Control*
El Medical
El Nurse Calls
O Outdoor Landscape Lighting*
O Protective Signaling
• Other
Total number of commercial systems: 1
*No licenses are required. Licenses are required
for all other installations
INSui1ding1Permits \ELC-PennitApp.doc 07/01/10