Permit i
CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
- COMMUNITY DEVELOPMENT Permit #: ELR2009 -00203
Date Issued: 07/29/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
, . Parcel: 1S135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD
Subdivision: Lot: 0
Project: Lincoln 2 DDC Upgrades
Project Description: Low voltage wiring for DDC controls for Common Areas •
FEES
Owner:
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555 Restricted Energy Permit 07/29/2009 $75.00
CALIFORNIA ST 49TH FL 12% State Surcharge - Electrical 07/29/2009 $9.00
PHONE:
Contractor:
AMERICAN HEATING INC
1339 SE GIDEON ST
PORTLAND, OR 97202
PHONE: 503 - 239 -4600
FAX: 503 - 239 -7038
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: Y Instrumentation: N Total $84.00
Intercom /Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N Required Items and Reports (Conditions)
Nurse Calls: N Protective Signal: N
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 ap.roved 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 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 II -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: 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' 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.
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City of Tigard �! a G PcnnitNo,' • Ili ' J b i E CE\
Plan .Bevtcw Other Permit:
w 13125 SW!ma B lvd„ Tigard, O 972 t 0
'' t Phone: 503.639.4171 Fax: 503 - 598.1960 11 c) 1 7 O pa�v — sets B SeoP°lge
Ins ectionLine; 503.639,4175 3U�— f+ Datc Ready /By: gT SecP eg e 2 f or ormation _
i iG olL!? p r Notifed/Method
Internet; www.tigard•or.gov y r i i ts {l�fyH rt�v 'ss
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��i � p +yy� �r 'yl° +
�l N a /17.t i� 'r'�.iMkt 4 • •� ,J. `, n. .r� 1 Ai::l (/" 1 i checked ):
�x1q � �� � � !sage chee a ll that a (s It 2 set8 of plans
0 New construction % Addition/altcratl •r =lent ❑ Service or feeder 400 amps or more In Building over three stories.
Marinas and boatyards.
❑ Other: where the available fault current ❑ M �
❑ Demolition El 4; ' 'lYjp exceeds 10,000 amps a t 150 volts or ❑ Floating buildings.
rffirWENG, r AV .c 1 igrir 'qrO tab ' ii', ti$ fr �, � ' y , (Y , 1 # +# Ytookii �1; A 4k, A ti( �'io :d e ' , less to 6rou ar exceeds 1G,000 0 Commerciel•use agricultural
❑ 1 - and 2-family dwelling ili Commercial/industrial ❑ Accessory building amps for nil other installations. boildulgs- r
❑ Fire pump. ❑ Installation of 75 K't A
Multi Islam! ❑Master builder Other: ❑ Em g p y system- larger separately derived system.
er m e
a+ a1 4 t . 1e � 1 f Addition of new motor load of ❑ ` or
yy�� 1 i rft, o. �
r� �. , { �I��k?.. ��)x :��d' � � � � ° �f � ocoupancy.
/ / (, �l _ I 100HP ar more.
Job site address: 10220 (Q/ c en b V, l� U O Six or more ntinl units. ❑ Recreational vehicle parks
Job 110 - — ❑Supply voltage for more than
0 77223 [ Health -care facilities, 600 volts nominal.
City/State/ZIP: Ti !rr ❑ Hazardous locations.
[ ] Se o r feeder 60D amps or mot's.
Suite/bldg./apt no.: Projcet Dante: � lr�c � � n PP( yr C '';. �; i °,, I$,n; ,�� ;1SC :A' - L'rlyi�'i'a�(S� "� 'A, fps ',i4A
Deeertption r Fee. 'resat •
Cross street/directions to job site: New residential dingle- or multi - family dwelling unit.
Includes attached garage,
1,000 sq. ft, or less 145.15 4
Subdivision: Lot no.: or 33.40 I
Ea. add'1500 sq, fl. or portion
Limited energy, residential 75.00 2
Tax map /parcel no.: , , '' `•c y r�? Swith ab ae�)
1i `���'i� t ,� , � � -�: „ i � r � '� r'1�4 Limited energy, multi - family 75.00 2 latitt
0 W V 7 6 c W! ('I /7 PDC C On *0 ) re sidential (widrabove ag n)
r Services or feeders installation, alteration, and/or relocation
i n l
200 amps or less 80.30 2
r� /L C -FJ � �� , . q,, I' , •,.,, 2 01 amps to 400 amps 106.65 2
�, Rg! r o ,� f .,, • *<<,' Gs( ,P Fit 404 Ii i!i' 401 amps to 600 a mps - _ 160.60 _ 2
Name: 60 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts , 454.65 2
Address: Temporary services or feeders installation, alteration, and/or
City /State /ZIP: relocation 66 85 1
Phone: ( ) Fax: ( ) 200 amps or less 201 amps to 00 amps
100.30 2
4_ III
Owner installation: This installation is being made on property that I own which is not 401 amps to 4 00 amps 133.75 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fce for branch circuits with
;( '} '4)'' 'e above service or feeder fcc, 6.65 2
{ 'Al i0111 t ` `� ' q
� �i '�i ,., l;
t m,19„ ! ra, "'' Y each branch circuit
B. Fee for branch circuits
Business name: yYl / 1 C ✓l e� without service or feeder fee, 46_85 2
Contact name: Do e qn'irn e 7-70 first branch circuit 1 2 -
//�� Bach add'I branch circuit I 6.65
Address: r SE LO ► ��V 1 _ Miscellaneous (service or feeder not included)
y Z Each manufactured or modular 90,90 2
G ' 1
City/State/ZIP: � � (� 0 dwelling, service and /or feeder
Phone: ($O3) 23 / - 0 Fax :: ($ O) 2 3 J 3 8 Reconnect only 66.85 2 -
E Pump or irrigation circle 53.40 2 p� ` of , Si or outline lighting 53.40 2
1 t v l'lC� ' r '� ri* 1'�X' 4 it " i ' P o t -� `' { sign „" ±p , "s ',4r � "l. Signal circuit(s) or limited -
Business name: YYl er) C a Yl eG ) ^ ' energy panel, alteration, or 2
' extension, Describe / Pa c 2
Address: � � / ! e tl 1R V
City /State /ZIP: 1
P O lri and r ` �� 4 O d Each additional i s! ection over allowable in an • of the ;shove Pcr inspection 62.50
Phone:
( 03) 23'7—'1000 I Fax: (o:3) 239-7038 _ Investigation per hour (l hr min) 62.50 I ^
P qc� :2 cf il � LEA plant per hour 73.75 4"
CCB Lie.: �� 3 Electrical Lie.:2 fro 1 I ��� Suprv. Lie. '(t 3 Industrial, 3 P. T.E iF 4,. ` 4 . ,- 1, " Igl `,;/
yt � A.� _Subtotal' 7,$ t''i
Suprv. Electrician signatu e, . �
. Plan review (25% of permit fee)'
Print name: T Ste v n 0 V n q Date: 7 1 State surcharge (12% of permit fee): y 10 •J ���^ TOTAL PEIZMI'f FEE: Q��
Authorized sigttaturc:' .�fJ+C� 2 This permit application empires if a permit Is not obtained erithin 180
f Date: " 2 / 7 c9 drays after It has been accepter! as campletc.
Print name: j q C� Ci n e S ' Number of inspections allowed per permit.
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1:1 Building \Pentit9rkLC•PermIWPP.dOC 0512.3/06