Permit If CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00287
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/6/2008
PARCEL: 1 S135AB -00900
SITE ADDRESS: 10200 SW GREENBURG RD 700 ZONING: C - P
SUBDIVISION: LINCOLN CENTER /FIVE LINCOLN LOT: JURISDICTION: TIG
PROJECT: FARMERS INSURANCE
Project Description: Low voltage for fire alarm installation. Job No. 280850
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: X OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
SHORENSTEIN REALTY SERVICES CAPITOL ELECTRIC CO INC
ONE SW COLUMBIA ST #300 11401 NE MARX ST
PORTLAND, OR 97258 PORTLAND, OR 97220 -1041
Phone: 503- 412 -4800 Contact #: PRI 503- 255 -9488
FAX 503- 257 -7121
Reg #: ELE 26 -496C
FEES LIC 48748
Description Date Amount SUP 3132S
[ELPRMT] ELR Permit 10/6/2008 $75.00
[TAX] 12% State Surcha: 10/6/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable
laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those rules are set orth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503.246.6•'• or 1.800.3 " _
Issued :y: ( I / Permittee Signatu : ♦ /Il/rd i
,
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'N: 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.
10/06/2008 14:25 5032551966 CAPITOL ELECTRIC PAGE 02
I(.lRoITI(i: l)IYL" 1i;ar "i =t •(';
Electrical Permit Application Rcoe
al �� Pcrtn it no "
City of Tigard � ece a � , .': + : -a., 8
/ ' 13 125 SW klift1131vt9„ Tigard, OR 9ri►�? Review Other Permit;
^, yc1` . Phone: 503.639.4171 Fax: 513.59; -1960 Date/By,
T1;GARI) InSpcctiOn Lithe: 51Y3 , OC- U 6 2OE Date Ready /By; See Pape for
Internet: www.tigerd- or,gov l• Notified /Method: sn Ism ,,,,i lnGwmntlon
L
WV OFT1 A,RU .
TYPE OF WORK {¢* t e� Q ... ..p.T.Ar, REVIEW ... , ..
New cot ruction I I Addition /altcrationJrcpl.8 j U NG D1 V ��.7'®�� Please chock all that apply (submit 2 Sals of plane w /ilnms checked below):
❑ Demolition ❑ Other; ❑ Service or feeder 400 amps or more ❑ Building over Three starlet
CATEGORY OF CONS'TRUCTTON where the available fault current ❑ Marinas and boatyards
H I. rind 2- family dwelling H Commercial /industrial Li building exceeds 10,000 amps at 150 volts or Floating buildings
t_.I Multi- f¢mily _ ❑ Master Builder . ❑ Other less to ground, or exCsaris 14.000 Gommerctal - uae agricu¢ursl
_ JOB SiTE INFORMATIONAND LOCATtt)N amps for all other installations. U buildin
❑ Fire Pump ❑ Installation of 75 KVA or
,doh no.: 280850 I Job site address: 10200 SW Greenburg Rd_ larger separate) derive sy
❑ Emergency system r9 y derived system.
9 7223 ❑ Addition of new motor load of Li "A", "E-. "1 2 " ", "1 -3 ",
City /State /ZiP: Tigard, p
100HP or more. Li occu etc y
Suite/bldg. /apt. no,: Suite 700 'Project name; Farmers Insurance T.I. ❑Six or more residential units ❑ Recreational unhlcle parka.
❑ Health -cart facilities ❑ Supply voltage for more than
Cross StreetfDireetions to job site; ❑ 1 locations ❑ 600 volts nominal.
L] Service or feeder 600 amps or more —
.FEE SCHEDULE ..
Subdivisirnn Lot no.' Description 1 Qt I Pee j rn,nl
Tax map /parcel no,: New residential - single or multi- family dwelling unit,
DESC or WORK "Includes attached garage.
install Fire Alarm Circuit 1000 : 5. ti. or less _ $ 145.15 _ 4
Ea. Add? 500 sq. ft or portion I 33.40
H PROPERTY OWNER [ H TENANT Limited energy residential
(with above sq. ft.) , S 75.00 i 2
Name: Shorensteln Real Services Limited energy, multi- family
residential with above a.. B. S 79.00 2
Address; Service or feeders installation, alteration, and /nr relocation _
200 ant or less S 8930 2
City /State /ZIP; 201 amps to 400 amps S 106,95 2
401 amps to 600 amps S 1660.0 2
Phone: Fax:
60I am,s t0 1000 am.s S 240.60 2
Owner installation: This installation is being made on property that f own which is not Over 1000 amps or valty _ $ 454.05 2
Intended for sale, lease, rent or exchange, according to ORS 447, 449, 670. and 701 - Terttporary services or feeders Installation, alteration, and /nr
Owner signature: Date: relocation
200 amps or less $ 65 85 1
— Li APPLICANT L iJ CONTACT PERSON 201 amps to 400 amps _ $ 100.30 2
401 amps to 600 amps S 133.75 2
BllainCSS Name:
B ranch circuits - new, alteration, or extension. p Anei
A. Fee for branch circuits with
Contact name: service or feeder fee, each
branch circuit 5 G.65 2
Address! B. Fcc for branch circuits
- without service or feeder fee,
City /StalefZIP: first branch Circuit 5 46.85 2 -
Each additional branch circuit; 5 6.65 2
Phone: Fax:
Mlseellaneous (service or feeder net include
--
E -mail: Each manufactured or modular
CONTRACTOR dwelling, service and or feeder S 90,00 2
Business Name: CAPITOL ELECTRIC GO., INC. Reconnect only f 66.55 2
Pump or irrigation circle $ 53.49 2
Sian or outline li'htin_ $ 53.40 2
Contact, name:
Signal Circuits) or limited-
Address: 11401 NE MARX ST. energy panel, alterations, or
extension. Describe; I Pipe 2 75.00 2
City /State /SLIP: PORTLAND, OR 97220 Fire Alarm Clrcult _
Each additional Ins te�t{on over allowable In any of the above
Phone: 503 - 255.9485 Fax; 503- 257 -7121 Per inspection - S 62.90
lnvcsti lien . er hour 1 hr min $ 62,50
CCB Lie.: 48748 Electrical Lie.," r' 496C Su rv. Lie.; 3172 -S r s industrial plant per hour $ 73.75
Suprv, Flcctriclan signature required; �` . FM Ma - ' ELECTRICAL PERMIT FEES°. .. - 7 5.00 •
Subtotal $
Print Name; DARR MCN Dfl� tg� + 10 06108 Plan review (2i " of permit fee)
Authorized signature; State surcharge ( 12% of permit fee) $ 9.0 0
TOTAL PERMIT FEE S 84 -00
Print Name: DARRELL Date; 10(06/08 ' rut* permttnnpllcntlnnestirts1 rit permitI.or!
day. miler It hm been .err a complete.
" Number of inspectinne per permit allowed.
CITY OF TIGARD _ 14.'
BUILDING DIVISION PERMIT #: ELR2000- 00287
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/6p008
Phone: (503) 639 -4171 - ����� 1iijlli
Inspection Requests (24 Hrs.): (503) 639 -4175 .c-�±+r 1.1.
INSPECTION WORKSHEET FOR DATE: 10/31/2008 TIME: 7:O0AM PAGE: 27
SITE ADDRESS: 10200 SW GREFNBURC RD 700 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER /FIVE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: FARMERS INSURANCE
DESCRIPTION: Low voltage for fire alarm installation. Job No. 280850
OWNER: SHORENSTNIN REALTY SERVICES, PHONE #: 503.412-4800
CONTRACTOR: CAPITOL ELECTRIC CO INC PHONE #: 503 -255-0488
Inspection Request Scheduled For: Date: 10/31/20013 Pour Time:
Code # Inspection Description onfirm -# Contact # Message
199 Electrical final 077456-02 871.506.1521 V
Corrections /Comments /Instructions: / R_ Pk\
.,, bit t Ia. MOM % - _ IN • , A .
TS
i llkii;N,, ,
C l i /
,./
is PASS ^ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL _ CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: cr Date: MI Phone #: (503) 718- 1—f r
CITY OF TIGARD .
,;) .-4,4- - •
BUILDING DIVISION PERMIT # • . ELR2008-00287
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1016/2008
Phone: (503) 639-4171 hootuNt I#
Inspection Requests (24 Hrs.): (503) 639-4175
. INSPECTION WORKSHEET FOR DATE: 10/17/2008 TIME: 7 PAGE: 26
SITE ADDRESS 10200 SW GREENBURG RD 700 CLASS OF WORK:
SUBDIVISION LINCOLN CENTER/FIVE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: FARMERS INSURANCE
DESCRIPTION: Low voltage for fire am installation. Job No. 280850
OWNER: SHORENSTEIN REALTY SERVICES, PHONE #: 503
CONTRACTOR: CAPITOL ELECTRIC: CO INC . PHONE #: 50.255.90w
Inspection Request Scheduled For: Date 1011712008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 0768001 971-506-1621 Y
Corrections/Comments/Instructions: Ces 0-
Coa_ sua: @, cif d
PASS El PARTIAL APPROVAL 0 CANCEL n NO ACCESS
CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: C 7---- • N Date: I (11%11,31 Phone #: (503) 718- /...1%.
. .