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Permit i 71 CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT ° COMMUNITY DEVELOPMENT Permit #: ELR200900182 Date Issued: 07/10/2009 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S135AB03400 Jurisdiction: Tigard Site address: 10260 SW GREENBURG RD 1165 Subdivision: LINCOLN TOWER Lot: 0 Project: Erik Bucher and Greenspan Project Description: Low voltage for phones and data. FEES Owner: LINCOLN CENTER LLC Description Date Amount BY SHORENSTEIN PROPERTIES LLC, 555 Restricted Energy Permit 07/10/2009 $75.00 CALIFORNIA ST 49TH FL 12% State Surcharge - Electrical 07/10/2009 $9.00 PHONE: Contractor: HI TECH SYSTEMS INC 512 NW CARTY RD RIDGEFIELD, WA 98642 PHONE: 360- 887 -7062 FAX: 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 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 ac dance 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. ATT NTION: Oregon la requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0410 through OAR 952 -001 -0100. Y y 0. - a copy of the rules or direct questions to OUNC by calling 503 6699 or 1.800.332.2344. ` Issued = • I _�i A 62- t' uv`✓t _f Permittee Signatu i gli . _./11' _11th ' 1.1& 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. �_ 07/06/2009 11:24 3608877065 HI TECH SYSTEM PAGE 03/04 ` ED Electrical Permit Application ECEIV EroR:c�rr.icr 11513 ONLY l.l� () Tigard Blvd., Reoivrt cc . '/ bermll Ni,,, G/.n`-f/Fn/ < " a9 /a 4UL 0 6 2009 Plan Review : (' � 1111 inv w 13125 SW Hall ll Dlv Tigard, OR 9722 Plan R II Phone 503.639.4171 Fax; 303,59 1900 Untc /t)y, Other Permit: TIC1�;ftD Inspection Line: 503,639.4175 C ITY OF TIGARD Date Ready /By: - brig. la Sec Page2for intcmcl: www,tignrd- or.gov BUILDING DIVISION Notified/Method: Supplemental Information • r..' T „ o r wok ; ; `LAN REVIEW ❑ Now construction V,..; cldition /alteration /replacement Please cheek all that amply (submit Ants of plans w/item,? checked below): 0 Service or feeder 400 amps or more ❑ Bu11(11ug over three stories ❑ Dermal ilion ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OI! exceeds 10,000 amps at I50 voles or In Floating buildings. . ❑ I find 2- family dwelling a Commercial /industrial ❑ Accessory building less to round, or ooceeds 14,500 y ctitr s Cl co ldl icrciat- u::etitraulniral � amp,e for all other installations bnildinits, ❑ Mu lti- family ❑ Master builder ❑ Other; ❑ Fire pump, ❑ Inslnllntion (.1 75 KVA or ❑ Emergency system. largo separately derives) System. JOB ' SITE']liIPORMATiON ANI) LOCATioN" ❑ Addition of new Junior loud of ❑ "A" "E" "1 ", °t -7•, -lob no,: �'(( .5 /1jr�r ,Q� . IOOIIP or rest Recreation. _ - ,... City /State /ZiP; I . Job site address: / V� () �" .7" ° ❑ Six m MOM units. 0 Recreational vehicle parks. 0 Supply 8 a for more than J C ? - o R , 7 _ rt' C Su I volm J i 4 -gy G / — GOO votes nrnn;nal ,..- �,.�.� 11 ❑ F lam locations. Suite/bldg./apt, no.; Protect name: ❑ Service or feeder GDO amps or morn, TE t SCOEAULE . Cross,sfreet /directions to job site: ` j'0 U (.05 Daerlrtinn fly. 1.2111. Total " New residential single - or multi - family dwelling unit. - Includes attached ,garage. Subdivision: I..nt no.: 1,000 eq. R, or less 145,15 4 En. add'I 500 sq, ft. or portion 33.40 1 Tax tap/parcel no.; Limited energy, residential • • '' DESCRIPTION 'V.ORK it (whlabove g sq, ft,) . 7.0 5 0 2 �ry� Limned energy, multi- family /T O de- P ht rIq___ � (� residernintwith above .cq, n,) 75.00 2 �� � ❑ �'rNAN 2 01. amps to 400 amps Services or feeders installation, alteration, And /or relocation 0 _ AD e PL C,1r k / 1 c... . 200 amps Or Icss 80.30 2 © PROPERTY ONNI'R', J 106,85 2 ... Name; 401 amps to 600 amps 160.60 2 001 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 City /State /ZIP: Temporary services or feeders installation, alteration, anti /or ., 1 "CIOCA[IOn Phone: ( ) Pax: ( ) 200 amps or less I 60.85 I Owner installation: This installation is being made on property that I own which is not 201 tunes to 400 amps 100,30 2 intended for stale, lease, rent, or exchange, according to ORS 447, 449. 670, and 701. 401 snips to 599 amps 133,75 2 Branch circuits - new, alteration, or extension. per panel — - Owner signature: Date: A. Fee for branch circnils with APP1,,.lCAN'P. • : ' .. ' ©, CONTACT'PERSON above se or feeder fee `' .. , 6,65 2 each branch circuit Business name: r .^ ,y 57-teens - � ���� � D. fee for branch circuits Contact. name; without service or feeder fee, .....4„ first branch circuit 46.85 2 — Address: [l _ zkth /�' \i , h c) Each add'i branch circuit 2 ` Miscellaneous (service or feeder not Included) ed) City /State /ZIP: ' )\O � �; et_ .6-6/ k Q r each manufactured or modular 90,90 2 �- _ dwelling, service and /or feeder Phone: 3k6 ) ,$? -- 1,7 0 ( Fax: : 31 SYS ri ' D C Reconnect only 66.85 2 E -mail: vS/ 7 J Pump or irrigation circle 53,40 2 C TRACTOR Sign or outline lighting 5 3.40 2 - Business name: 54-7n i e .A 4 n Signal circuit(s) or limited- 7 T A/ l energy panel, alteration, or Address: VV extension. Describe; Page 2 2 City /State/ZiP: Each additional inspection over allowable in any of the above Per inspection L 62.50 Phone: ( _) Pax: ( ) Investigation per hour (1 lir nun) 02,50 GCB Lie.; /A/136, 0 Electrical I . ryeK5 4 Suprv. Lic: 3 i ) ,y,P_¢• industrial plant per hour 73.75 — ELECTRICAL PERMIT .11;t5 Suprv. Electrician signature, required; rri T Sublor l; Print name: A pd . .. D 7 — / - ,,D Stale surcharge fee); (12 /n of permit fee): Authorized signature: # r TOTAL PERMIT' Err; E3 0 �-, _ This permit application expires if n permit is not obtained within ISO Print name: q a 0 , c, Date: 7 *� "^ (lays alter it Ims been accepted as 1--' J p complete. Number of inspections allowed per permit. T ABaildie g \Pcrmits\rtc.Parnttapp,dno minty, 440- 4015T(I 1105 /COMAVeIO ■,.-. , D7/06/2009 11:24 3608877065 HI TECH SYSTEM PAGE 04/04 a • Electrical Permit Application - City of Tigard Page 2 - Supplemental Information, LIMITED ENERGY PERMIT FEES: RESXDENTIA. L WdRIC.OINLV:,,., „ Eee for, i ll residential systems combined .., $75.00 Cheek Type of Work Involved: n Audio and Stereo Systems* fl Burglar Alarm n Garage floor Opener* ' n Pleating, Ventilation and Air Conditioning System* U Vacuum Systems* ❑ Other: COMMERCIAL .. WbR�bI`�Ly: Fee for gach commercial $75.00 system (SEE OAR 918 -309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems l 1 Boiler. Controls • ❑ Clock Systems Data Telecommunication Installation n Fire Alarm Installation fl - 4VAC n instrumentation [ . Intercom and Paging Systems n Landscape Irrigation Control* ❑ Medical n Nurse Calls ❑ Outdoor Landscape Lighting* n Protective Signaling ❑ Other Total number of commercial systems; i *No licenses are required. Licenses are required ' • for all other installations T1 1 :luhdinn \Permita1PLC•PermitApr.doc 03/13 /or