Permit w ,., ,
CITY OF TIGARD • ELECTRICAL RESTRICTED ENERGY PERMIT
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° '.` C OMMUNITY DEVELOPMENT Permit #: ELR2009 - 00200
1 3 125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/22/2009
T I+GIRD Parcel: 1 S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 110
Subdivision: Lot: 0
Project: Ridge Equity Solutions
Project Description: Install low voltage for voice /data.
FEES
Owner:
Description Date Amount
LINCOLN CENTER LLC
BY SHORENSTEIN PROPERTIES LLC, 555 Restricted Energy Permit 07/22/2009 $75.00
CALIFORNIA ST 49TH FL 12% State Surcharge - Electrical 07/22/2009 $9.00
PHONE:
Contractor:
TELEDIGIT INC
PO BOX 22287
PORTLAND, OR 97269
PHONE: 503 - 722 -8084
FAX: 503- 722 -9914
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 Required Items and Reports (Conditions)
Landscape Lighting: N Medical: N
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 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. ATTENT : Oregon =w requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -001 hrough OAR 952 -0i 1 - Si. Yo may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.23' ,
Issued L ! • f _ � _ �..: 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.
,.lectrical Permit Application, FOR - OFFICE LSE ON '
City of Tigard KECEI Y �T E� Received v� /� Q Pit r� .. - n 13125 SW Hall Blvd., Tigard, OR 97223
Date /B : / �/� O / Permit N ° i � -t�0�•(J
Tigard, Plan Review
1111 Phone: 503.639.4171 Fax: 503.598.1d01.. 2 2009
Date/B Other Permit: .
TIGARD' Inspection Line: 503.639.4175 Date Ready/By: MI Et See Page 2 for
Internet: www.tigard- or.gov Noti fied/Method: OFT : r � SupplementalInformation
CITY
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°.:2.4 .., • - £ :� � 4 > e - ,t;Wi r6 S !B( i 4 r [ rS ,r;..' k " .:a ' V ANZ "RE�'IE V1 q q:: 11'1
-. ._T,1 '.'�' -.. :110Dft d.,.a, _ -, ,,•,t,. :.r_ ,,,11,,„,,,,: ^ e t'1.}t ,,11,«.. , .;x1,c > 3 : 1 ', i, ''r,-, i1•..:'i.w r - -x,-,a «<.a•G.,,, -.:, ' -- =,rse. �= s '
❑ New construction ,Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
`<'J�: - <: � � � � y g p • :, - �'. �+,- , •'.'a zc s -:., ya. o-w.:- s'.r...a,. - «ei rxa.�, ; ;.��- „ -,.H, ., , t': ..,t,. ;: «'i * -. xx,`x,<ry - .
kE `. I`° AX: :' -4 C: "k= G ' I2 - - "'. ` = , ,; :r;: ° , ' t`�= exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
fo ,Y01, i,l - ? -q fiat' .i,:: =�:n,v�!aQ §,G®NSTR,L.CTION " a _° >: W -. r r, .
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ I- and 2- family dwelling ®Commercial /industrial ❑ Accessory building amps for all other installations. buildings
❑ Multi - family / ❑ ` Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
4 -'9 . = rs;. %rt:41' rs_i, .s,.ir g:- ov . >..u, =x i s, w. «_ s,;���.K ,,. � .,, , :s s.. a - . ya :'t'<4: ❑ Emergency system larger separately derived system.
. j $; la = ` ' i JOB SITE -i INFORMA`TIONI ( AN D L O C ATrION ' ,- •t 11F
�f�,��w�.,,� �� ,- �- .. � �a.,e ti�g. rxr,� . ,.„�,, ..a .4 anr+a�a.1 , �•,+`�� sa.,a �+ ❑ Addition o f new motor load of ❑ "A •E "I 2 'l _3
/ o i. 100HP or more. occupancy.
Job no.: Job site address:
/ 0 'i / e.3 ee4 ��r� / 1 ❑ Six or more residential units ❑ Recreational vehicle parks.
City /State /ZIP: /-2„... / d 67 4 y 7 2 Z3 ❑ Health -care facilities. ❑ Supply voltage for more than 600 volts / ❑ Hazardous locations o s n ominal.
Suite /bldg. /apt. no.: /iO Project name: N / C - I S ' if . . ❑ t _ p
Service or feeder 600 amps or more.
r 3 , .. ;, t= ;FMKIiEU_UI ° :w n } :. i 7 y n, .,
Cross street/directions to job site: a ^ � s I r y r�>� • -.�
Description 1 Qry. I Fee. I Total
• New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
'' =,•Y ., ,.,. , t' ., 75.00 2
at
... 4 � ; , DES [TON OF WORK #,,, 4'=_,* ir - ,,s, ' " r% , fi ,, :1 (with above sq. ft.)
. w„�,. -.... Ra. . -.,�, ,. -,.._ . -.a;_ :bid,_ k� 5€z4n" : >,treu*y;
•
� / /1...2,--71-4 , Limited energy, multi - family 75.00 2
t /�'� �� ' G.?.j f , -r + residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
,,
p . , „ : ,gfs'31Wrf - ,TS -' .:"'z,, t ..aka,'.rxa %ZO;" : '''; '' " � ' ' a: zec' `+L Z�� :+ :. rs: , #.zti, '. u ; .
0,-a,,,41.1„,, � • PROPER TI O r 4 , „® TE N;AN T
�_�.��,�� ,•h<, ;. -� � �t,�«�.�; � -. _.�._���s�a� .. � . -... ; ::�� � ... �� 20 1 amps [0400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 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, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
ok..: - 6 .='�"'s' ' at. �3 °`. ; ;3' "` ;` w2 '; l :: � i w aras -, :. - " tfia L ,
` ;t „ APP ICA .. - .� r , - :'' ® 'CO N T AC ,, T PERSONS above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
without service or feeder fee,
Contact name: first branch circuit 46.85 2
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular 90.90 2
dwelling, service and /or feeder
Phone:
( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
f "°`, - ;re;� r ,�,a Sx_ r'�- aka«., :,a; » <.,+,, ;+ "w"n``;t raik'.rY£„ ..s:; = *zv "' ;° �k:,' n • „ °- ',Lh'adu�t. ;� ;.,_�;.wa..,s, .
`=tA ENZA x . T.T�` ININ I ° ... ,fit.. , ;,:`= *r'::x. - s �.. l Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name: / -/ �h G energy panel, alteration, or
Address: /. 0 4 %h Z 2 2_9- / extension Describe: ) Page 2 �� -� 2
City /State /ZIP: tr ��( J U I 7 L6-9 Each additional inspection over allowable in any of the above
O� �" Per inspection 62.50
Phone: (' , ) 7 LZ 5'-0 5 , i' Fax: (5'11; 7 LZ - 777y Investigation per hour (1 hr min) 62.50
CCB Lie.: / /G'/ 5- - Electrical Lie. 3. .iff,/ '[� ' Suprv. Lie.: WS`L6 - 4 Industrial plant per hour 73.75
affeanlitearAltAtZfkliMitifikt:SVanell
Suprv. Electrician signature, required: --- Subtotal. .. "gip
,� Plan review (25% of permit fee):^
Print name. ,4 . /IO - .3 c t1 .-- Date. 7 / 2 /c ? State surcharge (12 %of permit fee): DO
Authorized signature: ,..... -'r"3 TOTAL PERMIT FEE: , O0
This permit application expires if a permit is not obtained within 180
Print name: / e S'.. -.4� Date: 7/2 L /07 days after it has been accepted as complete.
• Number of inspections allowed per permit
L\ BuddingWermits\ELC.PermitApp.doc 05/23/06 440 -461 ST( I1 /05 /COM/WEB
Electrical Permit Application - City of Tigard I I Other
Page 2 - Supplemental Information Total number of commercial systems:
LIMITED ENERGY PERMIT FEES: " licenses are required. Licenses are requir
for all other installations
Fee for all residential systems $75.00
combined
Check Type of Work Involved:
I Audio and Stereo Systems'
I I Burglar Alarm
I Garage Door Opener'
Heating, Ventilation and Air Conditioning
System*
Vacuum Systems*
7 Other:
tORMORESOUTONMEni:PTChn.i0;.
Fee for each commercial $75.00
system
(SEE OAR 918-309-0000)
Check Type of Work Involved:
7 Audio and Stereo Systems
•
I I Boiler Controls
I Clock Systems
Data Telecommunication Installation
. I Fire Alarm Installation
I I HVAC
Instrumentation
7 Intercom and Paging Systems
I Landscape Irrigation Control"'
I Medical
I Nurse Calls
Outdoor Landscape Lighting"
FI Protective Signaling
IABuildin 03/23/06