Permit CITY OF TIGARD COMMERCIAL MANUFACTURED
11 COMMUNITY DEVELOPMENT STRUCTURE PERMIT
T I G A R I? 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Permit : ELR2012 - 00044
Date Issued 03/15/2012
Parcel: 1S135AB01002 •
Site address: 10220 SW GREENBURG RD 601 Jurisdiction: Tigard
Project: Matrix Absence Management Subdivision: METZGER, TOWN OF Lot: 9
Project Description: Low voltage for fire alarm
Contractor: SAFE TECHNOLOGY GROUP INC Owner: LINCOLN CENTER LLC
6400 NE HWY 99 SUITE G375 BY SHORENSTEIN PROPERTIES LLC
VANCOUVER, WA 98665 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 360 - 699 -2130 PHONE:
FAX: 360 - 719 -1527
FEES
Specifics: Description Date Amount
Type of Use: COM Restricted Energy Permit 03/07/2012 $75.00
Class of Work: ALT Type of Const: 12% State Surcharge - Electrical 03/07/2012 $9.00
Occupancy Group:
Stories: Height: ft
Project Valuation: $0.00
Floor Areas:
First Floor Area:
Second Floor Area: •
Third Floor Area:
Total Area:
Required Setbacks:
Left: Right:
Front: Rear:
•
Required:
Parking Spaces: Fire Sprinklers: Total $84.00
Smoke Detectors: Party Wall:
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 through OAR 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By ` -ermittee Signature: / Lalepl‘ift.
Ca !3. • by 7:00 a.m. for the next available Inspec ate. f
This permit card shall ept In a conspicuous place on the Job site until c •mpietlon of the project
Approved plans are required on the job site at the time of each inspection.
•
Electrical Permit Applicat'l r r11, E0 FOR OFFICE USE o • City of Tigard DateB /Ma I Permit No. t / a - "e' [
1 SW Hall Blvd., Tigard, OR 97R 7 2012 Plan Review
' r, C Phone: 503.718.2439 Fax: 503.598.1960 D : Other Pen"'
T I G n It D Inspection Line: 503.639.4175 p o, 1® t
Date Ready/By: iuri+: 10 See Page 2 for
Internet: www.tigard -or.gov ��� OF (� � �� �A G ?ti Notified/Method: Supplemental Information
PC U I LtYNC DIV
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition /alteration/replacement Please check all that apply (submit 2 se:s of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stones.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
'` ' exceeds 10,000 amps at I50 volts or
CATEGORY OF CONSTRUCTION � - � '° � � ��� P 0 Floating buildings.
- -- less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- 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
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
. ❑Addition of new motor load of ❑ "A ", "E ", "l -2 ", "l -3 ",
Job no.: Job site address: 10220 SW GREENBURG RI) 100[iP or more. upancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: TIGARD OR 97223 ❑ Health-care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 601/91( Project name: MATRIX ❑ Service or feeder 600 amps or more.
FEE SCII EDULE
Cross street/directions to job site: LINCOLN 3 Description I Qty, I Fee. 1 Total 1 •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family 75.00 2
FIRE ALARM residential (with above sq. ft.) _
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER l ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: 601 amps to 1,000 amps _ 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City/State /ZIP: relocation
Phone: ( ) 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. Fee for branch circuits with
® APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7 42 1 2
each branch circuit
Business name: SAFE TECHNOLOGY GROUP INC. B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: JASON SWEET branch circuit
Each add'I branch circuit 7.42 _ 2
Address: 6400 NE HWY 99 SUITE G375 Miscellaneous (service or feeder not included)
Each manufactured or modular
City/State /ZIP: VANCOUVER WA 98665 dwelling, service and/or feeder 67.84 2
Phone: (360) 699 - 2130 Fax: : (360) 719 - 1527 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail: SALES @SAFETECHNOLOGY.NET Sign or outline lighting 67.84 - 2
CONTRACTOR Signal circuit(s) or limited- energy
Business name: SAFE TECHNOLOGY GROUP INC. panel, alteration, or extension. 1 Page 2 75.00 2
Each additional inspection over allowable in any of the above
Address: 6400 NE HWY 99 SUITE G375 Additional inspection (1 hr min) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
City/State/ZIP: VANCOUVER WA 98665 Industrial plant (I hr min) 78.18 / hr
Phone: (360) 699 -2130 Fax: (360) 719 -1527 Inspections for which no fee is 90.00 / hr
specifically listed (V2 hr min)
CCB Lic.: 173731 Electrical Lic.: CLE79 Suprv. Lic.: 4272LEA ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: /05/4.el Subtotal: 75.00
Plan review (25% of permit fee): ! —
Print name: JASON SWEET Date: 3 -1 -12 State surcharge (12 % of permit fee): g -do
°5 TOTAL PERMIT FEE: gq DU
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: JASON SWEET Date: 3 - - • Number of inspections allowed per permit.
1:\ Building \Permits\ELC- PermitApp.doc 07/01 /10 440- 4615T(11 /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined .. $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
- ❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
p Landscape Irrigation Control*
•
❑ Medical
• ❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\Buildineamits\ELC -Pe mitApp.doc 07/01/10