Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 -00181
T [GA R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/30/2012
Parcel: 1 S135AB00900
Jurisdiction:
Site address: 10200 SW GREENBURG RD •
Project: Lincoln Center Subdivision: METZGER, TOWN OF Lot: 9
Project Description: Electrical for fire alarm upgrade.
Contractor: E C COMPANY Owner: LINCOLN CENTER LLC BY SHORENSTEIN PROF
PO BOX 10286 555 CALIFORNIA ST 49TH FL
PORTLAND, OR 97296 SAN FRANCISCO, CA 94104
PHONE: 503 - 224 -3511 PHONE:
FAX: 503 - 295 -3012
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 03/30/2012 $63.60
Specifics: Service or Feeder
1 ea Signal circuit or Limited 03/30/2012 $75.00
Type of Use: COM Energy Panel
Class of Work: ALT 1 ea 12% State Surcharge - 03/30/2012 $16.63
Electrical
Type of Const:
Occupancy Grp:
Total $155.23
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 -101 -0090. You may cop e- estions to OUNC by calling 503.232.1987 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 the next available inspection date.
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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Mar. 29. 2012 3: 51 PM E IVED No. 4929 P. 1
Electrical Per i R
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City of Tigard MAR 2 9 2012 ESSE/MILIMIZEIWARM
i 13125 SW Hall Blvd , Tigard, OR 97223
Phone: 503.639.4171 Fax: 503.598. OF TIGARD ENFINIIIIIMIN Other Permit: ' / 4 , a __,,
, ,;. ;,,,,, Inspection Line: 503.639.4175 BUILDING DIVISION flateRerdy /ny: �; �°!, _ ®SCe Page ±for
Internet: www.tigard- or. gnv Notified/Medical: � J�Cp Supplemental information
TYPE OF WORK PLAN REVIEW
Please check all that apply (submit sets of pleos tv /itrnis checked below).
❑ New construction ® Additiordaiteration /rrphwcment
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑Other:
where the available tlu& await ❑ Manilas sod lawtyurds
CATEGORY OF CONS fRUClION cxcocds 10,000 amps at ISO yobs or ❑ Floating buildintg%
less to grcand, or exceeds 14,000 ❑ Commercial-mar mph:ultimo
❑ I- and 2- family dwelling IS Commercial/industrial ❑ Accessory building amps forail other installations. building..
❑ Multi- family ❑ Master builder ❑ Other: 0 hna piutyn. C.) lnsrallatirm or KVA or
JOB SITE INFORMATION AND LOCATION CI Emergency ay %hem. larger mantel) derived derived system.
❑ Additionof new motor load ot' ❑ "A" "E" "1-2", ''I-3",
1 0200 SW Greenburg R d Six or more. more Recrution
Job no.: 74 52 2 I Job site [e address: ❑ Six or more rraiamtlal units. D RocTerttioncd vehicle paces.
City/Stare/ZIP: Tigard, OR 97223 ❑Health- care facilmos• ❑ ly vottaix for momthan
❑Hazardous locations. volts nominal.
Suite/bldgittpl. no.: Project manic: Lincoln 5 Fire Alarm (] Service or feeder 600 amps ormore
FEE SCHEDULE
Cross street/directions to job site: one ipnimr i Qn 1 tier. 1 Taal I •
New residential single- or multi- family dwelling unit
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft or less 168.54 ' - 4
-- - -- 1 Fa, add'1500 sq. ft. or portion 33.92 • 1
Tax map /parcel no.: .......__.._.
Limited energy, residential 75.00
DESCRIPTION OF WORK (with above sq. II.)
Limited energy, multi- family 75.00 2
Fire Alarm Install residential (with above sq. n.) _ .
Services or feeders installation, alteration. and/or relocation
200 amps or less 100.70 2
®PROPERTY OWNER 0 TENANT 201 amps to 400 amps 133.56 2
Name:
401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1.OW maps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City/State/21P:
relocation
Phone; ( ) I Fax: ( ) 200 amps or lees 59,36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on properly that I own which is not 401 amps to 599 amps 168.54 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. Fee for brunch circuits with -
® APPLICANT I 0 CONTACT PERSON above service or feeder fee, 7 q, 2
each branch circuit
nasineys mime: EC Company B. Foe for branch circuits without
service ur feeder fee. first 1 16.18 56.18 2
Contact name: Kathy Kelley bnmchcircuit
Each mdd'I branch circuit 1 1 T 7.42 — 774 - 77. 2
Address: PO Box 10286 Miscellaneous (service or feeder not included)
• Lath manufactured or modular
City /Statc/ZIP: Portland , OR 97296 dwelling, service and /nr feeder I 67 ` 2
Phone: (5 0 3) 2 2 4 - 3 511 Fax :: (5 0 3) 295-3 012 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2.
E - mail: kathyk@e-c-co.com -
CONTRACTOR Sign outline ii0nlmg 67.84 2
�,.. - Sigrid circuit(s) or limited-energy 1 an 7 5.0 0 2
nuSiret SS name: EC COmpan
panel. alteration, or cacmaaion. _ Pape 2
....._- Each addidonal inspection over allowable in any of the above
Address: PO Box 10286 Additional inspection (I hr min) 661.25/ hr
Investigation (I hr min) 66.25/ hr
City/Stare /LIP: Portland, OR 97296
industrial plant (lhrmin) 78.18/hr
Phone: (5 0 3) 2 2 4 - - Fax: (5 0 3) 295-3012 lnspcdiuns fur which no fix is hr
s(tccifrrelly lis_tcd(% hr mein) _'
CC M Liu.: 49737 Emr,fii� ,w � Suprv. Lie.: 'l 5 ELECTRICAL PERMIT FEES
/' Subtotal: 13 8. 60
Suprv. Electrician sigttatt ,,(, Plan review (25% of permit fee):
Print name: Ron Co man V / Date: 03/29/2012 Stale surcharge (12% of permit fee): 16 .6 3
TOTAL PE.RMiT FEE: 155 - 23
Authorized signature: This permit application aplres Na permit is not °blamed within 180
Print name: Le la t t mow: 03/29/2012 days after it has been accepted as complete.
' Number allowed pap:met.
:muitamtuNaaa1Wu- remata ry.dvc 07/01/10 - atWm;uT(t I/USM.0M/WN.a
Mar. 29. 2012 3: 51 PM No. 4929 P. 2
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
❑ (;arage 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
❑ HVA(:
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems: 1
*No licenses are required. Licenses are required
for all other installations
I:1DuitditutV'etnits\ELC -P rmitApp4oe 07/01/10