Permit •
II CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
t3 COMMUNITY DEVELOPMENT Permit #: ELR2012 -00163
T t G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/31/2012
Parcel: 1 S135AB03400
• Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 300
Project: Alton Sakai Subdivision: METZGER, TOWN OF Lot: 9
Project Description: (1) Signal circuit or limited energy panel for TI
Contractor: CAPITOL DATA & COMMUNICATIONS Owner: LINCOLN CENTER LLC
11401 NE MARX ST BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97220 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503 - 255 -9488 PHONE:
FAX: 503 - 257 -7121
FEES
Description Date Amount
Specifics: Restricted Energy Permit 07/31/2012 $75.00
12% State Surcharge - Electrical 07/31/2012 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems:
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: N Fire Alarm: N
HVAC: N Instrumentation: N
Intercom/Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N Total $84.00
Other Desc: 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 A or 1.800.332.2344.
Issued By: Permittee Signature: PA A (AV 0 M
___ 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.
•
07/27/2012 10:33 5032551966 CAPITOL ELECTRIC PAGE 02
Electrical Permit,Ap llcati0 um; R 1012 PI rte a:1 ,�u
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City of Tigard y
Plan Review u P �i a _ 00
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13125 SW Hall Blvd., Tigard, OR 97723 JUL-24 2 012 may: other Permit: 1 00/ � .
. Phone: 503.639,4171 Floc: 503.598.1�/ 3 o / v ''. pate Rend /B saris: ■
It. ti inspection Li 503.639 75 Q� P • GA ® Notificd/Mcttwd: 1 1 L,
Internet: www- tlgard- or.gov Bi 1 on i f . ,
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New construction 0 Addition /alteratlon/replaccmem Please check all that apply:
• Demolition ■ Other Service Over 225 amps, comma Hazardous location
8 Service over 320 amps - rating Building over 10,000 sq.ft.
■ 1 and 2 family dwelling ✓ Commercial /industrial ex&sory building of 1 and 2- family dwellings 4 or more new residential
• Muhu fund • Master Builder ■ • System over 600 volts nominal unite in one structure
t± ry ,•; :',1 = 4C', J:7. :, 2 :, 21;i T1'_}_ 1_ .7 H: ?: .,`a {._ .I; ', Building Over throe stories R Feeekos. 400 amps or more
Job no.; C12266 Job site address. 10260 SW Grasnbur8 Rd Occupant load over 99 persons Manufactured structures or
Egress/lighting plan RV park
City /State/ZIP: Tigard OR 97223 Health—care facility Other.
Submit 2 sets of plans with any of the above.
Suite/bldg. /apt no.: 300 !Project name: Alton Sahel CO.. LLP
The above are not a IlCable l0 tent ra construction service "
111 ti
Cross StreeUDitcctions to job site: Description Qty. Fes Told
New residential - single or molt!- family dwelling unit.
Subdivision: I Lot no.: Includes attached garage.
1000 sq. R, or less $ 168.54 4
Tax • • arcel no,: Ea, Adds 500 sq. ft or portion I $ 33.92 I I
', _g - - : " ;;_':?`' . ,1?; `7 _ zt... . , ,., r:.w'?�_ . oa�Q.., iy Z7: Limited energy residential $ 75.00 2
Low voltage voice & data wiring. Limited energy, non- residential $ 75,00 2
Each mnnul'tctured home or modular
dwelling, Service and /or fhedar S 67.84 2
Service or feeders installation, alteration, and/or relocation)
Name; 200 amps or less S 100.70 2
Address: 201 amps to 400 amyl S 133.56 2 ,
401 amps to 600 amps $ 200,34 2
City/StatdLlP: 601 amps to 1000 snips s 30104 2
Over 1000 amps or volts S 552.26 2
Phone: Fax: Reconnect only S 67.84 2
Temporary serwiees or feeders Installation, alteration, and/or
Owner installation: This installation in being made on property that 1 own which is not relocation
intended for sale, lease, rent or exchange, according to ORS 447, 449, 670, and 701 200 amps or leas S 59.36 I I
Owner signature: Date: 201 amps to 400 amps S 125.08 2
401 amps to 599 amps S 168.54 2
1 * , 'z' a ■ — : " Branch Elremite - new, alteration, or extension, per panel
Business Name: A. Fee for branch circuits with
service or feeder tee, each
Contact name: branch circuit - S 7.42 2
B. Fee for branch circuits
Address: without service or feeder fee,
each branch circuit S 56,18 2
City/State/LIP: Each additional branch circuit; 5 7.42 2
Miscellaneous (service or feeder not Inchrdcd)
Phone: Fax: Pump or irrigation circle S 67,84 2
Sign or outline lighting S 67.84 2
E -mail: Signal circuits(s) or limited-
_' ... �ti ; '._ L;! 'i _ �..._ ` P . , = � .. - ..
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r: c orgy ra
y panel, altion, or
Business Name: Capitol Data & Communications, Inc. extension, Describe: Tele/Date 1 75 75.00 2
t Page 2
Contact name; Greg Hannon Each additional inspection over allowable In any of the above
Per inspection S 66.25
Address: 11401 NE Marx Stroet Investigation per hour (I In min) $ 66
Industrial plant per hour S 78.18
City/State/ZIP: Portland, Oregon 97220 :,.; , • _45 ";1 " :.. ;:Z:. :._', ..: :'.` °:l �:' i : z_ - Vi :7 - - - .`•
Subtotal 78.00
Phone: 603 - 2669488 Fax: 503-257 Plan review (25% of�amit fee)
7121 State surcharge ( 12% of permit fee) 9.00
,,CCB Lie.: 142457 IF,le eiiicnl Lie.: 26.1 CLE I p / uprv. Lie.: 27571. TOTAL PERMIT FEE 84.00
atu
Suprv. Electrician signre,required: .....—,___,..0___ _ '' Perb pplkn nen tap'veeif s permitiv netnmance w tntae
nn
_ _ V � days er h line been mewed so n
Print Name: To ru$Ch Date: 07127/12 • Fee methodology set by Tri- County Building fnduary Service Guard
Authorized signature: ----....--- V-"NatAtt? **Number cif inspections per permit allowed
Print Name; T Brasch
503- 718 -2439