Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
• COMMUNITY DEVELOPMENT Permit #: ELR2013 -00037
T j CARD 13125 SW Hall Blvd. Tigard OR 97223 503.718.2439 Date Issued: 02/14/2013
Parcel: 1S 135AB03400
Jurisdiction: TIGARD
Site address: 10260 SW GREENBURG RD 1250
Project: Reinich MacKenzie PC Subdivision: METZGER, TOWN OF Lot: 9
Project Description: (1) low voltage to wire access control - video intercom
Contractor: STONER ELECTRIC Owner: LINCOLN CENTER LLC
1904 SE OCHOCO BY SHORENSTEIN PROPERTIES LLC
MILWAUKIE, OR 97222 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503 - 462 -6500 PHONE:
FAX: 503 - 659 -4968
FEES
Description Date Amount
Specifics: Restricted Energy Permit 02/14/2013 $75.00
12% State Surcharge - Electrical 02/14/2013 $9.00
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: N Fire Alarm: N
HVAC: N Instrumentation: N
Intercom /Paging: Y 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 52-001-0090. You may obtain a of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.23344..
Issued By: "I/ Permittee Signature: 0/d 1kPpli/ 64470
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.
Feb. 13. 2013 2:09PM Stoner Electric Group No. 5291 P. 1
Electrical Permit Application RECEIV a a
FOR OFFICE USE ONLY
City of Tigard FEB 1 3 20 T: t eili ed : 04114 13 sr Penn 6L-g- 0 -013 - zi9O i*. 7
II ... - i• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
' 2 Phone: 503-639.4171 Pax; 503.598.1960 r, , ! f I t at . Other Pemlit
Inspection Line: 503.639.4175 Cl a k/FTI— : &Ready/By: HI See Page 2 for
T I Ci
AR D
Internet: www.tigard-or.gov BUILDING DIVI's ii! UdtMelhod: IIIIM Supplemental Information
: . --, ..,,,,'.:, -;' .:. ,..-,.',., : :.- .% viro 9 4-::...: ... .• .•:••!: ANH.141
Please check ali that opply (submit 2 sets of pins w/items checked below):
0 New construction , 51 Addition/alteration/replacement
0 s erv i ce or feeder 400 amps or mom 0 Building over three atones.
El Demolition D Other: where the available fault curreni CI Marinas and boatyards.
— •.
, 2 ..,..,..: :.: • : .....m. :..;/•:- 0 ., , .. . , 0: : ,....... :: : 77. :..: exceeds 10,000 amps ru 150 voila or In Floating buildings.
less to ground, or exceeds 14.000 0 Commercial-use agricultural
El 1- and 2-family dwelling MCommerciallindustrial 0 Accessory building amps for all other installations. buildings.
0 Multi El Master builder 0 Other: 0 Fire pump- ID Installation of 75 KVA or
larger separately derived system.
M : . 1:1:": • 17:-..',', . : _ .1'E .ii.c.../ l'41
..; .4 1 ( 1 , - ‘ AND 1' : . ,•:.:C •:` • : '': - :,ife: , . 0 Addilion of new motor load of 13"A", ir "1
100HP or more. occupancy.
Job no.: 1 c,i 9svi Job site address: / b z&c, 51,j 4,zeEwipez aft p ['Six or more residential units. D Recreational vehicle parks.
0 Healih-care facilities. p Supply voltage for more than
City/State/Z1P:...- £) 9 72-.2., 0 Hazardous locations. 600 yoke nominal.
dOP dg./apt. no.: (ZSE) Project name: " , A )2/ k -- Pe . 0 Service or feeder 600 amps Or more.
1...._ - SIR . L •::ln r,' .. :SUISPEOPSW " '' :
Cross street/directions to job site: Driertprien I Ou. I Per. I Total I •
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: . I Lot no.: 1 so. ft. or less 168,54 4
Ea. odd'! 500 sq. lt. or portion 33.92 1
Tax map/parcel no.: Limited energy, residential /5.00 2
-aeons's:
. ■.‘ . : r:I :
. . •''11 4 :'; ' .' t.e%' beitirriertir. WC) • .:•••agE • • ....., - ( with above sq. fl.)
Limited energy. multi-family 75.00 2
44.) ge "4•CCE ebArrat- -- 4 Deb /.4-VEgarsut residential (wilh above a ro .
- Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
SR• . . ' illoPERIVOEit'S. : !•;i:. :.':::: ..:. fit.717 • T iFel. • • .',.; 4T 201 amps to 4,30 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;
City/State/ZIP: relocation
Phone: ( ) I Fax ( ) 200 amps or less 59.36 I
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps
168.54 2
intended for sale, lease, rent, or exchange, according to ()Rs 447, 449, 670, and 701.
Branch circuits- new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
• `..' A above service or feeder (ee,
ME :. . '-' ';'. 0175 : POPM: • : $ .. 3V.1; "" " CAA . • ACT 'MN. .: .:;;7 Mi each brunch circuit 742 2
BUSifleSS name: 3. g; aye- B . Fee for branch circuits with d
service or feeder fee, first 56.18 2
branch circuit
Contact name: D A hi/A-reerh4 ::
Each add'I branch circuit - 7.42 2
Address: /9 cult. ''' Miscellaneous (service or feeder not Included)
Each manufactured or modular 67.84 2
City/State/ZIP: 4 / 1 ;4),,4-gi,e/ ,p,e 9 7022- dwelling, service and/or feeder
Phone: ( ) 4.42_-•5:2/4.- I Fax: : Ll5 )459 — 4.94,8 Reconnect only , 67,84 , 2
• Pump or Iffigalion circle 67.84 2
E-mail: Abv/..s • ,DLIf Ccn-4-4. .... Sign or outline lighting 67.84 . 2
, I THA
.. _ .. _.__ ..
f r• • • •••••:-,... •• • • ..0.... • ... W17- : ...z.;W: !' - :: .• :4IP. ;4::.". Signal circuit(s)or limited-energy } 75;ino
panel, alteration, or extension. / Page 2 _ 7S: 2
Business name: STONER ELECTRIC, INC , Each additional inspection over allowable in any of the above
Address: 1904 SE OCHOCO Additional inspection (I hr min) 66.25/ hr
Investigation (1 hr min) 1 66.25/ hr
City/State/ZIP: MILWAUKIE, OR 97222 Industrial plant (I hr min) 78.12/lie
Phone: ( 503) I Fax: ( 503) 659-4968 aspections for which no feo is tillliatticmin) 90.00/ hr
specay A
CCB Lic-: 44823 1 Electrical Lie.: 26-122C 1 Suprv. Lie.: 34968 mil .7:411 -1Ersler:.. ....
Subtotal: *-75:0.0 _
Supra. Electrician signature, required: pri 4,,,,,,,L.,,,,,,„„,... Plan review (25% of permit fee): t9 - ____
Print name: MICHAEL FALCONER Date: z/) , it-3 State surcharge (12% of permit fee): 9. cro
TOTAL PERMIT FEE: I/ 641 00
Authorized signature: This permit application aspires Ire permit Is not obtained within in
...
days after It has been accepted as complete.
Print name: Date: * Number of inspections allowed per permit.
. . . ... . .... _ _ . . . —..... • ••, •. vr/I 1 inttrfAinirDll
Feb. 13. 2013 2:10PM Stoner Electric Group No. 5291 P. 2
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
. RESII)prntr vizomoNLitY ':' ...'... :
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: —
re_7 Niko s... •
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
El Fire Alarm Installation
El HVAC
❑ Instrumentation
X Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
:b-b
Total number of commercial systems: I
*No licenses are required. Licenses are requited
for all other installations