Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
7 1 ° : - COMMUNITY DEVELOPMENT Permit #: ELR2013 00039
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/19/2013
Parcel: 1 S135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 417
Project: Cypress Subdivision: METZGER, TOWN OF Lot: 9
Project Description: (1) low voltage for AudioNideo System
Contractor: LEWIS AUDIO VIDEO Owner: LINCOLN CENTER LLC
2112 PORTLAND RD. BY SHORENSTEIN PROPERTIES LLC
NEWBERG, OR 97132 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
L.
PHONE: 503 - 538 -1190 PHONE:
FAX: 503 - 538 -5419
FEES
Description Date Amount
Specifics: Restricted Energy Permit 02/19/2013 $75.00
12% State Surcharge - Electrical 02/19/2013 $9.00
Type of Use: COM
Class of Work: ALT .
Total Number of Systems: 1
Audio & Stereo: y 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) r
L.
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: I LLA ! 1 ' ■ / _ " .4 Permittee Signature: Did ,L/ 4i—' .
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. •
can 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. 14. 2013 3:34PM No. 0596 P. 2
Electrical Permit Application RECErVED
FOR OFFICE tisi: ON1.1'
City of Tigard 601 4 2013 il ....ive r d . a. „ 11 1 1 s c.„..c
PErnit No.; et2 ?)I s - coo 39
13125 SW Hall Blvd,, Tigard, OR 97223 I Plan Review
N - : Phone: 503.7182439 Fax: 503.598.19€1TY OFTIGARD Date/By: Other Permit 3 ,3,,,, i 2,, - op c w3
Inspection Line: 503.639.4175 B See Page 2 for
A
'I 1CiR Ins
D BUILDING DIVISIO '":20=3;;I: .".. co
Internet www.tigard.or.gov Supplemental Information
. ..
, i.x . •,... .. .,•: ...... ...,...:i: z • :' . . T ypegar t 0.: . .:::.; ::: . ...::. :. ';:-:' ...;,.....; ... . . : • • .. : j'.. ::',: :; ,......Itiiki, ; iv i l- ..?..... . -
ii ,t.. ..... • , . • - :;',',4,f,ak,.. • . . • • ...:.
0 Ncw construction II Addition/alteration/replacement Please check all that apply (submit i sere of plans whams checked below):
['Service or feeder 400 amps or more DI holding over duce stories.
I=1 Demolition 0 Other: where the available fault current 0 Marinas and boaiyards.
• . 'i• •'. ' .. . .; ."•;:it'''' - ' a` C. .- • Fir nw • : meads 10,000 amps at 150 volts or 0 Floating buildings.
il',.!:: . , .: • ''.....:!;•M ••••, .2: -.....s.e.r..::o...• '''..':.‘ ' 2 ' . ' '' , , .-""'"'-'-:• ‘-'',..' 644r
' ..: ' less to ground. or exceeds 14,000 I:1 Conimarcisktse agricultural
q I- and 2-family dwelling ISI Commercial/industrial 0 Accessory building amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: Ei Fire pump. 0 Installation of 75 1CVA Or
, ... 0 Emergency system. Lirger separaiely derived sysiem
. ■i • • : • :.: : • ;' ; ti*?.:4110 Ir.•04 :..... .. ..;' :. 0 Addition of new motor load of 0 "A". "E"', '1-2", "1-3".
100HP or mere. occupancy.
Job no.: 1 Job site address: 10220 SW Greenburg Rd 4
0 six &more residential units. 0 Recreational vehicle paths.
City/State/ZIP: Tigard, OR, 97223 0 Health-cere facilities. 0 Supply voltage for more than
0 Hazardous locations. 600 volts nominal.
Suite/bldg./apt, no.: Bldg 3 all Project name: 0)4 p Pt,: 59 0 Service or feeder 600 amps or more.
. • . ... : .''' • .. H . i . • : .‘•••`•:';
Cross street/directions to job site: . Description I ply. I Fee. I Tent 1 •
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1.000 sq. ft. or less 168.54 4
Ea. addl 500 sq. It. or portion 33.92 1
Tax map/parcel no.: ._ , , ..,_ Limited energy, residential 75.00 2
scHrt . 0,0,0(i.,..: ' : .: ( v'th ° ft) -
Limited energy. multi-family 75.00 2
Limited Energy - Audio/Video residential (with above sq. ,ft.)
Services or feeders installatIonalteration, and/or relocation
200 amps or less 100.70 2
. ;;, 6 pitopzi. '::: . ..'i::: 1: „. ,, tjtgot:7,::t." 'I:: 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: Cypress Semiconductor 601 amps to l,000 amps 301.04 2
Address: 10220 SW Greenburg Rd - Lincoln 3 Fir Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP: Tigard, OR 91223 relocation
Phone: ( ) 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 ORS 447, 449, 670, and 701.
Branch circuits -new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
• . • • • • ---5 , - . .,.. „ -. -,...- • • • • ., . • .1 •,.. above service or feeder fee,
. . . ,--'; I 0
• • ' . ' .. u,, TSN
:1s • • .. '5 • - .
0tiI6Orr&S 1, Z4 . • . ; ' .I.. • - ' - A : !'. - . 1. . . . .. . ......-
- • . . . -.. N each branch are= 742 2
Business name: Lewis Audio Video B. Fee for branch circuits without
service or feeder fee, first
56.18 2
Contact name: Craig Mclndoo branch circuit - -
Each add'l branch circuit 7.42 2
Address: 2112 Portland Rd Miscellaneous (service or feeder not Included)
Each manufactured or modular
City/State/ZIP: Newberg, OR 97132 dwelling, service arid/or feeder 67.84 12
Phone: (503) 538 Fax : (503) 538 Reconnect only 67.84 2
Pump or irrigation circle 61.84 2
E craig@lewisay.com . Sign or outline lighting 67.84 2
:;17.7• .,;•.. . :, :•,,;;;,, •„•,520:;:;,,,,e,.:. : :::;'......4.450:iR,qaiii! Signal circuits) or limited energy 1 alteration, or extension. Page 2 2
75.00
_panel,
Business name: Lewis Audio Video
Each additional inspection over allowable in any of the above
Address: 2112 Pordand Road Additional inspection (1 hr min) 66.25/ hr
Investigation (I hr min) 66.25/ hr
City/State/ZIP: Newberg, OR 97132
Industrial plant (I hr min) 78.18/hr
Phone: (503) 538 i Fax: (503) 538 Inspections for which no fee is 90.00/ hr
specifically listed CA hr min
CCB Lie.: 177627 if41,4 Electrical Lie.: 36119CLE Suprv. Lic.: 562LEA :.: E' . .'..y:aff4:; , Fri : - X06 1.i3 11KIEMIT FEES i '.. .. Ei ...
allt 114- mil 1/Q Subtotal: I 75.00
Suprv. Electrician signature, required: )1
,,, ,s .t...._■• _ ....-....arr Plan review (25% of permit (ie):
Print name: Wallace E Pro , I Date: 02-14-2013 State surcharge (12% of permit fee):
Authorized signature: 1 ,- ‘ I TOTAL PERMIT FEE: 84.00
%-, :a.r. ) -4- rkis peemit application expires Ira permit Is not obtained within 180
..ede
days otter it has been accepted as complete.
Print name: Craig Mclndoo qlf Date: 02-14-2013 = Number of inspections allowed per permit
13.1kilaiapenath‘ELC-Pormitapp.a Go 07/0 MO 140-46151111/05/COMAWE
Feb. 14. 2013 3:34PM No. 0596 P. 3
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT PEES:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Doot Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other
.. COMMBRCIAL Vkiil k0 'I:V m
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
❑ 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
:\ausairocfmitate- PennaAppdoa 07101/10
Feb. 14. 2013 3:34PM No. 0596 P. 1
To: City of Tigard Building Dept Date: February 14, 2013
•
Fax: 503.598.1960
From: Craig Mclndoo, Lewis Audio Video Pages: 4 (including cover sheet)
Good Afternoon,
Here is our Limited Energy Electrical permit application for.
Cypress Semiconductor
10220 SW Greenburg Rd
3- Lincoln Ctr — 4 Floor
Tigard, OR 97223
Let me know if there are any questions or problems. Our fax number is at the
bottom of the page. Or, you can email the permit to my email address below.
Thanks!
Craig Mclndoo, Service Coordinator
Lewis Audio Video
(503) 538 -1190
craig @lewisay.com
Lewis Audio Video • 2112 Portland Road • Newberg, Oregon • 97132
Main; 503.538.1190 • Fax: 503.538.5419
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10220 SW GREENBURG RD 417, TIGARD, OR,
97223
Commercial - Electricial Limited Energy
199 Electrical final
02/21/2013
ELR2013-00039
PASS - No C of O
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10220 SW GREENBURG RD 417, TIGARD, OR,
97223
Commercial - Electricial Limited Energy
199 Electrical final
02/21/2013
ELR2013-00039
PASS - No C of O
Violation Summary:
Inspector Contractor