Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
s.: COMMUNITY DEVELOPMENT Permit #: ELR2013 00093
T
EGA R O 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/25/2013
Parcel: 1 S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 650
Project: New York Life Subdivision: METZGER, TOWN OF Lot: 9
Project Description: (1) low voltage for Data/Telecommunications
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 04/25/2013 $75.00
12% State Surcharge - Electrical 04/25/2013 $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: y 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 OA 9 - 001 -00 . 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: UVC.L Permittee Signature: DJ II-PP/Jed
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.
04/25/2013 07:13 5032551966 CAPITOL ELECTRIC PAGE 01
Fieetr Per A' Heaton DECEIVED Keccrvoc S1( P crmilno.:
Date/By: 4 r 3 El - 013,.. ` 13
City of Ti and „ � , Ilan Review __._
IN • 1312 SW Hari Blvd.. Ti erd, OR 97 APR 2 5 i Other Permit
fi _ . Dale /By:
>r phone: 503,639,4171 Fax: 503.598.1960
Date Kcudy /uy 'furls: / �tetaZe
T1GARI] InSpceti0n Line: 503.634.4175 CITY OF TIGARD Notified /Method: SO Snpplcmenror Lrriwmatlan
Internet: www.t.igard-or.gov
I II ■ III •V
i.nl N 71,-:i., lb , A
II New construction Addition/alteration/replacement Please check all that apply:
Demolition _• Other ❑ Service over 225 amps, comm'i 0 Hazardous location
” a.r~ 7.s': � •' r orF 2 tWu''.t!:t;rtr" t .:i_„ __,. ..,`.— ❑ Service over 320 amps • rating 0 Building over 10,000 SOIL
ti 1- and 2- family dwelling !71 Commercial /industrial r:: Accessory building of 1- and 2- family dwellings 4 or more new residential
n Multi -tamil n Master Builder n Other ❑ System over 600 volts nominal units in one Structure
iob no ma. 32 ' 8 � Nf !tt>"lia9ry.i� e �.d s+nt ,ig .i,;a�i __ -- `- _. _ ....I Building over three stories Feeders, 400 amps or more
El Job site address: 10260 SW Greenburg Rd Occupant load over 99 persons n Manufactured structures or
❑ Egress /lighting plan RV park
City /State /ZIP: Portland, OR. 97223 I=1 Health-Care facility ❑Other:
Submit 2 sets of plena with any of the above.
Suite /bldg. /apt. no 650 I Protect Hume: NYL Cable The above are not applicable to tem era construction service.
t V
Cross Strecl /Direetiona to ,job Site' nmcriptinn Qty. Fee, Total ..
New residential - single or mulii- family dwelling unit:.
Subdivision: I Lotno..
includes attached garage.
1000 sq, ft. or Icss $ 166.54 4
Ti —
x mop/ creel tie : Ea. Add'I 500 sq. ft or portion $ 33.92 t
�stRtnt Limited enemy residential _ 5 75.0U 2
Install Comcast coax from riser tap to suite 660 backboard. Limitecl enemy, non - residential $ 75.00 2
Each manufactured home or modular
. 'St11111 ° ,,..,;,:,,,;,_, ..77 ?r:,,. ______:L__.____, dwelling, Service and /or feeder I 57.85 2
Name; Service or fccdcrs installation. alteration, and /or relocation
200 amps or less $ 100.70 2
— . .
Address' 201 amps to 400 amps I _ 133.58 7
401 amps to 600 amps S 200.34 2
City/Slate/71P; 601 amps to 1000 amps $ 301.04 2
Over 1000 amps or volts b 552.26 2
Reconnect only $ 57.94 2
Phone, 503 -295 -5555 rah Temporary services or feeders instatllution, alteration, and /or _
Owner installation: This installation is being made on properly that] own which is not relocation
intended foe sale, lease, rent or exchange, according to ORS 447, 449, 670, and 701 200 amps or less $ 59„35 I 1
Owner signature: Date; 201 amps to 400 amps $ 125,00 l i I 2
401 amps to 599 amps $ 168,54 2
si.:.,,;111 l 9tbY tp ..w...,. ;. .. _,Jj . •„' _, .._....0 liccr L_ -1 4tl. _. Branch circuits• new, alteration, orextensiorl.per nnel
Business Name' A. Fee for branch circuits with
service or feeder fee, each
Contact name: branch Circuit $ 7.42 2
B. Fee for branch circuits
Address: without service or feeder fee,
each branch circuit $ $C, i 2
City/State/ZIP; Each additional branch circuit: S 7,42 i 2
Miscellaneous (service or (ceder not included) ..
Phone; Fax; Pump or irrigation circle S 57,84 2
Sign or outline) ighting 5 57,84 2
E•rnail; Signal circuits(s) or limited-
.
Lal;,.,_:„,,,,,,„;: _,.,,:,..L__.,..: : „i .,__,„. '. c : o EL4s=" v:: energy panel, alteration, or
Business Name: Capitol Data & Communications, inc. extension. Describe: Tcic /Darn 1 75 75.00 2
Page 2
Contad Home Each additional inpectien over allowahle in any of the above
/ F (', t. {' a . S C Per insp $ 65.25
Address' 11401 NE Marx Street Investigation per hour (1 hr min) $ 55.25
Industrial plant per hour 5 79.15
:,
City/StntdL,11": Portland, Oregon 97220 i) l l:;tn�n n J F i�t^urtr i7ci l_ S
Subtotal 75.00
Plan review (22% of permit Fee'
1'hono: 603.265.9488 Fax: 503. 257.7121 State surcharge ( 12% of permit fee) 9.00
- CCB Lie.: 142467 I laccuicnl Lie,; 26 - I, 4Cr.E Suprv. L 2757LEA TOTAL PERMIT FEE 84.00
d This pelsait app6cotlan expires if a permit is mat obtained within Iaa
Suprv. Electrician aignstwrs, rocir�ircd �.-- -- ,
- dap! after ■t hap been accepted nn cn•p4••
Print Nnme: Terry BreSCh .,,...--- Date. 04125/13 * Fee methodology act by Tri- County Building Indnsey Service nnnrd
Authorized signature: 0 ,..______ rt
...Number of inspcctiotts per permit allowed,
Print Nrrnu: Terry laranch
503 -719 -2479 FAXED
Lii `1- 2_5 7,_13
04/25/2013 07:13 5032551966 CAPITOL ELECTRIC PAGE 02
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
S,I NAMIWAR C.Ir�
Fee for all residential systesm 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*
�l Other:
Fee for each commercial sytem $ 75.00
(SEE OAR 918 - 260 - 260)
Check Type of Work Involved:
Ci Audio and Stereo Systems
Boiler Controls
❑ Clock Systems
❑ Data Telecommunication installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
• Intercom and Paging Systems
❑ Landscape Irrigation Control*
El 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
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
10260 SW GREENBURG RD 650, TIGARD, OR,
97223
Commercial - Electricial Limited Energy
199 Electrical final
04/29/2013 00:00
ELR2013-00093
FAIL
No contact to look at work done. Please recall with information
Violation Summary:
Inspector Contractor