Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
1111 ° COM MUNITY DEVELOPMENT Permit #: ELR2013 00115
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718 2439 Date Issued: 06/04/2013
Parcel: 1 S135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 200
Project: Swipe Now Subdivision: METZGER, TOWN OF Lot: 9
Project Description: Fire alarm
Contractor: CAPITOL ELECTRIC CO INC Owner: LINCOLN CENTER LLC
11401 NE MARX STREET 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 06/04/2013 $75 00
12% State Surcharge - Electrical 06/04/2013 $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: Y
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 hose rules are set forth in OAR
52 - 001 -0010 through O 52- 001 -0090 You may obtain a co
9py of the rules or direct questions to OUNC by calling 503.232 1 0 800 332 234
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 503.639.4176 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.
Electrical Permit Application FOR OFFICE USE ONLY
I City of Tigard RECEIVED Received ` 13125 SW Hall Blvd , Tigard, OR 97223
Date /By 411-r4 �/ �/ ermn no� '-'69e/4.5 '-'69e/4.5 Plan Review j �
Phone 503 639 4 17 I Fax 503 598.19 Date /By Other Penney C2c02 ��q /3'0694 V
TIGARD Inspection Line: 503.639 tY AY 2 3 2013 Date Ready /By. Juns U Sr e 'age 2 for
Internet• ww•w tigard- or.gov
C ITY OF TIGARD Notified/Method Supplemental Info motion
TYPE OF WORK BUILU1NGUIVISION _ PLAN REVIEW
❑ New construction U Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below)
❑ Demolition ❑ Other ❑ Service or feeder 400 amps or more ❑ Building over three stories
CATEGORY OF CONSTRUCTION where the available fault current ❑ Mannas and boatyards
LI I- and 2 - family dwelling U Commercial/industrial ❑ Accessory building exceeds 10,000 amps at 150 volts or Floating buildings
❑ Multi family Cl Master Builder ❑ Other less to ground, or exceeds 14,000 Commercial -use agncultural
JOB SITE INFORMATION AND LOCATION amps for all other installations ❑ buildings
Job no 130770 - 45 Job site address 10220 SW Greenburg Road CI Fire Pump CI Installation of 75 KVA or
❑ Emergency system larger separately denved system
City /State /ZIP. Tigard, OR 97223 CI Addition of new motor load of ❑ "A ", "E ", "1 - 2", "1 - 3
100HP or more ❑ occupancy
Sune/bldg /apt no. Suite 200 Project name. Swipe Now T.I.
III six or more residential units ❑ Recreational vehicle parks
❑ Health -care facilities ❑ Supply voltage for more than
Cross Street/Directions to job site ❑ Hazardous locations ❑ 600 volts nominal
❑ Service or feeder 600 amps or more
Subdivision Lot no. FEE SCHEDULE
Description I Qty. I Fee. I Total I ••
Tax map /parcel no New residential - single or multi - family dwelling unit.
DESCRIPTION OF WORK Includes attached garage.
INSTALL FIRE ALARM CIRCUIT 1000 sq. ft or less $ 168 54 4
Ea Add'I 500 sq ft or portion S 33 92 1
IJ PROPERTY OWNER I U TENANT Limited energy residential
Name (with above sq ft ) S 67 84 2
SHORENSTEIN REALTY SERVICES Limited energy, multi-family
Address residential (with above sq ft.) S 67.84 2
Service or feeders installation, alteration, and /or relocation
City /State /ZIP 200 amps or less S 100 70 2
201 amps to 400 amps 5 133.56 2
Phone. Fax. 401 amps to 600 amps S 200 34 2
601 amps to 1000 amps S 301 04 2
Owner installation: This installation is being made on property that I own which is not Over 1000 amps or volts S 552 26 2
intended for sale, lease, rent or exchange, according to ORS 447, 449, 670, and 701 Temporary services or feeders installation, alteration, and /or
Owner signature: Date relocation
200 amps or less 5 59 36 1
LI APPLICANT I H CONTACT PERSON 201 amps to 400 amps S 125.08 2
401 amps to 599 amps S 168.54 2
Business Name.
Branch circuits - new, alteration, or extension, per panel
Contact name: A. Fee for branch circuits with
service or feeder fee, each
Address branch circuit 5 7.42 2
B. Fee for branch circuits
without service or feeder fee,
City/State/ZIP. first branch circuit 5 56.18 2
Phone Fax: Each additional branch circuit. S 7.42 2
Miscellaneous (service or feeder not included)
E -mail: Each manufactured or modular
CONTRACTOR dwelling, service and or feeder S 67 84 2
Business Name CAPITOL ELECTRIC CO., INC. Reconnect only S 67 84 2
Pump or irrigation circle S 67 84 2
Contact name DAN WILSON 503.262.0411 DIRECT Sign or outline lighting S 67 Sa 2
' Signal circuit(s) or limited -
Address 11401 NE MARX ST. energy panel, alterations, or
extension. Describe. Fire Alarm I Page 2 S 75 00 2
City /State /ZIP PORTLAND, OR 97220 - 1041 - Each additional inspection over allowable in any of the above
Phone 503- 255 -9488 Fax 503 - 257 -7121 Per inspection S 6625
Investigation per hour (I hr nth) 5 66 25
CCB Lie • 48748 'Electric al 26 - 496C ISupry Lie.. 3 132 -
Industrial plant per hour S 78 18
Supry Electrician signature, required. // //���� " ELECTRICAL PERMIT FEES" ..) - ��P� �J�� /vim Subtotal $ 75.00
Print Name DARRELL MCNE Date 05/17/13 Plan review (25% of permit fee)
Authorized signature: State surcharge ( 12% of permit fee) $ 9.00
. i r t >mre-1 -at TOTAL PERMIT FEE $ 84.00
Print Name DARRELL M / L ° This permit application expires if a permit Is not obtained ssithm 180
days after It has been accepted os complete
• Number of inspections per permit allowed