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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT ' - COMMUNITY DEVELOPMENT Permit#: ELR2013 00221 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/04/2013 Parcel: 1 S135AB01003 Jurisdiction: Tigard Site address: 10300 SW GREENBURG RD 360 Project: DiLorenzo&Company Subdivision: METZGER,TOWN OF Lot: 9 Project Description: Low voltage for fire alarm Contractor: SAFE TECHNOLOGY GROUP INC Owner: LINCOLN CENTER LLC 6400 NE HWY 99 SUITE G375 BY SHORENSTEIN PROPERTIES LLC VANCOUVER,WA 98665 555 CALIFORNIA ST 49TH FL • SAN FRANCISCO, CA 94104 PHONE: 360-699-2130 PHONE: FAX: 360-719-1527 FEES Description Date Amount Specifics: Restricted Energy Permit 09/04/2013 $75.00 12%State Surcharge-Electrical 09/04/2013 $9.00 Type of Use: COM Class of Work: ALT Total Number of Systems: 1 Audio&Stereo: 0 Boiler Controls: 0 CCTV: 0 Clock Systems: 0 Data&Telecommunications: 0 Fire Alarm: 1 HVAC: 0 Instrumentation: 0 Intercom/Paging: 0 Landscape/Irrigation: 0 Landscape Lighting: 0 Medical: 0 Nurse Calls: 0 Protective Signal: 0 Security Alarm: 0 Other: 0 Total $84.00 Other Desc: Required Items and Reports(Conditions) This permit is issu •'-ct 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 rdance with a••roved 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. A ENTION: Oregon law re. ires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-00 -0010 through OAR 952-/01 -0098 V. may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Iss ed By: �� OF / 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 503.639.4175 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. Electrical Permit Application v)R o r1c i�: i Si.:(1\I.\ City of Tigard RECEIVED Date/13 eReceived ©/ � �y� Permit No.: et� 'j—BQ2 2./ 4.• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ' Ill Phone: 503.718.2439 Fax: 503.598:19f60 4 2 013 Date/13 : Other Permit: A.CJs�43 00 f� I'I G A R D Inspection Line: 503.639.4175 2013 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information CITY OF TIGARD TYPteirtliNt DIVISION Please check all that apply(submit REVIEW plans w/items checked below): ❑New construction ®Addition/alteration/replacement ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings. less to ground,or exceeds 14,000 ❑Commercial-use agricultural ❑ I-and 2-family dwelling ►1/ Commercial/industrial ❑Accessory building amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system. ❑Addition of new motor load of ❑"A","E","1-2","1-3", Job no.: Job site address: 10300 SW GREENBURG RD 100HP or more. occupancy. ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP:TIGARD OR 97223 ❑Health-care facilities. ❑Supply voltage for more than ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.:360 Project name:DILORENZO ❑Service or feeder 600 amps or more. Cross street/directions to job site:LINCOLN 1 FEE SCHEDULE J Description I Qty. I Fee. I Total 1 • New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4 Ea.add'I 500 sq.ft.or portion 33.92 1 Tax map/parcel no.: Limited energy,residential 7500 2 DESCRIPTION OF WORK (with above sq.ft.) Limited energy,multi-family 7500 2 FIRE ALARM residential(with above sq.ft.) Services or feeders installation,alteration,and/or relocation 200 amps or less 100.70 2 ❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 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/or City/State/ZIP: relocation Phone:( ) Fax:( ) 200 amps or less - 59.36 1 201 amps to 400 amps 125.08 2 Owner installation:This installation is being made on property that I own which is not intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2 Branch circuits-new,alteration,or extension,per panel Owner signature: Date: A.Fee for branch circuits with ® APPLICANT ❑ CONTACT PERSON above service or feeder fee, 7.42 2 each branch circuit Business name:SAFE TECHNOLOGY GROUP INC. B.Fee for branch circuits without service or feeder fee,first 56.18 2 Contact name:JASON SWEET branch circuit Each add'I branch circuit 7.42 2 Address:6400 NE HWY 99 SUITE G375 Miscellaneous(service or feeder not included) City/State/ZIP:VANCOUVER WA 98665 dwelling,service and/or feeder 67.84 2 Phone:(360)699-2130 Fax: :(360)719-1527 Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E-mail:SALES @SAFETECHNOLOGY.NET Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s)or limited-energy ' Business name:SAFE TECHNOLOGY GROUP INC. panel,alteration,or extension. 1 Page 2 75.00 2 Each additional inspection over allowable in any of the above Address:6400 NE HWY 99 SUITE G375 Additional inspection(1 hr min) 66.25/hr City/State/ZIP:VANCOUVER WA 98665 Investigation(1 hr min) 66.25/hr Industrial plant(1 hr min) 78.18/hr Phone:(360)699-2130 Fax:(360)719-1527 Inspections for which no fee is 90,00/hr specifically listed(V2 hr min) CCB Lic.: 173731 Electrical Lic.: CLE79 Suprv.Lic.: 4272LEA ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: i54PreAo Subtotal: 75.00 Plan review(25/o of permit fee): Print name: JASON SWEET Date: 9-3-13 State surcharge(12%of permit fee): 9.00 Authorized signature: c°5Cst-ee TO TAL PERMIT FEE: gT.G1D This permit application expires if a permit is not obtained within 180 Print name: JASON SWEET Date: 9-3-13 • days after it has been accepted as complete. • Number of inspections allowed per permit. I:\Building\Permits\ELC-PermitApp.doc 07/01/10 440-4615T(11/05/COM/WEB Electrical Permit Application - City of Tigard Page 2- Supplemental Information LIMITED ENERGY PERMIT FEES: :RESIDENTIAL:WORK ONLY: 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: COMMERCIAL'WORK.ONLY 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 0 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 1:\Building\Permits\ELC-PermitApp.doc 07/01/10