Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
a COMMUNITY DEVELOPMENT Permit#: ELR2013-00240
T I G AR O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/03/2013
Parcel: 1 S135AB01003
Jurisdiction: Tigard
Site address: 10330 SW GREENBURG RD
Project: Red Lobster Subdivision: METZGER,TOWN OF Lot: 9
Project Description: AudioNideo system.
Contractor: OHM SYSTEMS LLC Owner: LINCOLN CENTER LLC
PO BOX 86833 BY SHORENSTEIN PROPERTIES LLC
PORTLAND,OR 97286 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO,CA 94104
•
PHONE: 503-484-5700 PHONE:
FAX: 503-258-0382
FEES
Description Date Amount
Specifics: Restricted Energy Permit 10/03/2013 $75.00
12%State Surcharge-Electrical 10/03/2013 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio&Stereo: 1 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data&Telecommunications: 0 Fire Alarm: 0
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 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 gf`ffie rulealyirect questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued B Permittee Signature: .ill
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.
From:chad baldwin Fax:(503)258-0382 To: Fax: +1(503)598-1960 Page 2 of 4 102/2013 9:24
Electrical Permit Apnlic `it�`l1i � I:()R()Fin-I.-. I ,t: ()\1.\
City of Tigard I ' '' Permit No.: - ,� el
13125 SW Hall Blvd.,Tigard,OR 97223 a Plan Review 1I �� i .t
Phone: 503.718.2439 Fax: 503.598fl0i 2 2013 Datc/B . Other Permit: ' }j �CJQ y
1 1 I Inspection Line: 503.639.4175 Date Ready,By: i la See Page 2 for
Internet: www.tigard-or.gov oily v riGhv 6D Notified/Method: /�G Supplemental Information
_ .�.• .,^r;,: - - - .�Y1JI ®r •+ f \r _ -. ,_ - .L•,_ _ - •'N;nrr._.. t•-
..r i' 'il.- _ :,.,;-.:^i..•�;.?.: , ,p. .Awe y ,:4';,1 1 ' ti'..I
y� � rrr•:s•r.,'iy.;.f�, '..], •iw . J' •'-y�• �L' ,Li. �0�11:�. ,-. , •ar•t•.�' ,i. !!S !. "... _,r.• .FrwM��.;1;4•rdJ
®New construction ❑Addition/alteration/replacement
Please check all that apply(submit 2 sets of plans whtems checked below):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
"' ' exceeds 10,000 amps at 150 volts or ❑Floating buildings.
;w " '%::`.".; Si �.C`;;i•:`.. YSf LION";5:'r:`:`i;.:,.:. ... _;r
• less to ground,or exceeds 14,000 ID Commercial-use agricultural
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation oft 5o KVA or
- ,r• - ❑Emergency system. larger separately derived system.
-.. ;JOB`SiTE fl5P 049. ;ANfl` `7,#)14,;°.• ❑Addition of new motor load of ❑ A" E" 1-
- - 2„..I.3..
Job no.: I Job site address:10330 SW Greenburg Rd. 1001-Par more residential °Ccreaney.
❑Six or more residential units. ❑Recreational vehicle parka.
City/State/ZIP:Tigard/OR/97233 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
SuiteJbldg./apt.no.: I Project name:Red Lobster ❑Service or feeder 600 amps or more.
• •
Cross street/directions to job site: Pompom I Qty. I Fen I Total ' -,'7
New residential single-or multi-family dwelling unit.
includes attached garage.
Subdivision: Lot no.: 1.000 sq.ft.or less 168.54 4
Tax map/parcel no.: Ea.Biel 500 sq.II.or portion 33.92 1
Limited energy,residential
7::::,:„.. .:::-•_c• 75.00
2
:.�':=,,�::R�:5r.i. •��;..:,.... �.•..,; h7faa� iY it'OF_1YAl :..i � '�F" 'h' •.. . (with above sq.ft)
Limited energy,multi-family 7500 2
Low Voltage. Audio/Video system. residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
• • cr• 200 or lss:i'' ,.'r."r ;4 A - ; Q 1T _ : 100.70 2
201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
Address: 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP: 'Temporary services or feeders installation,alteration,and/or
Phone:( ) I Fax;( ) relocation
200 amps or less 59.36 1
Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits—new,alteration,or extension,per panel
,., A.Fee for branch circuits with
:....:a=.?'r , ;tar;,'. :,.4;,,,.,..,:....1,:... pr:;tA+ch%'v1ev'�
above service or feeder lee,
Business name: each branch circuit 7.42 2
B.Fee for branch circuits without
Contact name: service or feeder fee,first 56,18 2
branch circuit
Address: Each add'I branch circuit _ 7.42 _ 2
City/State/ZIP: Miscellaneous(service or feeder not included)
Each manufactured or modular
67.84 2
Phone:( ) I Fax: :( ) dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
'`:.. ' r;+-. E+;cr..,_,.,-',i.:r� c. .. : '. . . •.• . .. . . .• -1. Sign or outline lighting 67.84 2
Business name:Ohm Systems,LLC Signal circuit(s)or limited-energy I see 7500
panel,alteration,or extension. Page 2 2
Address:PO Box 86833 Each additional inspection over allowable in any of the above_
Additional inspection(I hr min) 6625/hr
City/State/ZIP:Portland/OR/97286
Investigation(I hr min) 66.25/hr
Phone:(503)484-5700 I Fax:(503)258-0382 19dustrial plant(l hr min) 78.18/hr
/ �//Inspections for which no fee is 90A0/hr
CCB l.ic.: 166819 Electrical Lie.: CLE6 / Suprv.Lie.: 4100LEA spe ifiarlly listed('f,hr min)
01 $.1r6C1Rift'AL;i PBt,0;';,,4°:.1.; , .
Suprv.Electrician signature,required:_ Subtotal: 75.00
_........new
Plan review(25%of permit fee):
Print name: Chad Baldwin Date: 1012/13
— State surcharge(12%of permit fee): 9.00 /
Authorized signature: TOTAL PERMIT FEE: 84.00
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
1:1BuildingTermits1ELC PermitApp.ELR_ERE.doc Rev 0521/2013 440-4615T(t1/05/COM/WEB
From:chad baldwin Fax:(503)258-0382 To: Fax: +1(503)598-1960 Page 3 of 4 10/2/2013 9:24
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
yy nty 13 reZ)'97J1rit','ih�;i:�19;," .i;;.'1
:'CIF f iL.: 'f.:"f l�'=1:•E I'a }j� � J S
Fee for all residential systems combined $75.00 Description O . Fe. Toed •
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to IS kva 133.56 2
❑ Audio and Stereo Systems* 15,01 to zs kva 200.34 2
❑ Burglar Alarm Wind generation systems in excess of 25 kva:
25.01 to 50 kva 301.04 2
❑ Garage Door Opener* 50.01 to loo kva 552.26 2
>I00 kva(fee in accordance with 552.26 2
❑ Heating, Ventilation and Air Conditioning OAR 918-309-0040)
System* Solar generation systems in excess of 25 kva:
Each additional kva over 25 7.42 I 3
❑ Vacuum Systems* >too kva-no additional charge 0.0 Ir 3
❑ Each additional inspection over allowable in any of the above:
Other: Each additional inspection is 66.25/hr 1
charged at an hourly('hr min) -
Inspections for which no fee is 90.00/hr
• s•=ifical listed %,hr min
?M.` 1�1�7 '� w� fi:'.;'�;:e.5:.a.u.rr r,. i;:`:i:°.::� .l�e5r4'U;t�;:.!!i:, W: -�aye qr[� '4 •. -� }'tS"...}' •..
Fee for each commercial system $75.00 Subtotal:
(SEE OAR 918-309-0000) Plan review,if required(25%of permit fcc):
State surcharge(12%of permit fcc):
Check Type of Work Involved: TOTAL PERMIT PEE:
This permit appikadon expires It a permit is not obtained within 180
ZAudio and Stereo Systems days after it has been accepted as complete.
• Number of inspections allowed per permit.
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
El HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
El Outdoor Landscape Lighting*
❑ Protective Signaling
•
•
❑ Other
Total number of commercial systems: I
*No licenses are required. Licenses are required
for all other installations
1:11luilding\Pennits\FLd'PermitApp_ELR ERE doe Rev 05/21/2013
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10330 SW GREENBURG RD, TIGARD, OR, 2013 -12 -05 00:00:00
97223
Record Type: Record ID:
Commercial - Electricial Limited Energy ELR2013 - 00240
Inspection Type: Result:
199 Electrical final PASS - No C of 0
Comments:
Violation Summary:
Inspector Contractor