Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
I COMMUNITY DEVELOPMENT Permit#: ELR2014-00005
Date Issued: 01/14/2014
T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718 2439 Parcel: 1S 135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 305
Project: Luscombe Engineering Subdivision: METZGER. TOWN OF Lot: 9
Project Description: Low voltage for 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 01/1412014 $75.00
12%State Surcharge-Electrical 01/1412014 $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 CC
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 adopted by the Oregon Utility Notification nter Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090 You ma obtain a co e rul or direct questions to OUNC by calling 50 987 or 1 800 332 2344
Issued By. Pormittee Signature: Xr
OWNER INSTALLATION ONLY
The installations being made on property I own which is not intended for sale lease or rert
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 ApplicatidtTECEIVED
Datety / /�
llty Ut rj 1 iil'(� " Re
Date/By: / l/„CJI Permit no.: , f r
13125 SW Hall Blvd.,Tigard,OR 971;1AN 0 6 2014 Plan Review
Other Permit L/06�,3� 7
Phone: 5f)3.G39.4I71 Fax: 503.598.1960 Date/By: ` bOL'X�
TIGARD Inspection Line: 503.6 39.4 175 CITY OF TIGARD Date Ready/By: Juris: LI Sc c Page 2 for
Internet: www.tigard-or.gov
BUILDING DIVISION Notified/Method: Supplemental lnlianiamm
TYPE OF WORK PLAN REVIEW
lJ New construction !A Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked below):
❑ Demolition ❑ Other: D Service or feeder 400 amps or more ❑Building over three stories
CATEGORY OF CONSTRUCTION where the available fault current ❑Marinas and boatyards
U I-and 2-family dwelling U Commercial/industrial ,i Accessory building exceeds 10,000 amps at 150 volts or Floating buildings
❑ Multi-family ❑ Master Builder Li]Other less to ground,or exceeds 14,000 Commercial-use agricultural
JOB SITE INFORMATION AND LOCATION amps for all other installations. ❑ buildings
Job nu.: 140081-45 Job site address: 10300 SW Greenburg Rd. ❑Fire Pump ❑ Installation of 75 KVA or
❑Emergency system larger separately derived system.
City/State/ZIP: Tigard,OR 97223 ❑Addition of new motor load of ❑'A","E',"1-2","1.3",
100HP or more. ❑ occupancy
Suite/bldg./apt.no.: Ste 305 Project name: Luscombe T.I.
r1 Six or more residential units [11 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: 1.01 no.: FEE SCHEDULE
Description I Qty. I Fee. l Total I
Tax map/parcel no.: New residential-single or multi-family dwelling unit.
DESCRIPTION OF WORK Includes attached garage.
INSTALI.FIRE ALARM CIRCUIT 1000 sq.ft.or less $ 168.54 4
Ea.Add'I 500 sq.ft or portion S 33.92 I
Li PROPERTY OWNER I U TENANT Limited energy residential
(with above sq.ft.) S 67.84 2
Name: SHORENSTEIN REALTY SERVICES Limited energy,multi-family
Address: residential(with above sq.ft.) 5 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 S 133.56 2
Phone: Fax: 40l 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 S 59.36 1
Li APPLICANT I U CONTACT PERSON 201 amps to 400 amps S 125.08 2
Business Name: 401 amps to 599 amps 5 168.54 2
Branch circuits-new,alteration,or extension,per panel
Contact name: A. Fee for branch circuits with
service or feeder fee,each
Address: branch circuit S 7.42 2
B. Fee for branch circuits
City/State/ZIP: without service or feeder fee,
first branch circuit S 56.18 2
Each additional branch circuit: S 7.42 2
Phone: Fax: Miscellaneous(service or feeder not included)
li-mail: Each manufactured or modular
CONTRACTOR dwelling,service and or feeder 5 67.84 . 2
Business Name: CAPITOL ELECTRIC CO.,INC. Reconnect only S 67.84 2
Pump or irrigation circle 5 67.84 2
Contact name: DAN WILSON 503.262.0411 DIRECT Sign or outline lighting S 67.84 2-
Signal circuit(s)or litnited-
Address: 11401 NE MARX ST. energy panel,alterations,or
extension. Describe: Fire Alarm 1 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 66.25
Investigation per hour(1 hr mitt) S 66.25
CCB Lic.: 48748 (Electrical Lic.: 26-496C !Styr; Lic. 2865-S Industrial plant per hour S 78.18
Suprv.Electrician signature,required: ELECTRICAL PERMIT FEES'
Subtotal $ 75.00
Print Name: RICHARD MARTIN Data 1102!14 Plan review(25%of permit feel
Authorized signature: State surcharge( 12% of permit fee) $ 9.00
TOTAL PERMIT FEE S 84.00
Print Name: RICHARD MARTIN This permit•ppltcation expires If permit is not obtained within 180
days after it has been accepted as complete.
•Number of inspections per permit allowed.
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
10300 SW GREENBURG RD 305, TIGARD, OR,
97223
Commercial - Electricial Limited Energy
199 Electrical final
2014-01-22 (null)
ELR2014-00005
PASS - No C of O
Violation Summary:
Inspector Contractor