Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
s • COMMUNITY DEVELOPMENT Permit#: ELR2015-00072
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/19/2015
Parcel: 1 S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 1100
Project: Spec Space 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 03/19/2015 $75.00
12%State Surcharge-Electrical 03/19/2015 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 0
Audio&Stereo: 0 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 ma •• -in a c o e ru direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
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 503.639.4175 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
Receive
City of Tigard Date/By: 4 /¢ �r1 n,Perrnit no.: E �/5 7�
• 13125 SW Hall Blvd.,Tigard,OR 97223 E C E I V E D Plan Review 7 1�'
Phone: 503.639.4171 Fax: 503.598.196 Date/By: Other Permit:C/1y �c7aU4Z--
T I G A R i) Inspection Line: 503.639.4175 2015 Date ReadyBy: Juris: (/ h
U Sea Page 2 for
Internet: www.tigard-or.gov MAR 16 Notified/Method: Supplemental Information
. T.
TYPE OF WO' s.-''''''' N - zw;.' e emu' i s; ,,,%; .e »" '. d
❑ New construction U Addition/alteration/replace '1" IP ' I . t�l 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 CONSTR where the available fault current ❑ Marinas and boatyards
❑ I-and 2-family dwelling U Commercial/industrial Accessory building exceeds 10,000 amps at 150 volts or Floating buildings
❑ Multi-family ❑ Master Builder ❑Other less to ground,or exceeds 14,000 Commercial-use agricultural
JOB SITE INFORMATION AND LOCA". i s amps for all other installations.
„�.�„�.. am p ❑ buildings
Job no.. 150119-45 Job site address: 10260 SW Greenburg Rd. ❑ Fire Pump El Installation of 75 KVA or
❑ Emergency system larger separately derived system.
City/State/ZIP: Tigard,OR 97223 ❑ Addition of new motor load of 111 "A","E","1-2","1-3",
100HP or more. ❑ occupancy
Suite/bldg./apt.no Ste.1100 Project name: VSP El Six or more residential units ❑ Recreational vehicle parks.
❑ Health-care facilities ❑ Supply voltage for more than
Cross Street/Directions to job site: ❑ Hazardous locations
LI 600 volts nominal.
❑ Service or feeder 600 am.s or more
Subdivision: Lot no.: ` :2,ss ,;, ,� EZ,t rt .,,_
lea ,.f.
• Description Qty. Fee. Total
Tax ma./.arcel no.: New residential-single or multi-family dwelling unit.
i.: xi itT,i," llkttoF 1 4 7, 64 ,,.x,. .a'r '; Includes attached garage.
INSTALL FIRE ALARM CIRCUIT 1000 sq.ft.or less $ 168.54 4
Ea.Add'l 500 sq.ft or portion $ 33.92 1
",4 a" ' owg knii -4,74 . .. •RT Mr -1 r 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.) $ 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 $ 133.56 2
401 amps to 600 amps $ 200.34 2
Phone: Fax: 601 amps to 1000 amps 5 301.04 2
Owner installation: This installation is being made on property that I own which is not Over 1000 amps or volts $ 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
). 'I'-FETC0. !.;t .0 ,,r;' _,;'g .. a,l ' . "elit u 4 ._. ... 201 amps to 400 amps S 125.08 2
Business Name:
401 amps to 599 amps S 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 $ 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: $ 7.42 2
Phone: Fax: Miscellaneous(service or feeder not included)
E-mail: ,� Each manufactured or modular
>'"a?k 5° „f'k Q t-`e"' „ .;a ., $tcQ 1 1 11d P= :4 ;.:33 - '',..;Vii, dwelling,service and or feeder $ 67.84 _ 2
Business Name: CAPITOL ELECTRIC CO.,INC. Reconnect only $ 67.84 2
Pump or irrigation circle $ 67.84 2
Contact name: DAN WILSON 503.262.0411 DIRECT Sign or outline lighting $ 67.84 2
Signal circuit(s)or limited-
energy 11401 NE MARX ST.
energy panel,alterations,or
extension. Describe: Fire Alarm I Page 2 $ 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: 503-267-7121 Per inspection $ 66.25
Investigation per hour(I hr min) 5 66.25
CCB Lic.: 48748 Electrical Lie.: 26-496C ISuprv.Lie.: 3132-S Industrial plant per hour S 78.18
ELECTRICAL PERMIT FEES* , - `." r:,:;
Suprv.Electrician signature,required: Subtotal $ 75.00
Print Name: DARfFFjLLMCNEEL e:'M 03/16/15 Plan review(25%of permit fee)
p
`jam/� la,. State surcharge( 12% of permit fee) S 9.00
Authorized signature: TOTAL PERMIT FEE $ 84.00
Print Name: DARRELL MCNEEL This permit application expires if•permit is not obtained within 180
days after it has been accepted as complete.
*Number of inspections per permit allowed.
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