Permit 111 CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
'`1 r • COMMUNITY DEVELOPMENT Permit#: ELR2015-00172
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/20/2015
Parcel: 1 S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 535
Project: Benjamin Edwards Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire alarm and data telecommunications systems.
Contractor: POINT MONITOR CORPORATION Owner: LINCOLN CENTER LLC
5863 LAKEVIEW BLVD STE 100 BY SHORENSTEIN PROPERTIES LLC
LAKE OSWEGO, OR 97035 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 503-627-0100 PHONE:
FAX: 503-627-0110
FEES 1
Description Date Amount
Specifics: Restricted Energy Permit 07/20/2015 $150.00'
12%State Surcharge-Electrical 07/20/2015 $18.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 2
Audio&Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data&Telecommunications: 1 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 $168.00
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 rul'. by the Oregon Utility Notific enter. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may ob-.• •• • uestions to OUNC by calli 503.233 .1987 or 1.800 2.2344.
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 !O FOR OFFICE USE 011 1
City of Tigard \\41 Received
DateB : 7 • is-- airJ Permit No.: I /, I, ` f/7.
13125 SW Hall Blvd.,Tigard,04 ; "' Plan Review
g Phone: 503.718.2439 Fax: 50 9 60 pO r101� DateB : Other Permit:
I I G A R[) Inspection Line: 503.639.4175 `\ P Date Ready/By: 0 See Page 2 for
Internet: www.tigard-or.gov ,V� `G\ ON Notified/Method: Supplemental Information
❑New construction in Addition/al :rya. acement Please check all that apply(submit 2 sets of plans w/items checked below):
IP❑Demolition /0 Other: ❑Service or feeder 400 amps or more ❑Building over three stories.
where the available fault current ❑Marinas and boatyards.
CATEGORY OF exceeds 10,000 amps at 150 volts or ❑Floating buildings.
less to ground,or exceeds 14,000 ❑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 of 150 KVA or
❑Emergency system. larger separately derived system.
t'\.
❑Addition of new motor load of ❑"A" "E" "1.2""1-3^
Job no.: Job site address: 102 620 dW C3�/ vt / 100HP or more. occupancy.
1 J ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: ev1( q 7;.;---5 G /1 ❑Health-care facilities. 0 Supply voltage for more than
`-�1 ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: N hie `„(i »/1 r amps or more.
Q'� ❑Service or feeder 600 am
Cross street/directions to job site: Description Qty. Fee. Total •
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.it or less 168.54 ' 4
Ea.add'l 500 sq.ft.or portion 33.92 1
Tax map/parcel no.: Limited energy,residential
DESCRIPTION OF WORK (with above sq.ft.) 75.00 2
/ Limited energy,multi-family
'Fur-e chat/►vi c j bq '� �� residential(with above sq.ft.) 75.00 2
Relneiva$le Energy. ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
f] TENANT 200 amps or less 100.70 2
t�A! 201 amps to 400 amps 133.56 2
Name: VVI] 401 amps to 600 amps 200.34 2
Address: i 03,_6()0 Y" �") ( /C_p�J 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, er panel
Ilig APPLICANT I ❑ CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,
Business name: f6( lit (/`/>1 o v t1 CO I each branch circuit 7`42 2
1 V B.Fee for branch circuits without
Contact name: " f I/�/�f Tv q feeder il service or eder fee,first 56.18 2
l � ( branch circuit
Address: �j eJ�3 t... �U �(• Iv of Each add'1 branch circuit 7.42 2
City/State/ZIP: LA l4 Qw{/tt Qfe 9 7 7 3 5 Miscellaneous(service or feeder not included)
Each manufactured or modular
Phone: (iOT?) 7,(21 00 I Fax: :( ) dwelling,service and/or feeder 67.84 2
E-mail: Al n �fl�t
Reconnect only 67.84 2
y leg>° �� K fi►rl Q•t I � ���! Pump or irrigation circle 67.84 2
re
� .. �.* : . I� Sign or outline lighting 67.84 2
Business name: f0( l.( f WI Ofrt(� ✓ CO e'. Signal circuit(s)or limited-energy See
^/ panel,alteration,or extension. Page 2 a 2
Address: 5 0&3 lc, v is� g I v U Each additional inspection over allowable in any of the above
City/State/ZIP: Got (� v� _ t or-- 703 c
Additional gat inspection(I hr min) hr min) , 66.25/hr
Investigation(I hr min) 66.25/hr
Phone:(y Q"-) (Qc-')' 01 0 0 Fax:( ) Industrial plant(1 hr min) 78.18/hr
r Inspections for which no fee is
90.00/hr
CCB Lic 3 17 Q/ I Electrical Lic. 3'1-50$c -C pry.Lic.: 4/4/604...E44. s ifically listed V2 hr min
Suprv.Electrician signature,required: `' ''''
` Subtotal: /,
Print name: .41,/- '71- Date �/ Plan review(25%of permit fee):
00 I I v v State surcharge(12%of permit fee): J/� d
Authorized signature:. /; .� a , TOTAL PERMIT FEE: `j This permit application expires if a permit is not obtained within 180
Print name: —Tao,( iv vie Date: 76-.0 days after it has been accepted as complete.
' * Number of inspections allowed per permit.
l:\Building\Permits\ELC_PermnApp_ELR_ERE.doc Rev 05/21/2013 440.4615T(Il/05/COMM'EB
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10260 SW GREENBURG RD 535, TIGARD, OR,
97223
Commercial - Electrical Limited Energy
135 Low voltage rough-in
PASS
ELR2015-00172
Chip Barnett
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10260 SW GREENBURG RD 535, TIGARD, OR,
97223
Commercial - Electrical Limited Energy
198 Low voltage final
PASS - No C of O
ELR2015-00172
Herb Stabenow
Violation Summary:
Inspector Contractor