Permit (103) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
• COMMUNITY DEVELOPMENT Permit#: ELR2016-00054
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/30/2016
T I G r�R D Parcel: 1 S 135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD
Project: Lincoln Tower 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 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 503-255-9488 PHONE:
FAX: 503-257-7121
FEES
Description Date Amount
Specifics: Restricted Energy Permit 03/30/2016 $75.00
12%State Surcharge-Electrical 03/30/2016 $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 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 95 -001-009 may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. _ /
Issued By: � � Permittee Signature: � ���e�170//
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 603.639.4175 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.
1
Electrical Permit Application
RECEIVED DateB ^ .
City of TigardDate/By:��/(p (. 1./h Permit no.:E��16�.�"'[j
IN.,__ . 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ��^���"I�/ T
Phone: 503.639.4171 Fax: 503.598.19Date/By: Other Permit:f�✓t�/4.-4,b
Inspection Line: 503.639.4175 �1AR 10 2016 Date Read /B Juris: ��
T1G ARI) Ready/By: U SeePage2for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: I Supplemental Information
1 ■ L I • 1.
.pax.. i i# ° e _4 ..- e .'Y.v.,. s ,x ,-;, < ninti r Nt. lia . r's ,6 O, haii v,v
• New construction El Addition/alteration/replacement 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
BntTiWteaiNSRCEAREEFAK:VIKEigijlMilrgXaSRERMSFirra:4:-;; where the available fault current ❑ Marinas and boatyards
II I-and 2-family dwelling El 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
m ' i;, i e la -y - l.. 'x; amps for all other installations. ❑ buildings
Job no.: 160511-45 Job site address: 10260 SW Greenburg Road 111 Fire Pump Ell Installation of 75 INA or Li Emergency system larger separately derived system.
City/State/ZIP: Tigard,OR 97223 CIAddition of new motor load of CI"A","E","1-2","1-3",
100HP or more. ❑ occupancy
Suite/bldg./apt.no.: (Project name: Restroom Remodels ❑ Six or more residential units ❑ 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: I Lot no.: 404 r k;na ' ,';1 .4t ktI s, 7_:1ST'. EDIJI.,B ( .., < ci r a.i
Description I Q'. I Fee. I Total
Tax ma./.arcel no.: New residential-single or multi-family dwelling unit.
3i
:=t a-. .< �' =els .1717,5 k,-OltalWRK 'Ar 4Aitw,,,o. :xr.'%=sIncludes attached garage.
RELOCATE FIRE ALARM CIRCUIT IN RESTROOMS,FLOORS 3,6,8,&10 1000 sq.ft.or less $ 166.54 _ 4
Ea.Add'I 500 sq.ft or portion $ 33.92 1
•" 4 a Limited energy residential
(with above sq.ft.) $ 67.84 2
SHORENSTEIN REALTY SERVICES Limited energy,multi-family
dress: residential(with above sq.ft.) $ 67.84 2
Service or feeders installation,alteration,and/or relocation
200 amps or less $ 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 $ 301.04_ 2 1
•wner installation: This installation is being madeon propertyown which is notOver 1000 amps or volts $ 552.26 2 i
intended t or exchange,accordingt ORS 447,449,670,and 701 Temporary services or feeders installation,alteration,and/or
• D. relocation
200 amps or less $ 59.36 1 1
.-',,17:'t"LICANT l'i.i =` 'r' .iiq. ., :I _ •.. :C etrrAm tl1 z ('..';"-' 201 amps to 400 amps _ $ 125.08 2
Business Name: 401 amps to 599 amps $ 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 $ 56.18. 2
Each additional branch circuit: 5 7.42 2
Phone: Fax: Miscellaneous(service or feeder not included)
E-mail: Each manufactured or modular
o '" ',,` l 0,, , dwelling,service and or feeder 5 67.84 2
Business Name: CAPITOL ELECTRIC CO.,INC. Reconnect only $ 67.84 2
Pump or irrigation circle S 67.84 2
Contact name: DAN WILSON 503.262.0411 DIRECT Sign or outline lighting $ 67.84 2
Signal circuit(s)or limited-
Address: 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: 503-257-7121 Per inspection $ 6625 _
Investigation per hour(1 hr min) $ 66.25
CCB Lic.: 48748 Electrical Lic.: 26-496C 1Suprv.Lic.: 3132-S Industrial plant per hour $ 78.18
f
Suprv.Electrician signature,required: ,/ a 1L: )SRVIrtIR&"S'` .s ., 5? <.,.'� ,m, .°
/��.,�� !n" 1 .�, Subtotal $ 75.00
Print Name: DARRELL MCNE Date: 03/09/16 Plan review(25%of permit fee)
Authorized signature: State surcharge( 12% of permit fee) $ 9.00
_-c I_1-• -s." tr�l TOTAL PERMIT FEE $ 84.00
Print Name: DARRELL L This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
*Number of inspections per permit allowed.