Permit (176) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
III
�1 ' COMMUNITY DEVELOPMENT Permit#: ELR2018-00139
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/23/2018
T I�'"�,I"�' 9 Parcel: 1 S 135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 500
Project: Bridgewell Resources Subdivision: METZGER,TOWN OF Lot: 9
Project Description: 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: 503-412-4800
FAX: 503-257-7121
FEES
Description Date Amount
Specifics: Restricted Energy Permit 08/23/2018 $75.00
Type of Use: COM 12%State Surcharge-Electrical 08/23/2018 $9.00
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: 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 -001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: �.`"›C.---__ Permittee Signature: , )/V, j 0G 1 ei'`�-%-77e
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.
R F 9017
Electrical Permit Application '. _,t ''t $ FOR OFFICE USE ONLYReceived
City of Tigard Date/B . ? .2 ; 4f- "':';' ' Irt/2 /F :el/3
INI " 13125 SW Hall Blvd.,Tigard,OR 97223 :A i it ew
.. ''i,' in 1 Yii .t i Plan • '.
3 2 Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit,5,2S7,26ed"
. Inspection Line: 503.639.4175 tr rf‘i f,)f':r i(.:.,4, •,tlady Date/By: Juris: 0 See Page 2 for
T1GARp Internet: www.tigard-or.gov Supplemental Information
TYrtittOIN#OttlitilAN'0411MESIOINMO VIMIPORO9Y2-YROtWtttVitWdKqMie2P-
0 New construction Z Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more Q Building over three stories.
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
'!1.5'Atfalq:TekttebAl*I00010IFTRAIP,PW. ,,n;M'ii;,;,;;,:il,g;P:Ag:;;;;,,A;!.;g,,,i,,,Aii,,, exceeds 10,000 amps at 150 volts or 0 Floating buildings.
0 1-and 2-family dwelling Z Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 Commercial-use agricultural
amps for all other installations, buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
40**(1*.otiowifiroppooporotioskosponasigigtomill 0 Emergency system. larger separately derived
D Addition of new motor load of system.
Job#: 181516 Job site address: 10200 SW Greenburg Road 100HP or more.
Six or more residential units. occupancy.
City/State/ZIP:Tigard,OR 97223
ID Health-care facilities. Recreational vehicle parks.
Suite/bldg./apt.#:500 Project name:Bridgewell 0 Hazardous locations. 0 Supply voltage for'more than
El Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
DescnptisnI Qtr. I Each I Total I *
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#:
Ea add'l 500 sq ft or portion 33.92 1
RE$CRI,rTT4APt7:WORrtRRMRWW:TAtbaie!'','4H':' Limited energy,residential
75.00 2
Install fire alarm circuit in suite 500 (with above sq.ft.)
Limited energy,multi-family
75.00 2
residential(with above sq.ft.)
ait,,niovgoivvTovyoolg,,:qrppFvr.!!!!:,m,fyz.,, ,.,..rl.,.,,tksoif,,,,,,,,,„,,,;,„: , 1, ,,,,o!,,,,, 1::::easmoer eneedregrys installation,alir:teieoill3ageand/or relocation
Name:Shorenstein Realty Services 200 amps or less 100.70 , 2
Address: 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
.4111!1111111:i:1:.11121,014aAtfp :**16i,0040:-4:4,,-.666#0 09NTACT:::TR$97*,--. -..illp-ii,i1:!islii
Branch 77:1;:t7auni:,circuits alteration,withor extension,Per panel
Business name: above service or feeder fee, 7.42 2
each branch circuit
Contact name: B.Fee for branch circuits without
service or feeder fee,first
Address: c56.18 2
City/State/ZIP: Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax: :( ) Each manufactured or modular
67.84 2
dwelling,service and/or feeder
Email: Reconnect only 67.84 2
to -Tiiiitiolik:::,,,:-.--::::151EK-:.!-INIMMI11111 Pump or irrigation circle 67.84 2
Business name:Capitol Electric Company,Inc. Sign or outline lighting _ 67.84 2
Signal circuit(s)or limited-energy
Address: 11401 NE Marx Street panel,alteration,or extension. El See Page 2 75.00 2
Each additional inspection over allowable in any of the above
City/State/ZIP:Portland,OR 97220
Additional inspection(1 hr mm ) 66.25/hr
Phone:(503)255-9488 Fax:(503)255-9488 Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email:shane@cepdx.com
Inspections for which no fee is 90.00/hr
CCB Lie.: 48748 Electrical Lie.: 26-496C Suprv.Lic.: 3132-S specifically listed('/hr min)
ELECTRICAL PERMIT
Suprv.Electrician signature,required: - ,,..,„..."..s...2.,...4_,,vot.r.-z...,,LSZ_ Subtotal: 75.00
Print name: DARRELL MCNEEL Date: 08/20/18 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 9.00
Authorized signature: c....14444"---)444x-Auk TOTAL PERMIT FEE: 84.00
This permit application expires if a permit is not obtained within 180
Print name: DARRELL MCNEEL Date: 08/20/18 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_EREdoc Rev 06/17/2015 440-4615TO 1/05/COM/WEB
. Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
D t, Each I Total
Description I Qty. '
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: s kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >100 kva(fee in accordance 552.26 2
with OAR 918-309-0040)
❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(%hr min)
.COMMERCIAL WORK ONLY. „ II ra!1 ;Ii;9lll�i�'I' ! °ddd 1!ltt 'EIECTRICA1-P» '.s �dr,W
�� T �ii (Illi) ay z�.����� i��, -� �� �. �i��.
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
y • Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
® Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
n Other:
Total number of commercial systems: 1
*No licenses are required. Licenses are required for all
other installations
1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015