Permit (179) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
1 COMMUNITY DEVELOPMENT Permit#: ELR2018-00156
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/13/2018
T([;;�Ii i) 9 Parcel: 1 S 135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 750
Project: CNH Finance Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Limited energy for fire alarm.
Contractor: POINT MONITOR CORPORATION Owner: LINCOLN CENTER LLC
5863 LAKEVIEW BLVD STE 100 BY SHORENSTEIN PROPERTIES LLC
LAKE OSWEGO, OR 97035 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503-627-0100 PHONE: 503-412-4800
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Restricted Energy Permit 09/13/2018 $75.00
12%State Surcharge-Electrical 09/13/2018 $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: 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 952-001-0090. You m obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: /It• ,4 / s" 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.
r. A
Electrical Permit Anplicati FOR()I I I( I i SI. (1yI.1
City of Tigard Received
Oat
1111/ • 13125 SW Hall Blvd.,Tigard,OR 9722.:I:2 1 3 L. .,112Plan Rev
/ .� 1 ffi /L "—
iew
Phone: 503.718.2439 Fax: 503.598.191 Date By: Related t ; )2
I I a A.t:i) Inspection Line: 503.639.4175 Ready Date/By: retic ` Page Z oor/a2 .
Internet: www.tigard-or.gov Notified/Method: Supplemental Information I
`+e,1-4_ T2 ate„ 0 1< .t ,
_ — .- - n -_ tom ,`iA'
®New construction ►C4 Addition/alteration/replacement Please check all that apply(submit a sets of plans w•items checked):
ID DetlrOlitiOn �
0 Service or feeder 400 amps or more 0 Building over three stories.
�- where the available fault moron Marinas and boatyards.
-- ti er'`_( + A_Z '.Ii .-n- s)+,:t 4 ' • -; exceeds 10.000 amps at 150 volts or 0 Floating buildings.
❑1-and 2-family dwelling ®Commercial/industrial ❑Accessory building leas to ground.or exceeds 14.000 0 Commercial-use agricultural
amps for❑Multifamily 0 Master builder 0 Other: 1 other installations. buildings.
- ._.FInstallation
or
`ems _ tr 0 r e+ 'X I oL ,(9s , —� "j 0 Firemergency system. 0 larger separately deKrived
Job#: Job site address:10200 SW Greenburg 100HP or mmore
Rd ❑nddnino oe.motor load of system.
. ❑"A»•"E","1-2""1-3"
City/State/ZIP:Tigard,OR 97223 ❑Six or more residential units. occupancy.on
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#:'750 Project name:CNH Financial 0 Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 voila nominal.
Cross street/directions to job site: n 1j2 J
nrerladoa 1 Otr. I Fad, Total I
•
New residential single-or multifamily dwelling unit.
Subdivision: Lot#: Includes attached garage.
•
Tax map/parcel#: 1,000 aq.ft or less 168.54 4
Ea.add'I 500 sq.ft.or portion 33.92 1
_3- -1'"'%tlZWI :ii:: .,l2A .
.—'�� -..-=� -��a Limited energy,residential
Fire Alarm-Notification Devices-Relocates Only (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.fl.)
r ''^.– 10k,)O Titl 'l� `1-40 __` 1 , i "1:. �'t ' Renewablener� ❑ See Pa d2/
` d" � � ` Services or feeders installationtalteraHon,and/or relocation
Name:CNH Financial 200 amps or less 100.70 2
Address:10200 SW Greenburg Rd Suite 750 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Tigard,OR 97223 601 amps to 1,000 amps 301.04 2
Phone:
Fax:( ) Over 1,000 amps or volts 552.26 2
Email: Temporary services or feeders installation,alteration,and/or
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
c33p� dy\;:0 ; � _� Branch cinnita–new,alteratloa,or extension,per panel
A.Fee for branch circuits with
Business name:Point Monitor Corp. above service or fader fee
each branch circuit 7.42 2
Contact name:Brooke Williams B.Fee for branch circuits without
fee
Address:5863 Lakeview Blvd.Suite 100 servicebranch circuit t feeder 'ft's 56.18 2
City/State/ZIP:Lake Oswego,OR 97035 Each add'I branch circuit 7.42 2
Phone:(503)627-0100 Fax:: Miscellaneous(service or feeder not included) _
( ) Each manufactured or modular
67.84 2
Email:bwilliams@pointmonitor.com dwelling service and/or feeder
Reconnect only 67.84 2
,_ ::,7f:-5::.7.'
4 .,P.x, . w- , .7,.LO _ 04 t .;;n,. r .: , *'"--;.17,:"..' ... Pump or irrigation circle 67.84 2
Business name:Point Monitor Corp. Sign or outline lighting 67.84 2
Address:5863 Lakeview Blvd.Suite 100 Signal circuit(s)or limited-energy
panel,alteration,or extension. ® See Page 2 I 2
City/StatelZIP:Lake Oswego,OR 97035 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)627-0100 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:bwilliams@pointmonitor.coro
Industrial plant p hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 135901 Electrical Lic.: 34508CLE Suprv.Lie.: 4460LEA specifically listed C'4 hr min)
ELECTRICAL PERIIT`,-1 S
Suprv.Electrician signature,required: Subtotal:
Print name: Ben Breit Date: 9/13/18 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: R, TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Ben Breit Date: 9/13/18 days after it has been accepted as complete.
• Number of inspections allowed per permit.
1.Budding•PermitaELC-Perm4App_E1.R_ERE.doc Re%-06.1'2015 440-46157(11 05'COM•'WEB
1
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
i�ESIDENTIAL. bRK O.NL x 'A Y E s-tatoa,
Fee for all residential systems combined: $75.00 Description I Qty. I Each I Total It.
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
El * 50.01 to 100 kva 552.26 2
Garage Door Opener >100 kva(fee in accordance
with)::1110
AR 918-309 0040) 552.26 2
❑ 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 (6.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is
specificall listed h hr min) 90.00/hr
COMMERCIALRetAt VCOAIC ONLY STM. OtitCAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
* 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
❑ Other:
Total number of commercial systems: 1
*No licenses are required, Licenses are required for all
other installations
i.
Building PermitsELC__PamitApp_ELR_ERE.doc Rev 06+I'2015