Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
2 :' COMMUNITY DEVELOPMENT Permit#: ELR2020-00037
T(GAR',D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/26/2020
Parcel: 1 S 135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 630
Project: Prodapt 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 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 503-627-0100 PHONE: 503-413-4844
FAX: 503-627-0110
FEES
Description Date Amount
Specifics:
Restricted Energy Permit 03/11/2020 $75.00
Type of Use: COM 12%State Surcharge-Electrical 03/11/2020 $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 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued B • „ —� 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 FOR OFFICEyy� USE ONLY
. City ofTigard Receive: ����r��� I� J�[.
`J g Date/: /t `
'I 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review �I�
Phone: 503.718.2439 Fax: 503.598.1960 Date/: : IMA 2 //��4M1
Inspection Line: 503.639.4175 Ready Date/By. Jens: El See Page 2 for
TICARU Internet: www.tigard-or.gov Notified/Method: Supplemental Information
' TYPE OrWORK PLAN REVIEW
❑New construction ® Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more 0 Building over three stories.
❑ Demolition ❑ Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION ,' exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑ I-and 2-family dwelling ® Commercial/industrial ❑ Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑ Multi-family ❑ Master builder ❑ Other: 0 Fire pump. ❑Installation of 150 KVA or
IMPOB SITE INFORMATION AND LOCATION ,. 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address: 10260 SW Greenburg Rd 100HP or more. ❑"A","E","1.2","l-3",
City/State/ZIP: Tigard,OR 97223 El Six or more residential units. occupancy.
0 Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#:.626601,., Project name: Prodapt-Lincoln Tower 0 Hazardous locations. 0 Supply voltage for more than
`V 0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: 111111111.1rFEE SCHEDUJ E
Description I Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
Ea.add'1500 sq.ft.or portion 33.92 I
DESCRIPTION OF WORK Limited energy,residential 75.00 2
Fire Alarm (with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
• Renewable Energy 0 See Page 2
0 PROPERTY OWNER ® TENANT Services or feeders installation,alteration,and/or relocation
Name:Prodapt-Lincoln Tower 200 amps or less 100.70 2
Address: 10260 SW Greenburg Rd Suite 4Z5' 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
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 I
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
® APPLICANT El CONTACT PERSON Branch circuits—new,alteration,or extension, r er panel
A.Fee for branch circuits with
Business name: Point Monitor Corp. above service or feeder fee, 7.42 2
each branch circuit
Contact name:Brooke Williams B.Fee for branch circuits without
Address:5863 Lakeview Blvd.Suite 100 service or feeder fee,first branch 2
branch circuit _
City/State/ZIP:Lake Oswego,OR 97035 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)627-0100 Fax: : ( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email:bwilliams@pointmonitor.com Reconnect only 67.84 2
CONTRACTOR 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 panel,al ateatonit(s)orlextension. El See Page 2 I 2
panel,alteration,or extension.
City/State/ZIP:Lake Oswego,OR 97035 Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
Phone:(503)627-0100 Fax:( ) Investigation(1 hr min) 90.00/hr
Email: bwilliams@pointmonitor.com Industrial plant(1 hr min) 78.16/hr
Inspections for which no fee is 90.00/hr
CCB Lie.: 135901 Electrical Lic.: 34508CLE 4uprv.Lic.: 4460LEA specifically listed('V*hr min)
i' ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name: Ben Breit .` Date: 3/5/2020 0 Plan Review Required(25%of permit fee):
I� State surcharge(12%of permit fee):
Authorized signature: / TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Ben Breit Date: 3/5/2020 days after it has been accepted as complete.
Number of inspections allowed per permit.
IdBuilding'Permits\ELC_PermiiApp_ELR_ERE.doe Rev 06,172015 440-46I5T(11/05/001vf/WEB
Electrical Permit Application—City of Tigard
Page 2-Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: ,; FEE SCHEDULE
Fee for all residential systems combined: $75.00 Description
°y' Each Total
y Renewwaable electrical energy systems:
Check Type of Work Involved: 5 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 kaa 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 an of the above:
❑ Other: Each additional inspection is 66.25/hr
charged at an hourly(1 hr min) --
Inspections for which no fee is 90.00i hr
specifically listed('/hr min)
COMMERCIAL WORKQNLY: µ , ,
ELECTRICAL 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
n Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems: I
*No licenses are required. Licenses are required for all
other installations
l:liBuildngWttmilsJELC_PrnnitApp_ELR_ERE.doc Rev 06/17/2015