Permit ` : CITY OF TIGAR® ELECTRICAL RESTRICTED ENERGY PERMIT
71 a COMMUNITY DEVELOPMENT Permit #: ELR2010 00039
T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/03/2010
Parcel: 1S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW Greenburg RD 1250
Subdivision: LINCOLN TOWER Lot: 0
Project: Reinisch & McKenzie
Project Description: Install (1) limited energy sytem for fire alarm installation.
FEES
Owner:
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555 Restricted Energy Permit 03/03/2010 $67.84
CALIFORNIA ST 49TH FL 12% State Surcharge - Electrical 03/03/2010 $8.14
PHONE:
Contractor:
SAFE TECHNOLOGY GROUP INC
6400 NE HWY 99 SUITE 375
VANCOUVER, WA 98665
PHONE: 360 - 699 -2130
FAX: 360 - 719 -1527
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: N Fire Alarm: y
HVAC: N Instrumentation: N Total $75.98
Intercom /Paging: N Landscape /Irrigation: N
Required Items and Reports (Conditions)
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N
Other Desc:
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 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. /
Issued By: 'gag WA V . L ��. . . 1 , 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 an inspection that business day.
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 Applicatiorir r ' '1 ` . FOR OFFICE USE ON i 1 I :
City of Tigard rt k, / G E Received Permit No.: /p
11114 `J Tigard Dale /BY: � A, . `. 46
Y 13125 SW Hall Blvd., Tigard, OR 97223 he P lan Review
. I Phone: 503.639.4171 Fax: 503.598.19601I 0 .3 2010 Date /By: Other Permit
T I G A R D Inspection Line: 503.639.4175 OF r Date Ready/By: Juris: 0 See Page 2 for
,,,- Internet: www.tigard - or.gov CITY OF 1 IGARD Notified/Method: Supplemental Information
TYPE OF WC)1&UIN( DIVISION PLAN 'REVIEW •
❑ New construction ® Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards
CATEGORY OF CONSTRUCTION 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 75 RVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION' AND LOCATION
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ".
Job no.: 976 Job site address: 10260 SW Greenburg Rd 100HP or more occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: Tigard OR ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 1250 Project name: Reinisch and Mackenzie ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Lincoln Tower Description I Qty. I Fee. 1 Total I
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1.000 sq. ft. or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
' DESCRIPTION OF . WORK (with above sq. ft.) 67.84 2
Limited energy, multi- family
67.84 2
Fire Alarm residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
❑ PROPERTY - OWNER ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name:
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City / State/ZIP:
relocation
Phone: ( ) Fax: ( )
200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
above service or feeder fee,
® APPLICANT ❑ CONTACT PERSON 7.42 2 each branch circuit
Business name: Safe Technology Group Inc. . 13. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: Jason Sweet branch circuit
Each add'I branch circuit 7.42 2
Address: 6400 NE Hwy 99 Suite G375 Miscellaneous (service or feeder not included)
Each manufactured or modular
City / State/ZIP: Vancouver WA 98665 dwelling, service and /or feeder 67.84 2
Phone: (360) 699 - 2130 Fax: : (360) 719 - 1527 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail: sales@safetechnology.net
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited - energy
Business name: Safe Technology Group Inc. panel, alteration, or extension. 1 Page 2 67 2
Each additional inspection over allowable in any of the above
Address: 6400 NE Hwy 99 Suite G375 Additional inspection (1 hr min) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
City / State/ZIP: Vancouver WA 98665 Industrial plant (1 hr min) 78.18/ hr
Phone: (360) 699 - 2130 Fax: (360) 719 - 1527 Inspections for which no fee is 90.00/ hr
specifically listed (' /z hr min)
CCB Lic.: 173731 Electrical Lic.: CLE79 Suprv. Lic.: 4272LEA .ELECTRICAL PERMIT FEES
Subtotal: 67.84
Suprv. Electrician signature, required: Plan review (25% of permit fee):
Print name: Jason Sweet Date: 1 0 State surcharge (12% of permit fee):
TOTAL PERMIT FEE: [ 8
Authorized signature: Th is permit application expires if a permit is not obtaineTwithin 180
-^ , / days after it has been accepted as complete.
Print name: )1t; � Date: j -3 ;; + Number of inspections allowed per permit.
1: \ Building \ Permits \ELC- PennitApp.doc 10/01/09 440- 4615T(11 /05 /COM/WEB