Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2010 -00037
[ GA RD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 02/25/2010
Parcel: 1S135AB04500
Jurisdiction: Tigard
Site address: 10250 SW GREENBURG RD 212
Subdivision: LINCOLN BUILDING Lot: 0
Project: Wave Q
Project Description: Install restricted enrgy for voice /data.
FEES
Owner:
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555 Restricted Energy Permit 02/25/2010 $67.84
CALIFORNIA ST 49TH FL 12% State Surcharge - Electrical 02/25/2010 $8.14
PHONE:
Contractor:
CAPITOL DATA & COMMUNICATIONS
11401 NE MARX ST.
PORTLAND, OR 97220
PHONE: 503 - 255 -9488
FAX: 503 - 257 -7121
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: Y Fire Alarm: N
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 thrqugh OAR 952- 001 -0300. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
n n /� (�
Issued By: V �' �. t 1 / � V / . �—` 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.
CaII 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.
02/25/2010 10:04 50 CAPITOL ELECTRIC G\ PAGE 7
! 1 . Pc Electrical Perin t Ap pli cation , -- rnnt no,; grrltta+� 011 O . . "' " C ity of Tigard FEB 2 5 2 010 1L�i�
P l ;m Review
I3I25 SW Flail Blvd„ Tigard, OR 97223 Datc/By; Oth crPcrmir.
' " -'•t 2 . Phone: 503,639.4171 Fax: 503.598.1960 r Q atc Rcad /By; +cc Pints 2 r
Inspection Line: 503 4175
� ns ecton ne: .639. ( '� C)° . I IGA�� y
Ti RID ' O Id1 n NOlificd/Mcthnd: 141 lunentnllnbrmnnan
ak Internet: www.ti or.gov i DING DIVISIN
TYPE OF WORK PLAN REVIEW
New construction 2..f Addition /alteration /replacement Please check all that apply:
n Demolition ❑ Other; ❑ Service Over 225 amps, (Omn I ❑ Hazardous 10CatiOn
CATEGORY OF CONSTRUCTION n Service over 320 amps - rating El Building over 10,000 soft,
L 1 -and 2- family dwelling I I Commercial/industrial Li Accessory building of 1- and 2- family dwellings 4 or more new residential
7 Multi - family ❑ Master Builder El Other ❑ System over 600 volts nominal units in one structure
1013 SITE INFORMATION AND LOCATION LJ Building over three stories Li Feeders, 400 amps or more
lob nn,: C10054 I Job site address: 10250 SW Groanburg Rd ❑ occupant load over 99 persons CI Manufactured structures or
LJ Egress /lighting plan RV park
City /5 +ate /7,IP: Tigard OR ❑ Health -care 'facIilty ❑ Other:
Submit 2 sets of plans with any of the above,
Suitc /bldg, /apt. no,; Bldg 4, SEC 212 Project name: Wave t Install The above are not applicable 10 temporary construction service.
FEE SCHPDULt
Cross Strcet/Dircctions to job sitc: Description I oty. I rec. i Toed I "
T New residential - single or multi- family dwelling unit.
Subdivision: I Lot no.: Includes attached garage.
1000 N. R. nr Icss $ 198,54 4
Tax map /pnrccl no.: Ea. Add') 500 sq. ft or portion $ 33.92 I
DESCRIPTION OF WORK Limited energy residential $ 67.04 2
J
Vcice and Data install Limited energy, non•residcntial 5 67,84 2,
_ Each manufucturcd home or nodular
LL PROPERTY OWNER ' 1 TENANT dwelling. Scrvicc and /or feeder _ 5 90.90 2
Scrvicc or feeders installation, alteration. and /or relocation
Name 200 amps or loss $ 100,7U 2
Address: 201 amps to 400 amps 5 132,56 2
401 amps to 600 amps 5 200,3 2
City/Stale/ZIP: G01 amps to 1000 amps $ 301.04 2
Over 1000 amps or volts $ 552.2( 2
Reconnect only $ 67.64 2
_
Phone: 503- 295 -5555 lax, Temporary services or feeders installation. alteration, and /or
Owner installation: This installation is being made on property the: 1 own which is not relocation
intended for sale, lease, rent or exchange, according to ORS 447. 449, 670. and 701 200 amps or iCSS $ 59.36 I
Owner signature; Datc: 201 amps to 400 amps 5 125.66 2
40I amps to 599 amps .5 160.54 2
l_ 1 APPLICANT 1 L CONTACT PERSON Branch circuits - new, Alteration, or extension, per panel
Business Name; A. Fee for branch cireuils with
norvico or feeder fee, each
I brnnclt circuit 5 7,42 2
C;on name: B. Fcc for branch circuits
without service or feeder Ice,
Address; each branch Circuit 5 56.16 2
Each additional branch circuit 0 7,42 _ 2
Cit� /7_TP Miscellaneous (service or feeder not included)
Phohc: tax; Pump 07' irrigation circle $ 67,04 2
I Sign or outline lighting 5 (7.04 2
E- Mail; Signal circuits(%) or limited -
—[I CONTRACTOR W energy panel, alteration, or
Busfncss Name: Capitol Data & Communications, Inc. extension. Describe: Tale /Dula 1 67,14 ors 2
Page 2
Each nutritional inspection over allowable in any of the above
-
Contact name: Terry Brasch
Per inspection 5 66,25
Address: 11401 NE Marx Street Investigation per hour (1 hr min) _ $ 45.25
I Industrial plant per hour 9 70.16
ELECTRICAL PERMIT PEES
(instate /7_IP; Portland, Oregon 97220 Subtotal 67.84
PltO 503.255 -9488 Fax: 503 - 257.7121 Plan review (25% o permit fcc)
State surcharge ( 12% of permit fee) 8.14
CCl1 1. ie,: 'Electrical tic.: 26- 1045CLE 1 Suprv. Lis.: 3 1325 TOTAL PERMIT FEE 75.98
Thit permit nptlentlnn expire, If n permit Is not oI' tined within IRO
SupYv. Electrician signature, required; :
i ..- ..e.,..0 - � � dote "fwr It h,�t becu aecryleA nA enmplr�e
• ice mU
Pritj lI t Neme: Darrell McNeal req Date: 02(25110 h uinlnay set by T •Cnunly Building Industry Scrvicc Dvnrd
Aulhorizcd signehlrc: I " "Number of inspac p per pct'mil n , expi
Print Name: Darrell Men eel ����