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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT 111 11 2 : COMMUNITY DEVELOPMENT Permit #: ELR201000249 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/19/2010 . Parcel: 1S135AB03400 Jurisdiction: Tigard Site address: 10260 SW GREENBURG RD 200 Project: Comsys Subdivision: LINCOLN TOWER Lot: 0 Project Description: Low voltage for HVAC Contractor: AMERICAN HEATING INC Owner: LINCOLN CENTER LLC 1339 SE GIDEON ST BY SHORENSTEIN PROPERTIES LLC PORTLAND, OR 97202 555 CALIFORNIA ST 49TH FL SAN FRANCISCO, CA 94104 PHONE: 503 - 239 -4600 PHONE: FAX: 503 - 239 -7038 FEES Description Date Amount Specifics: Restricted Energy Permit 11/19/2010 $75.00 12% State Surcharge - Electrical 11/19/2010 $9.00 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: N HVAC: Y Instrumentation: N Intercom /Paging: N Landscape /Irrigation: N Landscape Lighting: N Medical: N Nurse Calls: N Protective Signal: N Security Alarm: N Other: N Total $84.00 Other Desc: Required Items and Reports (Conditions) This permit subie the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be „ ciofe in accordance with approve. •lans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 da s. ATTENTION: Oregon law equ' -s you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 9 2- 001 -0010 through OAR 952 +01 -0k9 Y u may obtain a copy .f the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. C �1 ! f gr,i /�G,c 0CS sued By: �..������� 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 E - , r9R oF usE Ol\w ' '' k , IN Received Permit No.: a1/ 1111r of Tigard DateB : 1 .� O # �� ? • 13125 SW Hall Blvd., Tigard, OR 9722 Plan Review ' V 0 O O Other Permit: Phone: 503.639.4171 Fax: 503.598.19 ■ t Y Date/B : Inspection Line: 503.639.4175 Date Ready/By: Juris: B1 See Page 2 for 1 fCrARp p Supplemental Information Internet: www.tigard-or.gov CITY OF TIG Notified/Method t,. . ra Fi) x ? V # ` . . ' ;. 3- ;. h n '' : a� + 4 7 '''.4''''"''''''' 4 r �ayy1 g d � x„ 1 � F_ . #f„ ��' S � : � :1 3*� .,�� .. �r f= �� ... ;r"e. #-s T' ... , .. .. - , .�!}:.,S�.SS'.. T ... .., . r�.r .F� . off �mrk� 9 �i � :rc _. J. .W ... -_ .- .rf - r:rf ❑ New construction Addition /alteration/replacement Please check all that apply (submit 2 sets of plans wlitems checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current 0 Marinas and boatyards. i a " exceeds 10,000 amps at 15 or Fl gs. a0 volts Floating buildin �,- ,_ ,,, u ar less to ground, a exceeds 0 14,000 volts ❑C oating u 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 KVA or ❑ Emergency . system. larger separately of 7 KVA system. t � ' $f Y 6 ❑ Addition of new motor load of ❑ "A ", "E ", "1.2 ", "1-3 ", r p , � V$ �k:� :s,...,.,�� _`�5�ib. :.� . :...,., , occupancy. p —f 100HP or more. Job no.: Job site address: I 07 <D 0 5 w (o 1 ee b u rh /� v 0 Six or more residential units. 0 Recreational vehicle parks. rr V ❑ Health -care facilities. ❑ Supply voltage for more than City/State /ZIP: e' G U © � ❑ Hazardous locations. 600 volts nominal. • • Suite/bldg. /apt. no.: 2 O (9 Pro j ect name: C O Vh )/ S S ❑ Service or feeder 600 amps or more. • �' s ' ik =.::-x r c ,.. `L t d ���` t i +. , ,? l rr�': s , . . Cross street/directions to job site: Description I Qty. 1 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'l 500 sq. ft. or portion 33.92 1 Tax map /parcel no Limited energy, residential , 67.84 2 � .. . r r; T v f a i .s g i , / With above sq. ft.) .. . .::w { �n .`�..— , ,4 �1,T',r -; g s4_. � .. s . ._ >x"" V Limited energy, multi - family 67.84 2 /01/4/ Vol - f - 1 q e V I r I �f residential (with above sq. ft.) �J ✓ Services or feeders installation, alteration, and/or relocation 200 amps or less 100.70 2 a 9,0#� 1 R 3 , d 'Tk :',. 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 401 amps to 4 00 amps 125. 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with �7;LI# I - above service or feeder fee, 7 42 2 �i( t 3 A:'QN, . < . ... .:. � , �..rv_� w., h�� =. ;.:� . >. -< each branch circuit Business name: A rne r I h Het -f - i n B. Fee for branch circuits // without service or feeder fee, 56.18 2 Contact name: r - Gj / GI /7 C e S e r first branch circuit /33 ! S r ^ ,, G� O t'1 5 Each add'. branch circuit 7.42 2 Address: Miscellaneous (service or feeder not included) City/State /ZIP: p r _ 1 a'' cri O / p `7700 2 Each manufactured or modular 1 67.84 2 dwelling, service and/or feeder Phone: (503 )23.7- L/ C9 0 0 Fax: : (SO3) 2 3''7'- 7O3 S Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E-mail 0 Sign or outline lighting 67.84 2 �� - Signal circuit(s) or limited - Business name :A er' / 4 ? /---/ e9 if 7 energy panel, alteration, or i '��� • Address: / 33 t 1 5E (o f d Gel S extension. Describe: Page 2 2 d City/State /ZIP: / t'r-t J '- �J OA 972 02_ Each additional inspection over allowable in any of the above �n / Per inspection 66.25 Phone: ($03) 231- " �V/0O Fax: (5o 3 ) Z31- 7 O3 S Investigation per hour (1 hr min) 66.25 O:_ 1 L Electrical Lic.: 1 �� 13 2 ! Industrial plant per hour 78.18 _ ., 13 CRe Suprv. J Lic.: 2 Vio LERj ... GTRI ECi I" PEr$rt,. �'' S1ii>>v. Electrician signature, required�� -_ Subtotal: 7�� _ - Pr Ytt name:T S -1-c V y V '�1 Date: J I 1C\ \.0 Plan review (25% of permit fee): — y' State surcharge (12% of permit fee): • Authorized signature: �if .p� 4.S r TOTAL PERMIT FEE: S Print name:god ^'' �� eS � I /���/ p This permit application expires if a permit is not obtained within 180 /' Date: ! days after it has been accepted as complete. * Number of inspections allowed per permit. L \BuildingWermitsELC- PermitApp.doc 10/01/09 440461 5T (1 I /05 /C O M/ W EB