Permit H CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
11 1- '._ COMMUNITY DEVELOPMENT Permit #: ELR2011 -00156
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/30/2011
Parcel: 1S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD
Project: One Lincoln Subdivision: LINCOLN ONE Lot: 0
Project Description: Low voltage for fire alarm.
Contractor: ADVANTAGE PROTECTION INC Owner: LINCOLN CENTER LLC
8510 -C EAST MILL PLAIN BLVD BY SHORENSTEIN PROPERTIES LLC
VANCOUVER, WA 98664 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 360- 695 -5072 • PHONE:
FAX: 360- 696 -2901
FEES
Description Date Amount
Specifics: Restricted Energy Permit 06/29/2011 $75.00
• 12% State Surcharge - Electrical 06/29/2011 $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: Y
HVAC: N 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 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 throu• OAR 952 - 001 -0090. You �,may � a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332233444
Issued By: ■ - �i1iL Permittee Signature: , /Lc-9-1.
• 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.
From: Andrea Rice 06/29/2011 11 :18 #211 8.004/018
Electrical Permit Application r'0 orFier tusc O`LV
City of Tigard i D eived � � Permit No.: la- Ro /1--eV/
13125 SW Hall Blvd., Tigard, O
• f Phone: 503.718.2439 Fax: 50 6 ` 1 , ��� Davy Review Other Permit: / 5 0 ,?,fa/` L9
TI G A I. D Inspection Line: 503.639.4175 le �tJ Jun
Date Ready /By: e: See Page 2 for
Internet: www.tigard \� l � ' �lotifed/M Supplemental Information
aM s`r 3a'a a &i�eu -.:7 ^'3` '` ^ .....va �i* .. ` ,�A' ;x s t - a € , .7+ - c A.•x m - q.'' ' ° , s, r .''-' 'a, ' 4 i' —6' '4
❑ New construction ® Addition/alteratio _o, • - Please check all that apply (submit 2 sets of plans w /items checked below):
El Demolition El Other:
` 1" M ❑ Service or feeder 400 amps or more ❑ Building over three stories.
• ! V where the available fault current ❑ Marinas and boatyards.
' ° ^` +` _ S "' 'te a Sj exceeds 10,000 imps at 150 volts or ❑ Floating buildings.
.G`' , N;��: .. .._,.ry.....:•,,.,, •-..fir .. - r' - -- Q,„x.�..:;.v^
>A less to und, or exceeds 14,00D
1 - and 2- family dwelling ® Commercial/industrial ❑ Access' building gr° ❑ Commercial agricultural
1:1 g amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
R r- ^n m Ewer c s stem.
Z t x s M r- t � ' ° f` f 6 ❑ Y Y larger separately derived system.
.:� � � �._ � ��� -T; ..f. R 3 -, 3 . ..c:za�,. ❑Addition of new motor load of ❑ °A «E", "1_2 ••I.3 ",
Job no.: Job site address: 10300 SW Greenburg Road ,,• iOOFIP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: Tigard, OR, 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Serv ice 6
Suite/bldg. / apt. no.: Pro name: 1 Lincoln ❑ or feeder $ mps or more.
ati {*4�i. G 4. +, i E U
Cross street/directions to job site: Description X' d K ; :4: ea�v_ n
Qty. Fee. Total •
New residential single or multi - family dwelling unit.
Includes attached garage.
Subdivision: I 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
�, ,t�, ,f„ rt e ,; ,� s• �r r �� ;r-ya , t , . �. `�„t Limited energy, residential
y ,g (with above s (t 75.00 2
z
> ..:. �* , ,- s?' -;��'� n � 4 s^�'� `� i. � � �� �- si�s�� s �. 'w t�`c:.:'� � � �'� ( q• )
Limited energy, multi-family 75.00 2
Fire radio installation to existing equipment residential (with above sq. ft.) _
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
r i, „ 1 : "'7'°^ ' ' di '�. �'. rn ` ". i44,,, .`_y. r= r' `S
.s� x 3 ;.�r.� .
u :, ;: -,s : 4. 1.. r 40,1 z, I i�r � . t "L ,..4 -.-S s� : " ' 201 amps to 400 amps 133.56 2
c
Name: Lincoln Center LLC
401 amps to 600 amps 200.34. 2
601 amps to 1,000 amps 301.04 2
Address: 555 California St 49 FL Over 1,000 amps or volts 552.26 2
City/ State/ZIP: San Francisco, CA, 94104 Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I F ax: ( ) 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 599 amps 168.54 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
,. ;� � c ..a b oo al s h7 above service or feeder fee,
`� ' ' ' �^` .'=u,�If each branch circuit 7.42 2
Business name: Advantage Protection, Inc. B. Fee for branch circuits without
service or feeder fee, first
Contact name: Jason Keller branch circuit 56.18 2
Each add'l branch circuit 7.42 2
Address: 8510 - East Mill Plain Blvd Miscellaneous (service or feeder not included)
City/State/ZIP: Vancouver, WA, 98664 Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: (360) 695 - 5072 , Fax :: (360) 696 - 2901 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E jasonkeller@advproinc.com
q - sa Signor outline lighting 67.84 2
��x ���: Signal circuit(s) or limited-energy
Business name: Advantage Protection, Inc.
panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 8510 - East Mill Plain Blvd Additional inspection (1 hr min) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
City/State/ZIP: Vancouver, WA, 98664 Industrial plant (1 hr min) 7818/ hr
Phone: (360) 695 -5072 I Fax: (360) 696 -2901 Inspections for which no fee is 90.00/ hr
s eci icall listed A hr min
CCB Lie.: 114312 I Electrical Lic.: 37- 672CLE 1 Suprv. Lic.: 3217LEA 42.A , a - , - £ . 7
Suprv. Electrician signature, required:
Plan review (25% of permit fee):
Print name: yvp (_ r � Subtotal:
r p
( ate: S tate surcharge (12% ofpermit fee):
t TOTAL PERMIT FEE:
Authorized signature: This permit application expires if a permit is not obtained within 180
Print name: rs Se9 t(4.`\ LX Date: 6h0 d t 1 * Number of inspections allowed een accepted as complete.
I:\ Bui ldittePcrmlts'BLCPermitApp.doc 07/01/10 440- 4615T(11/05 /c0M/WEB
From: Andrea Rice 06/29/2011 11:19 11211 P.005/013
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
PRifiltiaT •
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
O Other:
Fee for each commercial $75.00
system
(SEE OAR 918 309 - 0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
• Fite Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
E 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:' BuidizePecmits1ELC- PamitApp,doc 07/01/10