Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2009 -00145
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/18/2009
Parcel: 1S135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 120
Subdivision: Lot: 0
Project: Ameriprise Financial
Project Description: TI - Fire alarm low voltage
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555 Restricted Energy Permit 06/02/2009 $75.00
CALIFORNIA ST 49TH FL 12% State Surcharge - Restricted Energy 06/02/2009 $9.00
PHONE:
Contractor:
CAPITOL ELECTRIC CO INC
11401 NE MARX STREET
PORTLAND, OR 97220
PHONE: 503 - 255 -9488
FAX: 503 - 255 -1966
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 $84.00
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 accor a• - , ith 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. ATTE ON: Oregon law - quires you to follow the rules adopted by the Oregon Utility Notifica_tio, Center. Those rules are set forth in OAR
952 - 001 -00 0 through OAR 95 :01-111 r You may obtain a copy of the rules or direct questions to OUNC b� i q 503_,246.6699 or 1.800.332.234
/ r ,
Issued Q �1 /lA J�L�' "1 /t Permittee Signat e` 2 -- _.-4i 4 ' t4VV
r
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.
A
Electrical Permit Application •-::.---,••••',:--.-.,:::::,:::-: FOR OFFICE USE ONLY.:: '..i..::.:; ',.:::::'.:::•.;: ::: ::'....- • Received /
City of Tigard Date/By: co. , p_ 0 ... Permit no.:
. . .
. . ::...' • :..;,•:'.
I'd 13125 SW Ball Blvd., Tigard, OR 97223 Plan Review
Other Permit:
1: - • ° - ••••,: Phone: 503.639.417 I Fax: 503.598.1960 Date/By: 1
-• ' ' - '
Ti GARD Inspection Line: 503.639.4175
. Date Ready/By: Juris.,,..--- I See Page 2 for
- Inteniet: www.tigard "
Notified/Method: Supplemental Information
- • • ' . . • — '
Li New construction Li Addition/alteration/replacement Please check all that apply (submit 2 sets of plans wAtems checked below):
0 Demolition EJ Other: r] Service or feeder 400 amps or more [11 Building over three stories
. . • ''''-•, ., ...-'::... : , . '.' . . •-: . CATEGORY CONSTRUCTION .: '• '. . . • . .' ..' ... ' • • • where the available fault current [1] Marinas and boatyards
U I- and 2-family dwelling Ll Commercial/industrial U Accessory building exceeds 10,000 amps at 150 volts or Floating buildings
0 Multi-family 0 Master Builder El Other less to ground, or exceeds 14,000 Commercial-use agricultural
. ' :- '• ::•. - .",.,..' , . JOB SITE INFORMATION AND LOCATION • •.. . : . amps for all other installations. 0 buildings
0 Fire Pump 0 Installation of 75 KVA or
Job no.: 290657 Job site address: 10220 SW Greenburg Rd.
0 Emergency system larger separately derived system.
0 Addition of new motor load of 0 "A", "E", "1-2", "1-3",
City/State/ZIP: Tigard, OR 97223
100HP or more. Ill occupancy
ID Six or more residential units [1] Recreational vehicle parks.
Suite/bldg./apt. no.: Suite 120 Project name: Ameriprise Financial T.I.
0 Health facilities 0 Supply voltage for more than
Cross Street/Directions to job site: El Hazardous locations Ei 600 volts nominal.
1i Service or feeder 600 amps or more
Subdivision: Lot no.:
Description 1 Qty. I Fee. I Total I "
Tax map/parcel no.: New residential - single or multi-family dwelling unit.
.- ' • ...•.• : .., .: ...... :.: ," '• -•:' : :: 1 —•:..'DESCRIPTIONOFVORK : ' .' , . .• • . ' ' :' :, • .• ' . : . . Includes attached garage.
Install Fire Alarm Circuit 1000 sq. ft. or less $ 145.15 4
Ea, AM! 500 sq. It or portion $ 33.40 1
PROPERTY OWNER :' ,' • •I ' .,' • . ' '. ' , • ' ' '' Li TENANT. '. ' :-..... . ' . -: ...:- .::::: .: Limited energy residential
Name: (with above sq. ft.) $ 75.00 2
Shorenstein Realty Services Limited energy, multi-family
residential (with above sq. ft.) 5 75.00 2
Address:
Service or feeders installation, alteration, and/or relocation
•
City/State/ZIP: 200 amps or less $ 80.30 2
201 amps 10 400 amps $ 106.85 2
Phone: Fax: 401 amps to 600 amps S 160.60 2
601 amps to 1000 amps $ 240.60 2
Owner installation: This installation is being made on property that I own which is not Over 1000 amps or volts $ 454.65 2
intended for sale, lease, rent or exchange, according to ORS 447, 449, 670, and 701 Temporary services or feeders installation, alteration, and/or
Owner signature: Date: relocation
200 amps or less S 66.85 1
. • Li . APPLICANT :: :- - . - ' " . -I • • ' Li "CONTACT PERSON • . 201 amps to 400 amps $ 100.30 2
Business Name: 401 amps to 600 amps S 133.75 2
Branch circuits - new, alteration, or extension, per panel
A. Fee for branch circuits with
Contact name:
service or feeder fee, each
branch circuit S 6.65 2
Address:
B. Fee for branch circuits
without service or feeder fee,
City/State/ZIP:
first branch circuit $ 46.85 2
• Each additional branch circuit: $ 6.65 2
Phone: Fax:
Miscellaneous (service or feeder not included) _
E-mail: Each manufactured or modular
.- *: '.. '• -:::' :- .:. :.- .: ' :-- • - CONTRACTOR .• - - ' ' • - -• . . . • dwelling, service and or feeder • $ 90.90 2
Business Name: CAPITOL ELECTRIC CO., INC. Reconnect only $ 66.85 2
Pump or irrigation circle S 53.40 2
Contact name: Sign or outline lighting $ 53.40 2
Signal circuit(s) or limited-
Address: 11401 NE MARX ST. energy panel, alterations, or
extension. Describe: 1 Page 2 75.00 2
Fire Alarm Circuit
City/State/ZIP: PORTLAND, OR 97220-1041 —
Each additional inspection over allowable in any of the above
Phone: 503-255-9488 Fax: 503-257-7121 Per inspection $ 62.50
Investigation per hour (1 hr min) $ 62.50
CCB Lie.: 48748 IElectrical Lie: 26-496C IS rv. Lic.: 2865 ' Industrial plant per hour S 73.75 _
ELECTRICAL PERMIT FEES* -'., ::. •. ' .. ' " • ' : • .,--:.' ' : :, .% • -:' . -
Suprv. Electrician signature, required:
Subtotal $ 75.00
Print Name. RICHARD MARTIN Date: 06/04/09 Plan review (25% of permit fee)
Authorized signature: /if State surcharge (
TOTAL PERMIT FEE $ 12% of permit fee) $
9.00
84.00
Print Name: RICHARD MARTIN Date: 06/04/09 This permit application expires If a permit is not obtained within 180
days after It has been accepted as complete.
. Number of inspections per permit allowed.