Permit C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2009 - 00043
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/3/2009
PARCEL: 1 S 135AB -01002
SITE ADDRESS: 10220 SW GREENBURG RD 301 ZONING: R -12
SUBDIVISION: LINCOLN CENTER/THREE LINCOLN LOT: 009 JURISDICTION: TIG
PROJECT: COMSYS
Project Description: Restricted energy for fire alarm installation.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: X OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
SHORENSTEIN REALTY SERVICES SAFE TECHNOLOGY GROUP INC
ONE SW COLUMBIA ST #300 6400 NE HWY 99
PORTLAND, OR 97258 SUITE G #375
VANCOUVER, WA 98665
Phone: 503- 412 -4800 Contact #: PRI 360 - 699 -2130
FAX 360 - 719 -1527
FEES Reg #: ELE CLE79
LIC 173731
Description Date Amount SUP 4272LEA
[ELPRMT] ELR Permit 2/3/2009 $75.00
[TAX] 12% State Surch 2/3/2009 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow 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 copies of these
rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: �(2) O j suth Permittee Signature:
OWNER INSTALLATION ONLY G �
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'N: 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.
cco43
Electrical Permit Application RECEIVE ' FOR OFFICE USE ONLY
3 2009 Received 1 ' ' � Z^ COCI
` - '� o) '�00 Date/By: Q V 3
II III
City of Tigard r � � Permit No.. �' L e,„,,, ft.,. " 13125 SW Hall Blvd., Tigard, OR 97223 �+ Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit J 0
y: Z . 20C�� •
TIGARD Inspection Line: 503.639.4175 CITY GFTIG' ' � I Date Ready/By. Jas: El See Page 2 for
Internet: www.tigard - or.gov BUILDING DIVISI Notified/Method. t I el Supplemental Information
TYPE OF WORK PLAN ( REVIEW
❑ New construction Ig 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 XCotnmercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3
Job no.: Job site address: j o ' 2 o SW t.- n bc, r p{ Six or or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: f7 6 r .6)0,A ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: -- 4 k Project name: e a S y5 ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: 7
Description I Qty. I Fee. 1 Total
New residential single- or multi -family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential -
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
// / Limited energy, multi - family
Z h (/ 5 t ci /'ire.. i4 I a r tv j../ - /5..t o b e..s Ara ply} L ea Y10.1 residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City /State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
APPLICANT ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: r
S et ,c,.._ 1 a c�1 n pl o g y t o Q B. Fee for branch circuits
I without service or feeder fee,
Contact name: (. q tn,.. 5 -i e_. s - - first branch circuit 46.85 2
Address: r1 - Each add'l branch circuit 6.65 2
U V y 9 S v , t # 3 S Miscellaneous (service or feeder not included)
City / State/ZIP: U G e_ o k" v w A 9X 5 Each manufactured or modular 90.90 2
Fa o dwelling, service and/or feeder
Phone: (3(, 0)
C c q _ . 1 3 0 (3(0 ) '7 ( q ) 5 Z • 7 Reconnect only 66.85 2
E - mail: q 5 w a-. a. - d 6) S S k a 'i s c.L. IA 4. j p b y , yl ,, - Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name: 5 q .tel g „ . ` ms s I o S y rte" ( energy panel, alteration, or
Address: # 3 extension. Describe: 1 Page 2 1 2 y
City /State/ZIP: v y n c O u ✓r_ !' i w 4 9 g c, (o s Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (34,c1) c 19 - Z i 3 o Fax: (3 t90) - 7 / - / 5 2 7 Investigation per hour (1 hr rmn) 62.50
CCB Lic.: , 7 3 7 3 ( Electrical Lic.: c. L L 7 7 Suprv. Lic.: y,--),2LGA. Industrial plant per hour 73.75
. ELECTRICAL PERMIT FEES
, Suprv. Electrician signature, required: J Subtotal: '7>✓
Print name: jets b St, j. - . Date: J -30 _01 Plan review (25% of permit fee):
/ State surcharge (12% of permit fee): Q , CO
Authorized signature: . ii_ t1 o,a — TOTAL PERMIT FEE:
Print name: % his permit application expires if a permit is not obtained within 180
345 Si Date: i , O p, / days after it has been accepted as complete.
* Number of inspections allowed per permit.
t. \Building \Permits \ELC- PennitApp.doc 05/23/06 440- 4615T(11 /05 /COM/WEB
• •
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
n Garage Door Opener*
n Heating, Ventilation and Air Conditioning System*
n Vacuum Systems*
❑ Other:
•
COMMERCIAL WORK ONLY: - --
i
Fee for each commercial $75.00
•
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
n Audio and Stereo Systems
n Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
Fire Alarm Installation
n HVAC
n Instrumentation
n Intercom and Paging Systems
❑ Landscape Irrigation Control*
n Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required.- Licenses are required
for all other installations
I:\ Building \Permits\ELC- PermitApp.doc 03/23/06
, -
Cr'sY, OF TIGARD
1 thilifIiNG DIVISION
A i A PERMIT #: ELR2009-00043
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 20312009
Phone: (503) 639-4171 :routfillif
Inspection Requests (24 Hrs.): (503) 639-4175 ,....._4* --...,
INSPECTION WORKSHEET FOR DATE: 7111/2009 TIME: 7:00AM PAGE: 23
SITE ADDRESS: 10220 SW GREENBURG RD 301 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/THREE LINCOLN LOT #: 009 TYPE OF USE:
PROJECT NAME: COMSYS
DESCRIPTION: ReWicted energy for fire alarm installation.
OWNER: SHORENSTEIN REALTY SERVICES, PHONE #: 503-4124800
CONTRACTOR: SAFE TECHNOLOGY GROUP INC PHONE #: 36(1.6992130
Inspection Request Scheduled For: Date: 2/11/2009 Pour Time:
Code # Inspection Description C ' # Contact # Message
199 Electrical final 080477-02 360-518-5685 N
Corrections/Comments/Instructions:
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4 6Ve ItO c‘ .%Q41 0
PASS n PARTIAL APPROVAL I I CANCEL 0 NO ACCESS
MAI fl CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: '"".-- , N) ba.1---**" Date: 2- 11 - O Phone #: (503) 718- vf Lit
cry, OF TIGARD
i aiti5ING DIVISION , 1:::.
PERMIT #: FLR2009-00043
• 13125 * SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/3/2009 11
Phone: (503) 639-4171 kosAiatil
Inspection Requests (24 Hrs.): (503) 639 t -4175 : AU ■ fl....,.
INSPECTION WORKSHEET FOR DATE: 2/9/2009 TIME: 7:00AM PAGE: 10
' 7112601
SITE ADDRESS: 10220 SW GREENBURG RD 301 CLASS OF WORK: ---
SUBDIVISION: LINCOLN CENTER/THREE LINCOLN LOT #: 009 TYPE OF USE:
PROJECT NAME: copoisys
DESCRIPTION: Rearicted energy for fire alarm installation.
OWNER: SHORENSTEIN REALTY SERVICES, PHONE #: 503-412-4800
CONTRACTOR: SAFE TECHNOLOGY GROUP INC .. wm, - PHONE #: 360-699-2130
Inspection Request Scheduled For: Date: 2/9/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 080399-01 360-518-5685 N y
Corrections/Comments/Instructions:
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NRPs 1 "L-
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2(.. (r.tNlikl *Gs) C-4
0 PASS 0 PARTIAL APPROVAL 0 CANCEL Li NO ACCESS
,q FAIL CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: &-\ 0 6 G \--‘. Date: ?.....- 1 - i Phone #: (503) 718- __________
Case Activity Listing 2/10/2009
CCEL
Case #: ELR2009 -00043 12:08:56PM
a g Up t
a B: B . Notes -
Actte�ty .Descn tton �� � Dated - �~ Date2 N - -. D 3; Aold• ts To �� � � � *:
� �: A�.:�- , �,.D„�P �� ... < �Y . � . Y e _ �.r a ��r�
ELR1010 Application received 2/3/2009 None RECD LS 2/3/2009
BLD
ELR1020 Permit created 2/3/2009 None DONE LS 2/3/2009
BLD
ELR1030 Check for parcel tags 2/3/2009 None DONE LS 2/3/2009
BLD
ELR1280 Issue permit 2/3/2009 None DONE LS 2/3/2009
BLD
. ELR2199 Electrical final 2/6/2009 2/9/2009 2/9/2009 None IIEM GN 2/9/2009 080399 - 01 -- 360 - 518 - 5685 - VM -
STl Y - 180
Page 1 of 1 CaseActivity..rpt