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Permit I I J~ CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT . '' - COMMUNITY DEVELOPMENT Permit #: ELR2009 -00127 Date Issued: 05/11/2009 •TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S135AB01004 Jurisdiction: Tigard Site address: 10220 SW GREENBURG RD 320 Subdivision: Lot: 0 Project: Ameriprise Project Description: Low voltage for fire alarm Owner: FEES LINCOLN CENTER LLC Description Date Amount BY SHORENSTEIN PROPERTIES LLC, 555 Restricted Energy Permit 05/11/2009 $75.00 CALIFORNIA ST 49TH FL - 12% State Surcharge - Restricted Energy 05/11/2009 $9.00 PHONE: Contractor: CAPITOL ELECTRIC CO INC 11401 NE MARX STREET 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: Boiler Controls: CCTV: Clock Systems: Data & Telecommunications: Fire Alarm: Y HVAC: Instrumentation: Total $84.00 Intercom /Paging: Landscape /Irrigation: Required Items and Reports (Conditions) Landscape Lighting: Medical: Nurse Calls: Protective Signal: Security Alarm: Other: 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 don n accor ance with approved plans. This permit will expire if work is not started within 180 of issuance, or if work is suspended for more the 180 ys. ATTENTION :''Ore! • equires you to follow the rules adopted by the Oregon Utility No ifiration Center. Those rules are set forth in OAR 952 -001' 0010 through OAR 952ir01 -0101. Yo may obtain a c•py of the rules or direct questions to OUtIC by calling 503. , 6.6 9 or 1.800.33 . 344. Issu By: 7. d °(---1 Permittee Signatur-. _ L /P' / (d---.---- , 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'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. Electrical Permit Application , FOR OFFICE USE ONLY City of Tigard CEIVED Date/By: 5 /I 09 _, Permit no.: <2ag�11 .D / 2 7 III 13125 SW HaII Blvd., Tigard, 0 7 23 Plan Review G _ ' Phone: 503.639.4171 Fax: 503.598. 9 0 n Date /By: Other Permit: TICARD Inspection Line: 503.639.4175 MAY ] 1 2 00 J Date Ready/By: Juris: ❑ See Page 2 for Internet: www.tigard- or.gov / lemental Information CITY OFTIG Notified /Method: c / Su pp TYPE OF WOR�UII .DING V DIVISION PLAN REVIEW ❑ New construction ❑ Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Demolition ❑ Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories CATEGORY OF CONSTRUCTION where the available fault current ❑ Marinas and boatyards ❑ 1- and 2- family dwelling H Commercial /industrial ❑ Accessory building exceeds 10,000 amps at 150 volts or Floating buildings ❑ Multi- family ❑ Master Builder ❑ Other less to ground, or exceeds 14,000 Commercial - use agricultural JOB SITE INFORMATION AND,LOCATION amps for all other installations. ❑ buildings Job no.: 290652 Job site address: 10220 SW Greenburg Rd. ❑Fire Pump ❑Installation of 75 KVA or ❑ Emergency system larger separately derived system. City /State /ZIP: Tigard, OR 97223 ❑ Addition of new motor load of ❑ 'A ", "E ", "1 -2 ", "1 -3 ", 100HP or more. ❑ occupancy Suite/bldg. /apt. no.: Suite 320 Project name: Ameriprise Financial T.I. CI Six or more residential units ❑ Recreational vehicle parks. ❑ Health -care facilities ❑ Supply voltage for more than Cross Street/Directions to job site: 2Lincoln Center ❑ Hazardous locations ❑ 600 volts nominal. ❑ Service or feeder 600 amps or more Subdivision: Lot no.: FEE SCHEDULE Description I Qty. I Fee. I Total I .• Tax map /parcel no.: New residential - single or multi - family dwelling unit. DESCRIPTION OF WORK Includes attached garage. Install Fire Alarm Circuit 1000 sq. ft. or less $ 145.15 4 Ea. Add'I 500 sq. ft or portion 6 33.40 I H PROPERTY OWNER I ❑ TENANT Limited energy residential Name: (with above sq. ft.) $ 75.00 2 Shorenstein Realty Services Limited energy, multi- family Address: residential (with above sq. ft.) $ 75.00 2 Service or feeders installation, alteration, and /or relocation City /State /ZIP: 200 amps or less $ 80.30 2 201 amps to 400 amps $ 106.85 2 Phone: Fax: 401 amps to 600 amps 5 160.60 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 5 66.85 1 ❑ APPLICANT I ❑ CONTACT PERSON 201 amps to 400 amps $ 100.30 2 Business Name: 401 amps to 600 amps 5 133.75 2 Branch circuits - new, alteration, or extension, per panel A. Fee for branch circuits with Contact name: service or feeder fee, each branch circuit $ 6.65 2 Address: B. Fee for branch circuits without service or feeder fee, City /State /ZIP: first branch circuit $ 46.85 2 Phone: Fax: Each additional branch circuit: $ 6.65 2 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 $ 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 City /State /ZIP: PORTLAND, OR 97220 -1041 Fire Alarm Circuit 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) 5 62.50 CCB Lic.: 48748 'Electrical Lic.: 26 -496C ISuprv. Lic.: 3132 -S Industrial plant per hour 5 73.75 Suprv. Electrician signature, required: /� L_PERMIT FEES* ��/f /�/f/j/�fJ,[��`V"' � ELECTRICA Subtotal $ 75.00 Print Name: DARRELL MMCN Date: 05/08/09 Plan review (25% of permit fee) Authorized signature: / J �� 44 ���� J� Me' ! State surcharge ( 12% of permit fee) $ 9.00 l J / , TOTAL PERMIT FEE $ 84.00 Print Name: DARRELL MCNEEL Date: 05/08/09 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.