Permit • r r
CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2009 -00137
Date Issued: 05/22/2009
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: (1) restricted energy system for voice and data.
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555 Restricted Energy Permit 05/22/2009 $75.00
CALIFORNIA ST 49TH FL 12% State Surcharge - Restricted Energy 05/22/2009 $9.00
PHONE:
Contractor:
TELEDIGIT INC
PO BOX 22287
PORTLAND, OR 97269
PHONE: 503 - 722 -8084
FAX: 503- 722 -9914
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: Y Fire Alarm: N
HVAC: N Instrumentation: N Total $84.00
Intercom /Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N Required Items and Reports (Conditions)
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 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 through OAR 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: MA / Permittee Signature: A p f/
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.
; ,05!19/2009 15:14 FAX 5037229914 ErFI rT»INC. 2 001
Electrical Per•mi p :'�
t� locat ` . I
i lig '- ' City of Tigard MAY 1 9 Z009 • l weivod
■ {3125 SW Hall 13lvd.,1'igard, ()R 97223 Datdo" 1'ornut No.: 1 1 . -_,I , 0 ��, Cx)1 ? '
Plan �
f ` _ - Phone: 503.639.4171 Fax: 501.598.19C DP( OF TIGARD
[ i n ir;l „t Inspection Line: 503.639.4175 other Permit:
DIVISION bat°Read �u� I lil See Page 2for
Internet; www.hgnrd- or,gov Notified/Method: Supplemental Information
. . T v�...wa .
Q Now construction CRI Addition/alteration/replacement iibmii ItI W
Ptan.v chec alI that apply (arbour 7 lots of plans w /item.v checked below);
Demolition Service or l'oador 400 amps or more ❑ Holding over three stvries.
-
Other: where the available fault curtest
CATEGORY!„ OT+. CONSTRUC TlQN exceeds 10,000 amps at 1$0 volts or Ftoating bu Id boatyards,
❑
T ❑, 1- anc12 2-family dwelling less to ground, or exceeds 14.600 0 Commorciat•use agricultural
g 0' Connmercial/industrial 0 Accessory bntkltrs ; amps ibr all other installations. building,,
0 Multi- family ❑ Master builder ❑ Other: 0 Fire pump. ❑ I of 75 KVA or
. ' . ^3OR. E INFOR11dA�'N)IY AND .LOCATION n Lmosgenuy system. linger separately derived system.
C I Addition of new Mohr fond of 0' A” "E" 1_2 ", •
Job no.: 3606 Job site address: 10220 SW Greenburg Rd rl1r1HP or more. occupancy.
0 Sit: or more residential units, [] Recraativnal vehicle park.,.
City /State/ZIP: Tigard, OR 97223 ❑ Hn41ah -care taciiitiao, ❑. Supply voltage far morn than
❑llazardous locations, (00 oohsnntnina)
Suitc/bldg_ /apt. no.: 320 1 Project name: Ameriprise Ubervis or feWitr 600 amps or move.
Cross street/directions to job site:
.. rlascrtfiha E 917- i Poe. I •FaMr 1.
New residential single- or multi-family dwelling milt.
- Includes attached 'garage.
Subdivision: i 000
Lot no.: q. 11, or less 145.15
Taxmap/parool no,: — Ea. odd'I 500 sq. R. or portion 33,40
D R Ii Limited a energy, „)idential
Voice and Data C WQ ove 75.00
•
abling l ,imi ssd 0ncr�y, multi- family 75,00 U Mil
— " residential (with above ,y. a.
Services or feeders bisIa (atlon, alteration, and/or relocation_
P PE12'f Y: •
..,_
_ amps or less BO.3U
.... ,,;. : ... ....... .... i∎p Q TptA.N1' . . 01 ampa 106.85
200 2
Name: 401 amps to 600 amps OM 160.60 Mini
Address; - 601 amps to 1,000 toutpa - 240.60 NMI 2
Over 1,000 amps or volts MI 454.65 IEM
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
.phone: ( ) Fax: ( ) 200 att,ps or Jess I 66.85 1
Owner installation: This installation is being made on properly that 1 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 594 amps rn 133 2
Owner signature: Date: Branch circuits - new, alteration, or extension er torte/
Fee for branch circuits with
A
� l : CT. PERSON.: ' ... . above sorvicc or feeder fee,
AFJP CAIVIE : .. .
BusitleSS name:
each branch circuit 6.65 2
a. Fee for branch cironits
Contact name: without service or leader lee,
_. ftt'st branch circuit 46.85 2
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /Slate/ZIP: - Each manufactured or modular
dwelling, '0.90 2
Fax:: (✓ ) g, service end/or fader
Phone: ( )
Reconnect only 66.85 2
E- trail:
- - .
to p or irrigation rank .53.10 2
Ct�NEll1ACTgR..
Sign or outline lighting 53.40 y
E3usineSS name: Tetedigit Inc Signal err wt(a) or limited-
energy panel, alteration, or 75,00
Address: PO Box 22287 extension. Describe: 1 Page 2 2
City /State/Z(P; Portland, OR 97269 Each additional inspection over allowable in any of the above
Phone: (503) 722 - 8084 Fax: (503) 722 -9914 Per inspection 62.50
Investigation per hour (I 6r min) 62.50
CCB Lie.: 116188 Electrical Lie,: 3- 414CLE • Suprv. Lie.; 81SLEA Industrial plant per hour 73.75 .. ' 1
v Elffi 1RIGOt'E,..PERMY1 :FHB .... _
Suprv. Electrician signature, required : - - -
. subtotal'. 7j
•
Print name: Art Rosario Date: 5/19/09 Plan review (25% of permit foe); µ •
Authorized signs _ -
State surcharge (12% of permit fee): 9.00
• TOTAL PERMIT FEE: 84,00
Print name; Art Rosado .I Date: S /19 /09 This permit sppIIcattwt a <pirrA if a permit is not obtained within 190
darn after It leas been accreted as complete.