Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
2 '$• COMMUNITY DEVELOPMENT Permit #: ELR2009 -00262
SIG RD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/11/2009
> Parcel: 1 S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 830
Subdivision: LINCOLN TOWER Lot: 0
Project: Mortgage Express
Project Description: Low voltage for fire alarm system. Job No. 290667
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555 Restricted Energy Permit 08/11/2009 $75.00
CALIFORNIA ST 49TH FL 12% State Surcharge - Electrical 08/11/2009 $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: 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 a e 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. AT NTION: Ore I. req .'res you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -00 0010 through OAR 9:r -001 -! '0. You may obtain a copy of the rules or direct questions to OUNC by calling .•. '6.6699 or 1.800.332.2344.
Issu By: ` �- L�� • Permittee Signature � 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.
r Electrical Permit Application Received .
FOR OFFICE USE ONLY
City of Tigard \NV9 Date /By: ire) •
i Permit no.: &I2 41:0?_. DDaIO�
u l 13125 SW Ball Blvd•, Tigard, OR 97 C , J Plan Review
1 Other Permit:
_
Phone: 503.639.4171 Fax: 503.598.E 'S, e 0 09 Date /By:
TIGARD Inspection Line: 503.639 �a 01 p Date Ready /By: Jurts� ❑ See Page 2 for
Internet: www.tigard-or.gov \ ' G�l° o Notified /Method: </ 16, Supplemental Information
TYPE OF WORK �l`c,L .1 \V PLAN REVIEW
U New construction ❑ Addition /alteration /replacemen Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Demolition 1] Other: V 1 ❑ Service or feeder 400 amps or more ❑ Building over three stories
CATEGORY OF CONSTRUCTION rr where the available fault current ❑ Marinas and boatyards
LJ
H I - 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
❑ Fire Pump ❑ Installation of 75 KVA or
Job no.: 290667 Job site address: 10260 SW Greehburg Rd.
❑ Emergency system larger separately derived system.
City /State /ZIP: Tigard, OR 97223 ❑ Addition of new motor load of ❑ "A ", "E "1 - ", "1 - ",
100HP or more. ❑ occupancy
Suite /bldg. /apt. no.: Suite 830 Project name: Mortgage Express T.I. CI Six or more residential units El Recreational vehicle parks.
❑ Health -care facilities ❑ Supply voltage for more than
Cross Street /Directions to job site: Lincoln Tower ❑ 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 5 33.40 1
❑ 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.) S 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 $ 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 $ 66.85 1
❑ APPLICANT I ❑ CONTACT PERSON 201 amps to 400 amps $ 100.30 2
Business Name: 401 amps to 600 amps $ 133.75 2
Branch circuits - new, alteration, or extension, per panel
Contact name: A. Fee for branch circuits with
service or feeder fee, each
Address: branch circuit $ 6.65 2
B. Fee for branch circuits
City /State /ZIP: without service or feeder fee,
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 5 53.40 2
Contact name: Sign or outline lighting 5 53.40 2
Signal circuit(s) or limited -
_
Address: 11401 NE MARX ST. energy panel, alterations, or
extension. Describe: I 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) $ 62.50
CCB Lie.: 48748 'Electrical Lie.: 26 -496C ISuprv. Lie.: 3132 -S d Industrial plant per hour $ 73.75
-
Suprv. Electrician signature, required: /,fin ELECTRICAL PERMIT FEES*
i� -0'7-1%7- 1 �/ f � � Subtotal $ 75.00
Print Name: DARRELL MCNEEL Date: 08/05/09 Plan review (25% of permit fee)
/ State surcharge ( 12% of permit fee) $ 9.00
Authorized signature:
�CMA4 A/L TOTAL PERMIT FEE $ 84.00
Print Name: DARRELL MCNEEL Date: 08/05/09 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.