Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2012 -00058
T I G A RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/30/2012
Parcel: 1 S135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 601
Project: Matrix Absence Management Subdivision: METZGER, TOWN OF Lot: 9
Project Description: Data telecommunications system.
Contractor: OREGON ELECTRIC CONSTRUCTION INC. Owner: LINCOLN CENTER LLC
1709 SE 3RD AVE BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97124 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503 - 234 -9900 PHONE:
FAX: 503 - 234 -1001
FEES
Description Date Amount
Specifics: Restricted Energy Permit 03/30/2012 $75.00
12% State Surcharge - Electrical 03/30/2012 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: N
Security Alarm: N
Garage Door Opener: N
HVAC: N
Vacuum System: N
Other: N
Other Desc: Total $84.00
Required Items and Reports (Conditions)
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 -0090. You may obtain a copy of the rules • direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
WiNO 11P• / i a
Issued By:, Permittee Signature:
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 the next available inspection date.
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 A lication FOIZ 01+1(:r. 1..SF, 07%/1.1'
Cit of Tigard % Received
Daterliv. No ___„,, ..,
Elfrar 'emit .. _
II 13125 SW Hall Blvd., Tiga See\ Sts t ,... (N. Plan Review
' I ' Phone: 503.718.2439 Pint. - i • 1961 Ci• -.CXj i Tate:8 .: i Other Permit:
TIGAR.12. inspection Line: 503.639.417. 4 6,,ce aim Ready14,1.: i •isi j 21 See Page 2 for
)
interact: www.ligard-or.gov NotifiediMethosT I 7:1>te Supplemental Information
•>
-1 2c; ' ':' ," .. C :'.'N''' - .: 1 ''./.i!,- - :•':',. ,, i ., 5 - -: .-. :". :- t ..- .•: l'• -....: :`.:',•,:•:',..•.',..•.....::• ::::,::::•.: • .: '-•
0 New construction
0 Additionialteratio*/) acement Please check all that apply (submit I. sets of phuis %%Items checked below): 1
()Service or feeder 400 amps or more 0 Building over three stories.
• 0 Demolition
0 Other:
::.::l': .:,:-.....,.::.....::::,ic4T:f.R.94Y.'i.PF:=..:PPIISW.g)cg9/1 e
:.. ..,. ,::. .-.. ,:...!..,.. ..:'.':-..,. .: whore the available Omit eunent 0 N farina:: and boatyards.
exceeds 0000 10. amps at 150 v olts oi 0 Floating building
s. I
less hi ground, or exceeds 14.000 0 C■ ■mmerc ia I- use agricultural
0
1- and 2-family dwelling El Coininercial!industrial 0 Accessory building amps fur all other installations. buildings.
0 Mulli-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or
-•:', ...,:.:;.'....-;-_:....' :•!-,`..:‘.',:-:: ..',.';;; --.• -;At' • • ...,: .-.., .., - . : • - .-.. .,. 0 1 system, larger separately (fenced system.
', •...-,...,..:- ...,.--',-.....•.;.:', .:..-.,;,:. iwiet,....;-: . . ,. , .. ., . ..- -`.r•ttt. -.., 7. .,- k.,. .: • " - - : . • ""- • :- - '-- .1. 0 Addition or new motor low of
Job no.: 55352 Job site address: 10220 SW GREENBURG RI) 1011? or more. occupancy.
0 Six or more residential units. 0 Recreational vehicle parks.
Cit TIGARD, OR 0 Heahh-care facilities 0 Supply voltage for more man
I- 0 llazadous locations. 600 via": nominal.
I •
Suite:bld roig./apt. no.: 601 i Pro name: MATRIX ABSENCE 0 Servicc or recder 600 amps or more.
.
...„,•:1' /...;■.- .:':-.: .':, . , - ,
Cross street/directions to job site: Description I orv. I kce. I Toidl J
— -..---.
New residential single- or multi-flintily dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
-- Ea. add) 500 sq. IL or portion 33.92 1
Tax map;parcel no.:
Limited energy residential
75.00
4, ,',.'.:k...:t (with above sq. R.)
Limited energy. multi-family
LOW VOLTAGE VOICE & DATA CABLING residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation
200 amps or less I 100.70 I 2
133.56 '
140,00 ' : „'.;:.:.-:...' 201 amps t„ 400 amps
t,..,
i 401 amps to 6110 amps 200.34 2 !
Name:
I 601 amps to 1,0(K) amps 301..04 2
i
_
--i
Address: j Over 1,000 mips or volts 552.26 _
I Temporary services or feeders installation, alteration, and/or
CityiStatciZIP: relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
r I
1---- ! ,
Owner installation: This installation is being made on property that I own which is riot 201 amps to 400 amps P5.08 --
406 amps In 599 amps 1 168.54 . 2
intend(xi for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
above service in feeder rec..
. :-:-• '. • ,i•••;•-..", ••• : ::;;;.'1.•;: each brunch circuit 7.-42
Business name: B. Fix for branch circuits without
--j service Of (redo fee. first
56.18 2
Contact itamc: MA TI NISWONCER I branch circuit
i Each add 'l branch circuit 7.42 s ,
_ .
! —
Address: Miscellaneous (service or feeder not included) 1
_1 .
i Each manufactured or modular
City/State/ZIT': dwelling, service undies' feeder 137 s4 2
Phone: 5
RC.COMICCt :Ally 67.84
I Fax: : ( t -
(03) 957-6428 ) 1 -T--
Pump or Irrigation circle 67.84
t : s
E-mail: , Slip or outline lighting 67.84 ' l -
2
1
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:,.:-. :
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.:: ;-.: - - -.- •••• ' .:•-\•,.-':. Si ci. edner
gral &reolt(s) tiMit-eay.
- " - - • •••• • - • • - - 75.00
nand, o
Business name: OREGON 1;;LECTRIC CONSTRIJCTION, INC alteration, r extensieu.
... ._ ......_____ Each additional inspection over allowable in any of the above_
_
Address: 1709 SE 3" A‘rE Additional insNct:on (I hr min) 66.25/ hr
Investigation !I hr min) I 66.251 hr
City/State/ZIP: PORTLAND, OR 97214
Industnai plant (I hr min) 78.181hr
Phone: (503) 234 • Fax: (503) 234-1001 Inspections for which no fee is
90.r)of hr
specifically listed (Y4 hr min) J ,
CCB Lie.: 203 Electrical Lie.: 26-95c Suprv. Lie.: 4818S ." .''FLES -:. • -
_
Subtotal: 75.00
Suprv. Electrician signature. required: I
- Plan review (25% of permit fee):
Print name: MARK WEINBENDER Date: 3/30/12 State smrcharge (12% of pcnnit fe41): 9.00
TOTAL PERMIT FEE: 84.00
Authorized signature: This permit application expires If a permit is nut obtained within 180
„
days after it has linen accepted as complete.
Print name: MARK WFINBENDER Date: 3/30/12 i i ' Number of inspections allowed per permit.
lAioi1ciir.2Rennov.I.:LC-Poini:•k1p.sInc. ■:751 I, IU 40.4613T(11515/COMN.776