Permit •
CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
•
COMMUNITY DEVELOPMENT Permit#: ELR2012 00151
T t GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/18/2012 •
Parcel: 1 S 135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 300
Project: Jason & Leiberan Subdivision: METZGER, TOWN OF Lot: 9
Project Description: (1) limited energy panel - relocate fire alarm notifcation devices (3)
Contractor: STONER ELECTRIC Owner: LINCOLN CENTER LLC
1904 SE OCHOCO BY SHORENSTEIN PROPERTIES LLC
MILWAUKIE, OR 97222 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503 -462 -6500 PHONE:
FAX: 503 - 659 -4968
FEES
Description Date Amount
Specifics: Restricted Energy Permit 07/18/2012 $75.00
Type of Use: COM 12% State Surcharge - Electrical 07/18/2012 $9.00
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
Intercom/Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N Total $84.00
Other Desc: Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 9 - 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987
# 32.1987 or 1.800.332.2344. /�
Issued By: t✓ Permittee Signature: tM Po C i477D�L
OWNER INSTALLATION ONLY
•
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE: Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept In a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each Inspection.
Jul. 18. 2012 12:58PM Stoner Electric Group No. 3398 P. 1
Electrical Permit ApplicaticREC I FOR OFFICE 11sr. ()NIX
City of T J UL 18 2012 D • OM Permit l ' J . X /l7
V 13125 SW Hall Blvd.. Tigard. OR 97223
Plan Review ' v Phone: 503.639.4171 Fax: 503.5916 j ® DDamns , Other Pe •• s S Jo/A.- �� Q3
i 1 t: A it I t Inspection Line: 503.639.4175 I r F TIGARD Date Ready/13y: IMII la See Pace 2 for
Internet; www,tigard- or.gov BUILD!N9 p 1 1 (
Notified/ Method: Supplemental Information
i z "-; n,, �''1 :; " 5 ' r ei yi, iz k ='-' -.. F � •N l 3 � .
�' `, ! l a�`•• `..!...'(..-/1.1'4-'4c.:- Cr T . A tJi` •�tJrCl1 . Y. lid: +$ 1.,_- .il itlLL�,' n n. - +�
.. Ar a � � • rr. r i •:F�. • . • � '1` :. .: � -
❑ New construction IN Addition/alteration/replacement Please check all that apply (submit Z sets o plans w items checked below):
❑ Demolition El Other: ❑ Swim or feeder400 amps or more 0 Building over three stories.
wherelhe available fault current ❑ Marinas andboeyerds.
` tjTSGORY; OF sCONSTRI . AN Yv�RI ; exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
0 ' l:'J - u• ' . "- _'' " -: `- `" less to ground, or exceeds 14.000 ❑ Commercial-use agncultmal
❑ 1 and 2 family dwelling V Commercial/industrial ❑ Accessory building amps tar all whet installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
a =. ,� ❑L•margency system. larger separately derived system.
. JOII • INRORMATIO 'Tqt�r ?' ,
.. ._ R ❑ Addition thaw motor load of • ❑ "A ", "E ", "1 -2 ", "1 -3
n �. or res. ocrneanry.
Job no.:/5 no.:/5 5 [Job site address: /03 Op 6R L/4 , JCB psi), Six or or nwre residential unity. ❑ Recreations] vehicle parts.
City /Statc/Z1P 1) 0R 972 ci Heal ih•cetefealides. ❑ Supply voltage foe mum than
El Hazardous locatims. 600 volts nominal.
S gJapt. no.: 360 I Project name' i ,,, 400 O Semce or feeder 600 maps or more.
Cross street/directions to job site: OIIIri/vCALAJ • c_ - it J Dw criotioo I Qty, I Fee. I Tow I
New residential single- or multi - fancily dwelling unit.
Includes attached garage. _
Subdivision: I Lot no.: 1.000 sq. B. or less 168.54 4
Es_ add'l 500 stn. or portion 33.92 1
Tax map /parcel no.: �s. Limited energy, residential
: DF5.01 -0 OSaa.4 •.: (with above sq. IL) 75.00 2
� Limited energy, multi - family 75.00 2
�
/ eL D ceps'
,. 14 r7.�/P.eitd ArenAi COP/7CA) residential (with above sq. R.)
Services or feeders Installation, alteration, and /or relocation
? f/� � 200 amps or less 100.70 2
I� w e s : , 201 amps to 400 amps 133.54 2
PItOPEItCY OWNER..::.:.X N7': - .. : .
Name: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Ci /StateI21P: Temporary services or feeders installation, alteration, and/or
ry relocation
Phone: ( ) J Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that 1 own which is net 201 amps to 400 amps 125.08 2
401 amps to 599 amps 168.54
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 2
Branch circuits- new, alteration, or extension, per panel -
Owner signature: Date: A. Pee for branch circuits with
5 above sotvieo or feeder fee,
.:..': .. Q; AP PLICANT•. .' I . . 5 Ol!I'',.. each branch circuit 7.42 2
Business name: B. Fee for branch circuits wh iteM
service or feeder fba, first 56.18 2
Contact name: branch circuit
Each add'I branch circuit 7.42 2
Address: Miscellaneous (service or feeder not Included)
City/State/ZIP: dw ng anN or modular 67.84 2
Phone: ( ) I Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E-mail: Signor outline lighting 67.84 2
• • • .. • • . : CONTI.t'�cro c .; :...; .
, � ' - ' � � � . Signal circuit(s) or limited energy r
Business name: STONER ELECTRIC, INC. panel, alteration. or extension. I Paget , 7. i 0 2
Each additional inspection over allowable In any of the above ,
Address: 1904 SE OCHOCO Additional inspection (1 hr min) 66.25/hr
City /State/ZIP: MILWAUKIE OR 97222
Investigation uiplant (1 66.25/ hr
a Industrial plans (1 hr min) 78.1181 hr
Phone: ( 503) I Fax: ( 503) 659 -4968 Inspections for which no fee is 9000 / hr
_specifically listed(� /e hr min)
CCI3 Lie.: 44823 I Electrical Lic.: 26 -122C Suprv. Lie.: 3496S �.:`. . . ..•.. LECTRICAI, PERMit F,S�'.S % :'.t '•
Suprv. Electrician signature, required: pi:r )...14,—........ Subtotal: 7 --
Plan review (25% of permit fee): - e--
Print name: MICHAEL FALCONER Date: 7 // , State surcharge (12% of permit fee): t 0 9 gD
TOTAL PERMIT FB2:
Authorized signature: s-, OD
This permit applieadon aspires ita permit is not obtained within 180
daya after It has been accepted as complete
Print name: I Date: • • Number of inspections allowed per permit. 40.
I: lBuildingtPerroi hs5LC•PemurApp.doc 07 /01/10 440- t615T(1110f/COM/wfia • as
Jul. 18. 2012 12:58PM Stoner Electric Group No.3398 P. 2
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
Fee for a residential systems combined........ $75.00
Check Type of Work Involved; •
❑ Audio and Stereo Systems*
•
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
FOOrdr RCIAL WORK :ONLY::
Pee for each commercial $75.00 •
system •
(SEE OAR 918 -309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
Fire Alarm Installation •
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls'
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems: I
*No licenses are required. Licenses are required
for all other installations
L1DidldingPavdls1ELGPeimiIApp .doe 07/01/10