Permit 7 • • • f n CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
4 COMMUNITY DEVELOPMENT Permit #: ELR2013 00099
TIGARD; 13125 SW Hall Blvd , Tigard OR 97223 503.718.2439 Date Issued: 05/06/2013
Parcel: 1 S 135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 200 '
Project: Farmers Insurance Subdivision: METZGER, TOWN OF Lot: 9
Project Description: Low voltage for security upgrade, access control & CCTV. .
Contractor: HUSER INTEGRATED TECHNOLOGIES Owner: LINCOLN CENTER LLC
1313 NW 17TH AVE BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97209 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE. 503 - 227 -6688 PHONE
FAX• 503 - 227 -5941
FEES
Description Date Amount
Specifics: Restricted Energy Permit 05/06/2013 $75.00
12% State Surcharge - Electrical 05/06/2013 $9 00
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 N
HVAC N Instrumentation: N
Intercom/Paging' N Landscape /Irrigation: N
Landscape Lighting: N Medical' N
Nurse Calls' N Protective Signal. Y
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 i - • •an . ' • approved •lans This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days • TENTION Oregon =w -quir-s you to follow the rules adopted by the Oregon Utility Notification Center hos= rules are set forth in OAR
952-111-0010 through OAR 952 -s •, -0090 Yo ay obtain a copy of the rules or direct questions to OUNC by calling 503.232.19= •r 1 8'0' 2 2344
Is ued By: ( Permittee Signature:
'/ MB/ 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 Applica art T CEIVED FOR OFFICE USE ONLY
City of Tigard Received
'1 r n�/ 6 X 013 Date/By S & / 3 (1�0 -, � Permit No. 6 - [ 4 5 .(J� �
13125 SW Hall Blvd., Tigard, OR 971123 Plan Review
111 Phone: 503.718.2439 Fax. 503.598.1960 Date/By Other Permit
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By Inns Ea See Page 2 for
Internet. www.tigard - or.gov BUILDING DIVISION Notified/Method Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition/alteration/replacement Please check all that apply (submit 2 sets of plans whtems checked below)
❑ Service or feeder 400 amps or more ❑ Building over three stones.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations buildings
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately derived system
❑ Addition of new motor load of ❑ "A ", "E ", "l -2 ", "l -3 ",
Job no.: Job site address: I 0 ZOO SJ G i� EEN BULL(, 4O Six or or more occupancy
0 or more residential units. ❑ Recreational vehicle parks
City/State /ZIP: Ti G - Ars;rrl D X- ❑ Health -care facilities ❑ Supply voltage for more than
/
/ ❑ Hazardous locations 600 volts nominal.
Suite/bldg. /apt no.: 2.6 0/. Project name: /iR'/L/L/f,v, i,Jeero i! ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq ft or less 168 54 4
Ea add'I 500 sq. ft or portion 33 92 1
Tax map /parcel no.: Limited energy, residential 75 00 2
DESCRIPTION OF WORK (with above sq. ft.)
� Limited energy, multi - family 75 00 2
. r/ 591 L(. A y c G (5' C, N XI C■ /C c rV /s et-0C, -' / residential (with above sq. ft )
Renewable Energy ❑ See Page 2
V e' i A- & 3 Services or feeders installation, alteration, and/or relocation
IA PROPERTY OWNER ' TENANT 200 amps or less 100 70 2
_ 201 amps to 400 amps 133 56 2
Name: 2 INA Fr /Z C / 5' U t'1,*T ■1 L t 401 amps to 600 amps 200.34 2
Address: 601 amps to 1,000 amps 301 04 2
Over 1,000 amps or volts 552 26 2
City/State /ZIP: Temporary services or feeders installation, alteration, and /or
Phone: ( ) Fax: ( ) relocation
200 amps or less 59 36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125 08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168 54 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
❑ APPLICANT ❑ CONTACT PERSON A Fee for branch circuits with
above service or feeder fee, 7 42 2
Business name: each branch circuit
B Fee for branch circuits without
Contact name: service or feeder fee, first 56.18 2
branch circuit
Address: Each add'I branch circuit 7 42 2
City/State /ZIP: Miscellaneous (service or feeder not included)
Each manufactured or modular 67.84 2
Phone: ( ) Fax: : ( ) dwelling, service and/or feeder
Reconnect only 67 84 2
E - mail: Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67 84 2
Business name: I4v 3NTt G- fl -ArE9 rect-((VOC.JGIES Signal circuit(s) or limited-energy 7��,p0
panel, alteration, or extension ( Page 2 2
Address: ) 7 / 3 N W j 1 t'N C , Each additional inspection over allowable in any of the above
City/State /ZIP: p 0 (�.-$ ✓fad/ 04, ? 2 V Investigation inspection (1 hr (1 hr min) 66 25/ hr
Invega (1 hr mm) ) 66 25/ hr
Phone: ((o ) legir. 2.14-(dOg Fax: ( ) Industrial plant (1 hr min) 78 18/ hr
Inspections for which no fee is
CCB Lic.: 114 2.11 Electrical Lic.: 0.,......-- Suprv. Lic.: 45 t-15' LEA specifically listed (%: hr min) 90 00/ hr
Suprv. Electrician signature, required: � ELECTRICAL PERMIT FEES
Subtotal: 76
Print name: ✓ a. C fc V KZ N Date: 54, //3 Plan review (25% of permit fee):
State surcharge (12% of permit fee): q, 0 v
Authorized signature: TOTAL PERMIT FEE: g'[/ .0
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
I \ Building \Permits\ELC_PermiApp_040913 doc 440- 4615T(1 I /05 /COM/WEB
Electrical Permit Application — City of Tigard
Page 2 — Supplemental Information
Limited Energy Permit Fees: • Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: � FEE ,SCHEDULE
Fee for all residential systems combined........ $75.00 Description I Qty. I Fee I Total I
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 10070 2
5.01 to 15 kva 133 56 2
❑ Audio and Stereo Systems* 15 01 to 25 kva 200 34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25 01 to 50 kva 30104 2
• '• 50 01 to 100 kva 552 26 2
❑ Garage Door Opener* >100 kva (fee in accordance with
'OAR 918- 309 -0040) 552 26 2
❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva— no additional charge 0 0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 66 25/ hr
charged at an hourly (1 hr min)
Inspections for which no fee is 90 00/ hr
_ M _ specifically listed (%f hr min)
',CO MERCIAL WORK ON'L'Y' , , e 4`1 ELECTRICAL PERMIT FEES „
Fee for each commercial system • $75.00 Subtotal.
(SEE OAR 918- 309 -0000) Plan review, if required (25% of permit fee):
State surcharge (12% of permit fee):
Check Type of Work Involved: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
❑ Audio and Stereo Systems • days after it has been accepted as complete.
• Number of inspections allowed per permit
❑ 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:
*No licenses are required. Licenses are required
for all other installations
I \ Budding \Permns\ELC_PermiApp_040913 doe
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10200 SW GREENBURG RD 200, TIGARD, OR,
97223
Commercial - Electricial Limited Energy
135 Low voltage
06/04/2013 00:00
ELR2013-00099
PASS
Violation Summary:
Inspector Contractor