Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
11111 " Permit #: ELR2013 00116
COMMUNITY DEVELOPMENT Date Issued: 05/28/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 parcel: 1 S 28/201 1004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 200
Project: Swipe Now Subdivision: METZGER, TOWN OF Lot: 9
Project Description: Low voltage for data
Contractor: WEST SIDE ELECTRIC CO INC Owner: LINCOLN CENTER LLC
1834 SE 8TH AVE BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97214 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503 - 231 -1548 PHONE:
FAX: 503 - 736 -0677
FEES
Description Date Amount
Specifics: Restricted Energy Permit 05/28/2013 $75.00
12% State Surcharge - Electrical 05/28/2013 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: N Boiler Controls: N
CC TV: N C lock Systems N
Data & Telecommunications: y Fire Alarm: N
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 •A • -001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: AL .4� Permittee Signature: r/A/ �/ L� e 770/\/'
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.
2013 -05 -23 20 :58 WEST SIDE ELECTRIC 15037360677 » 5035981960 P 2/3
Liectritcai Permit Applicatip CEIVED fo RR (01. I(1 I SI t) \1.
g:
City of Tigard Received ` e ?, r n 2
Datc/By: 6 �8 / ✓ l Permit ��p(�IJ� 60/ /:)
13125 SW Hall Blvd., Tigard, OR 9 in
Phone: 503.718.2439 Fax: 503.598, v q Q 2013 Plan Review
+ G U date / y other Permit: 6 ( P te / 3 000
Inspection Line: 503.639.4175 r Date Ready /By Jun, 71 See Pa 2 for
Internet: www.tigard - or.gov CITY QF TIGARD NotifIed/Met)tad: , Supplem tal Information
I ❑ New construction !►I Addition/alteration/replacement Please check all that apply (submit 2 sets of plans wincros checked below):
❑ Demolition Other: I ❑ Service or feeder 400 amps Or more ❑ Building over three stor'ea.
where the available fault current ❑ Marinas and boatyards.
+r ' " - 4"-t -0 : ry'' • i b .,9s,t' 'ti,,, " .1:!L.. exceeds 10,000 amps at 150 volts or I] Floating buildin gs.
" ' "i 'rli�ia 1" " ' �' ' less to ground, or exceeds 14,000 ❑ Commercial -une agricultural •
❑ 1- and 2- family dwelling ommercial /industrial 0 Accessory building ;imps for all other installations buildings.
❑ Multi - family Master builder ❑ Other: L I Fire pump ❑ Installation of 75 KVA or
y ._ 5 . y T ., ❑ Emergency system target aepararely derived system.
±u,. .;Y..+RK�r,+tt< w�.. 1:.+' r"[" i .,. f � ,: '� a ' �_ .._ 1 7 ❑ Addition of new motor load m ❑ .. .. _ I _Z.... ,.i ",
Job no.: � j cj ?f j Job site address: ', n 100HP or more, occupancy
J (� r��� r 7i� C�r l� 03 I�V Six or more residential units. ❑ Recreational vehicle parks.
Cityd5tatc/ZIP:
- h- - / ❑ health - care faciimes. ❑ Supply voltage for more than
( i
1 t C� -r c l C � ` l � G � -�' -- I I CI Hazardous locations. 600 volts nominal
Suite/bldg. /apt. no.: GG / I Project name: , ` ( `)0p I El Service or feeder 600 trope or more
;:1 S.n ' ;' -: , FEE kilEDULE .
Cross street/directions to job Sits. Description i Qtv. i res. l Total 1
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. R. or portion 33.92 I 1
Tax
l n Li energy, res identi a l I 7500 i 1 2
w ek4 *i 1`0!''r:�. , � f Limited above sq. ft,) { I
e z r y L . , s { , united energy, multi - family — r 2 I
0 Q- . - \( 0,t -)30k 0-U2.1) i residential (with above sq. ft.)
Services or feeders installation, alteration. and /or relocation
200 amps or less r 100.70 I I 2
a ,'< it f '"' '^'•. "` i 74, 201 amps to400amps 133.56 I 2
Name, 401 amps to 600 amps E 200 34 I 2
601 amps to 1,000 amps FFF 301.04 I 1 2
Address: I Over 1,000 amps or volts I 552.26 I 1
Temporary
services or feeders installation, alteration, and /o
City /State/ZIP: r
Fax: 200 amps or less 59.36 I 1
2
Phone: ( ) ( ) - I I
201 amps to 400 amps 125 08
Owner installation: This installation is being made on property that I own which is not 401 amps to 59Q amps i 168 54 i 12
intended for sale, lease, rent. or exchange. according to ORS 447, 449, 670, and 701.
y Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A Fee for branch circuits with f 1
j s.�_v r p ,. :. , above service or feeder fee, I 2
. C&NT ,y .u :. r , "'.;J'.. .I.. ,, dC CC I j
, ��� ,a n ,� � . - .: "., .z:• each branch circuit .r
Business name: . B . Fee for branch circuits wllhour
- service or feeder fee, first 56 18 2
Contact name: branch circuit
-- Each add'I branch circuit 7 42 2
— Address: Miscenaneous (service or feeder not Included)
Each manufactured or modular I 67.84 2
City /State/ZIP: I dwellin s service and/or feeder
Reconnect only I 67.84 2
( ) F.
' I
Phone: 1 ( )
Pump or irrigation circle I I 67.84 2
E-mail: rSign or outline Iighting 67 84 1 2
"*r " -= '
1f y � +` 'yhn ^s Signal ci rcuit(s) or limited - energy , I Page 2 1 75 UL �
':•:'•''• . .: ' ,'tea r . ' -' r1 : -, Business name: West Side Electric Co., Inc. panel, a dds t tiona l i extension. l g e i
Each addil inspection over allowable in any of the above J
j 66.25/hr I
Address: 1834 SE 8 Ave. Additional inspection (I hr min) -V
— 1 Investigation (I hr min) I 66.25/ hr
City/State/ZIP: Portland /OR/97214 — i ( Y Industna plant ( hr mi n) 78.18/ hr I j —
Phone: (503) - 1548 Fax: (503) 736 -0677 Inspections fm which no fcc is 90 00/ hr '
s ctficall listed ('h hr min
CCB Lie.: 13306 31 I Eiie Lie.: 26 - 135C Suprv. Lie_: 4654 -S »EC:ECTRICikT _P 'r. ' ES` ...: ' '
Subtotal: 1. CC
Suprv. Electrician signature. require i ...11: , Plan review (25% of permit fee):
Print name: Randall F Roberts Date: h/11/1 Stale surcharge (12% of permit fee):
TOTAL PERMIT FEE: I Y.. C� i
Authorized signature: I I This permit application expires if a permit is not obtained within 1813
— I days after it has been accepted as complete.
i Print name: Date. i • Number of inspections allowed per permit.
440.46I5T(11 /o320MnvEB
l BuildingWa rmtts\ELC.ParmitApp.doc 07/01/10
I
2013 -05 -23 20:58 WEST SIDE ELECTRIC 15037360677 » 5035981960 P 3/3
Electrical Permit Application — City of Tigard
Page 2 — Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
:F',!I'RM��IIII��� 41 , �.Y�l�t.l ��l',�Il1 .,.1:i �$�1 ��., I1+� 1� �i '�1 •pr
Fee for all residential systems combined ... $75.00 Dexcriptlon I Q. i Kee Total
Renewable electrical energy systems:
Check Type of Work Involved: 1 kva or loss 100.70 r 2
5.01to15kva 133.56 12
❑ Audio and Stereo Systems* 1
15.01 to 25 kva , 200.34 I 2
❑ Burglar Alarm Wind generation systems in excess of 25 kva:
2 5.01 to 50 kvu 301.04 12
1--
❑ Garage Door Opener* 50.01 to 100 kvu 552.26 2
>100 kvu (fee in accordance with
0 55
Heating, Ventilation and Air Conditioning
OAR 9 - 309-0040) 2 2 •
System* Solar generation systems in excess of 25 kvu:
Each additional kva over 25 I 742 3
❑ Vacuum Systems* 100 kva no additional charge 0.0 3
❑ Each additional inspection over allowable in any of the nbovc:
Other: Each additional inspection is
66 .25/ hr I
s ,,., ,.., . .::..•: •,; s�ccifCally l isted l ( % hi-min)
r) n L00/ hi
cow ?4'caRiib
� � i _ , . rlell�,y ��L1� ; ^,i.i,:;l l�,:I��id..,. .. ;�i +!I'� :�IiA °I '�Pll:i�:�''�' � ' . I'�'':���i '
Fee for each commercial system $75.00 SubtotaP_
(SEE OAR 91$ -30 -0000) Plan review, it requi d (25% of pcnnit 100:
Slate surcharge (12% of permit fec):
Check Type of Work Involved: TOTAL PERMIT FEE:
❑ nit permit application expires if a permit i0 not obtained within 1110
Audio and Stereo Systems days after II has been urreptcd as complete.
• Number of inspecdons allowed per permit,
❑ BoileI Controls
❑ Clock Systems
® Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
n Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
n Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
IaaaildinePPrmnu \ELC PwmaAep CLR CRE.dnc Rev 0O/2 1r art
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
10220 SW GREENBURG RD 200, TIGARD, OR,
97223
Commercial - Electricial Limited Energy
199 Electrical final
06/03/2013 00:00
ELR2013-00116
PASS - No C of O
Violation Summary:
Inspector Contractor
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
10220 SW GREENBURG RD 200, TIGARD, OR,
97223
Commercial - Electricial Limited Energy
199 Electrical final
06/03/2013 00:00
ELR2013-00116
PASS - No C of O
Violation Summary:
Inspector Contractor