Permit 11 ...... CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
1 4 C OMMUNITY DEVELOPMENT Permit #: ELR2013 00160
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/29/2013
Parcel: 1 S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 525
Project: Kannact Subdivision: METZGER, TOWN OF Lot: 9
Project Description: Low voltage for fire alarm
Contractor: CAPITOL ELECTRIC CO INC Owner: LINCOLN CENTER LLC
11401 NE MARX STREET BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97220 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503 - 255 -9488 PHONE:
FAX: 503 - 257 -7121
FEES
Description Date Amount
Specifics: Restricted Energy Permit 07/29/2013 $75.00
12% State Surcharge - Electrical 07/29/2013 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data & Telecommunications: 0 Fire Alarm: 1
HVAC: 0 Instrumentation: 0
Intercom /Paging: 0 Landscape /Irrigation: 0
Landscape Lighting: 0 Medical: 0
Nurse Calls: 0 Protective Signal: 0
Security Alarm: 0 Other: 0 Total $84.00
Other Desc: Required Items and Reports (Conditions)
This permit ' issued subjec • the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done n accordance with appr• ed 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. TTENTION: Oregon law r' • • Tres y• . • • follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -0 1 -0010 thr•ugh OAR 952 -00 1 1 You s
Y • tain a copy of the rule or direct questions to OUNC by calling 503.2 1987 or 1.800.332.2344.
Iss B 0 � 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 FOR OFFICE USE ONLY
Received
� �
City of Tigard Dalte /By: By: / $ 3 �. � Permit no.: & 4 a0/5 �� _ 60 /�P�
13125 SW Hall Blvd., Tigard, OR 97223 � Plan Review
Phone: 503.639.4171 Fax: 503.598.19A1 Date /By: Other Permit.
TIGARD Inspection Line: 503.639.4175 JUL _ Ot n'3 _ Date Ready /By: _ Juris: H See Page 2 for
Internet: www.tigard- or.gov
C ,[ Notified /Method: Supplemental Information
Rpjrr OFTIGARn
TYPE OF WORIYUILJINGDfIISION PLAN REVIEW
❑ New construction H Addition /alteration /replacement Jl l � Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Demolition ❑ Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories
CATEGORY OF CONSTRUCTION where the available fault current ❑ Marinas and boatyards
❑ 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
Job no.: 131024 I Job site address: 10260 SW Greenburg Road ❑ Fire Pump ID Installation of 75 KVA or
❑ Emergency system larger separately derived system.
City /State /ZIP: Tigard, OR 97223 El Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
100HP or more. ❑ occupancy
Suite/bldg. /apt. no.: Suite 525 ( Project name Kannact T.I. ❑ Six or more residential units
❑ Health -care facilities ❑ Recreational vehicle parks.
❑ Supply voltage for more than
Cross Street/Directions to job site: ❑ Hazardous locations ❑ 600 volts nominal.
❑ Service or feeder 600 amps or more
Subdivision: Lot no.: FEE SCHEDULE
Lincoln Tower Description I Qty. I Fee. I Total
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 $ 168.54 4
Ea. Add'I 500 sq. ft or portion S 33.92 t
H PROPERTY OWNER I ❑ TENANT Limited energy residential
Name: (with above sq. ft.) 8 67.84 2
SHORENSTEIN REALTY SERVICES Limited energy, multi - family
Address: residential (with above sq. ft.) S 67.84 2
Service or feeders installation, alteration, and /or relocation
City /State /ZIP: 200 amps or less S 100.70 2
201 amps to 400 amps 5 133.56 2
Phone: Fax: 401 amps to 600 amps $ 200.34 2
601 amps to 1000 amps 5 301.04 2
Owner installation: This installation is being made on property that I own which is not Over 1000 amps or volts $ 552.26 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 5 59.36 I
❑ APPLICANT I ❑ CONTACT PERSON 201 amps to 400 amps 5 125.08 2
Business Name: 401 amps to 599 amps S 168.54 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 $ 7.42 2
B. Fee for branch circuits
without service or feeder fee,
City /State /ZIP: first branch circuit $ 56.18 2
Phone: Fax: Each additional branch circuit: $ 7.42 2
Miscellaneous (service or feeder not included)
E -mail: Each manufactured or modular
CONTRACTOR dwelling, service and or feeder 5 67.84 2
Business Name: CAPITOL ELECTRIC CO., INC. Reconnect only $ 67.84 2
Pump or irrigation circle $ 67.84 2
Contact name: DAN WILSON 503.262.0411 DIRECT Sign or outline lighting 5 67.84 2
Signal circuit(s) or limited -
Address: 11401 NE MARX ST. energy panel, alterations, or
extension. Describe: Fire Alarm 1 Page 2 $ 75.00 2
City /State /ZIP: PORTLAND, OR 97220 -1041 -
Each additional inspection over allowable in any of the above
Phone: 503 - 255 -9488 Fax: 503 - 257 -7121 P'r inspection $ 66.25
I estigation per hour (I hr min) $ 66.25
CCB Lic.: 48748 lElec al Lic.: 26 -496C ISuprv. Lie.: 3132 -S I' plant per hour S 78.18 _
Suprv. Electrician signature, required: a ��� „ ,,,k LECTRICAL PERMIT FEES`
/ Subtotal $ 75.00
Print Name: DARRELL MCNEEL Date: 06/2 /13
/ ,”
Plan review (25% of permit fee)
State surcharge ( 12% of permit fee) $ 9.00
Authorized signature: - / J � TOTAL PERMIT FEE $ 84.00
Print Name: DAR - ' CNEEL ' 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.