Permit n CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
e • COMMUNITY DEVELOPMENT Permit#: ELR2013-00260
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/17/2013
Parcel: 1 S135AB04500
Jurisdiction: Tigard
Site address: 10250 SW GREENBURG RD 110
Project: Family Health Subdivision: 1991-055 PARTITION PLAT Lot: 1
Project Description: Low voltage for data
Contractor: PROGRESSIVE TELEPHONE SYSTEMS&COMMUNI Owner: LINCOLN CENTER LLC
PO BOX 190 BY SHORENSTEIN PROPERTIES LLC
GRESHAM, OR 97030 555 CALIFORNIA ST 49TH FL
• SAN FRANCISCO,CA 94104
PHONE: 503-665-4900 PHONE:
FAX: 503-665-4830
FEES
Description Date Amount
Specifics: Restricted Energy Permit 10/17/2013 $75.00
12%State Surcharge-Electrical 10/17/2013 $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: 1 Fire Alarm: 0
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 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 • •- •'th 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. • ENTION: Oregon aw requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-08 -0010 through OAR 952-101-1!•r. Yo I may obtain a copy of the rules or direct questions to OUNC b - 987 or 1.800.332.2344.
Is ued By: • / Permittee Sign• •!: /_'..Og (71,"
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.
From: 10/14/2013 09:48 #606 P.002/005
10/14/2013 07:40 503598196 rir 0 CITY OF TIGARD PAGE 02/S4
Fro : , ,1 RI \ tl , 10/11/2013 13:44 0504 P.001/002
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Electrical Permit AnD141441,;1..h:i-,,-Tics, • rm.:01:11, 1.1.;s1.4.,■\1.1
City of Tigard 1 ' '`U\1\I 1 1/44)4'i '''j'i-' "*Icd / Affill Arni
- 1,NeV _Cutely; ie ' ..___. P`gmitNw ELtelei_AfX,02.4re)
I 13125 SW Nall Inv&Tigard.o....,*,-m.,,..37 4 Es;i3
' • Plume: 503.718.2439 larci?515&398AM- ' ' Detettly; Others Parrett: t 490/5-..02/0 7
,,,,,,, lospostion Lian 503.639.417,4 -.- ...--. . , Dare Rouly/Ely: 1 . 1
, SP Sce Pep I tor
' . Wilmot: wwl:b8mIL-at•Sovia I l I L,..-0:c.i.-•ei.t., bratifred/Methete 1 Sopalawaitsltakvanoten
•-
•,..45iNgatt..7fitoga '.:,, ,..;:•.;:::. 1:.:•:,.... ...',',000,4y,a;.•:'2;:ATil.,2.-t: -.1V Takatietatit#011441*OM, ,4VIVS:1
-0 New ecesiniction tvft AdditiOnJokerationhcplacentent Nesse(Week MI dot apply Noliset a sear of nem Wawa.decked below);
['Service or theder 400 mem or more C Bonding ever dues swiss:
0 Demolition •Other: sehero the&Wattle&tit cum CI Murices and bowed.,
013.11*77=017ZMil..;,WPWX:;;YO ■'.'qArt 4/61661 I aiX/D arnia it 150 VON or 1:1 Flowies beadiest
ILI41+4:-41 hat ta gram;or caned.14.000 13 COMMITeig.070 window
[I I-and 2-family dwelling b7.•Commerciat/indestria1 0 Accessory building ewe for ell ether Wesel/ekes biASeas.
0 Multi-11May 0 Master builder 0 Other Mire maw. Clastallniot of 130 KVA of
•itate.:47.Y..nr.i.:T.R.01,■'.717774 :...,.-7','..-,. ., 3.:,,F.-1:.'45A-4,,fiiplz,:l crsdil:„7,Z14,,,' kw of 0-luArt.V.a.f,21"117"edi_r. "am'
Job DO. 19m.,-17 Job Site address: I.09-60.5k)etetia.,,tbil ild men- etcupeacy.
0&X or Imre tesideatio1 amita 0 listraalinaal wha Palm-
--
Cky/StidearP: 7,1'''-j.cict....t. (1)ft C17;3:;•3 0 Reddieare nagrier. 0 Surely volley fee were then
. / 0 laterdess*sem don wits nortineL
Suite/bldg./RA.no.: 1(O 111 namo:Voti. e,.. _bar jgrC4at9L.,m• Cavite or Soda 600 rope as were.
Cross stroot/dirceticma to job site: --74ttr,1...y 1/64-4.r7- .... E90_. •
,..
Ott Tee. Teta •
----...---e- New realdattird dash-or tenItWhntIty dwelling unit
Iodate attached grams
Sutxlivision: I Lot 00.: 1,000 sq.ft or Ina 168.54 4
- Eil.Adiri 500 so.it.or portion 33.92 1
Tax map/parcel no.: waked menlY,=Wendel
77,7","17=:!"'?•VARti:VAN*WANVitgrANO,440,t'V '.fvegq:FWCtir41.5, in(iAtit&I'm fit'fil- 7500 2
1.01tesifeern Malltamib
t'eita-a C-ft76 1_1(a..11L-r-4,-14 0.6)...062.1 residadral(with above ta.ft) 75.00 2
41edieilidsle'llairb..;:4 •••••:• ..:,:, t.c:of=7.11g;=;:;i;,.,:-..,-,:.,..,
&Mtn or Wm humilities,alkorlementeVar rehrofior'-'
31:3f, AMASIOCC,•4441Lingragt.?,24AnalgOVOOMA?-li*M 213,--°"micla /40770-r- -2
201 amps to 400 amps _ 133.56 2
Name7r2-tridzi ri.Q.CLL+44. 44x-r-i-oc-rs 401 awe.600 amps ..,
200.34 2
Address: I D,p5e, Si.6 t .r.0,,,,,,k)Ls.reh R a ,E.$1,...,:kz, it 0 601 amps 101.000 amps 301.04 2-
-- Ova 1,000 acsio a vette ST2.26 - 2'
City/State/Z1P: -1- - ' t(;) 2.
-■ °-ve ( Temporary services or feeders installetten,alleration,andlo
Plt011e:(SO) 61413,40 S S nee:( ) -!711
AO tap ee Leo 59.36 1
Owner installation:This installation is being made on property that 1 own which is not - ----
201 amps 10400 aram__ ___5,08 2
intended for sale,lean,rent,Or exchange,according to ORS 447,449,670,and 701.
401 amm to 399 amps 168.54 2
Owner signature: Date: _ Brooch*mitt-new,al34101340,or 449404344 wonei
:•: "6!`$.'"?.1,Raite.400.4§-St.MtINVWF.t.ga-glt0
0 " ti
.7;100****3eifr:, 4.k? ell retilleit cttcjitta widt
- •,• above service or feeder fee,
Bustler:0 nameTliznovss.1.1w.
•.8.1.04 Kest.4...-ge..at.:4.41-1 c:3-. ex-r-w.../4-: oath branch circuit 742 2
- - ------------- 13..Pee 6sr brad eieetels WORM :
Colithet thenverri:.AA- 7.tLe>b 4.4 tervice or feeder 9ee,first
. .. . - eireti
36.19 2
Addros: .. •
1.4 6 Each add')branch amen 1 7A2 2 „ - ,
:
hilwelbroectu(service or feeder not Inekdod)
CO)/State/ZIP: ea._.1.-Ls 1‘4-....4. Ora Ce/c5 3 6
..._.......-.4. . Each matalfactunx1 armadillo irut4 2 !
Phoug:(603) t.R.j,5;4 get) Fax::603) wis-. 2436 melee and/or feeder
Reconnect only . 67.es 2 : '
.E.121,1:., 71.!...,i.?"4752'.2. 12,.... ...... PaatP or brillatiax sileie 67.84
2 •
..i.J.. .LI:i41:lia...,-.1•-ttsia:3's.'"? ' . •'` '..4;41,44:1„;;!;0'..1'.q.:SiV•Zl:::.',W1'..:1.7. Sigo or outline lildein8 67.84 2 .
15/15ine33 `-:
•Ca°" q44-6)"?'"A einelSkgnia.rilcbatetalitiort.14)GrorlinlitaUtaeratboolon :13' 1 Sr°
Page 2 76'c't 2
Address:.20 N'i.5 b,g, -a,Bb K. i q 0
...-
/e4a44.
Rath addfdrand inspection ever allowable lie any of tha above
natant!impost=(1 br rhori)
City/Stott:MP:0#72 S____....._ 6),2 -f-/O 1) Invadmilon(1 hr miss) 66.25/1x
Phone!(SCS &IL C. 4 q t-0 Pax;(CD N 6 to S-■iLef 1 6 ladostrial plan(1 le ran) 78.18/le •
• .C.L.e
CCB Lie.:i So 0( Eloctrical Ltc.. A....w.....iika••• --- In fa Muds ISO tbe i9
I Suprv,Lie,:-')5 g LE'rA :....&Al limed te • 90.00/lc .
f •
ty-;:;;;:ir.V1'*,:.•:a. 5777".fr ""' >,*,!.: MIXOliil2, v:!.."Ii
Supre.Electrician signature,required: - q:VI
&knack 7.5-",41,e
Print namc: V0411./ '11 \./(• (a\--• vErcitc:_12/.21.22 r•3
, ci-1_1-3 Plan review(2546.2f2ersait fee); (-----.-
Si*init69194 OM arper49t.(04): e Cc'
Authorized signature. ••• . 4, .2,1._ TOTAL Mb=FES: g - i.,
---..
rat permit tvialmtion tvIrm a mask fa mt*Mama 61.I M
Pril"'MUM irling.g,I -RLCA41-... Date: (0 f i .Z4 UP/An'lt Ma ken ecmpted as templet.
...........
' 'Rumba Of 14tTata 44S allamd tm porta .
IalatIdittehnollatC.P •'MOM&=atm 91.03/217041-. _ •SIOMI MI teourowww
c..g.12.0.. rt, ..,c,,,,ic..,, 7ci./,‘- kJ U.vvv..1..... LD0..... k...00 fa,r. •
•
From: 10/14/2013 09:51 #606 P.003/005
10/14/2013 07:40 5035981960 CITY OF TIGARD PAGE 03/04
From: 10/11/2013 13:48 #604 P.002/002
Electrical Permit Application-City of Tigard
Page 2-Supplemental In1onnation
Limited Energy Permit Fees: Renewable Energy Permit Fees:
.7a,,40.';711,1.7-)--,i;A.P::. .7Mga.W.Wa gaNggiFAM,=•.:=4,70ralian=
Fee far all residential systems combined..-... $75.00 trne immozrienniut
Renoweldet*dried Ewa system:
Check Type of Work Involved: 3 ha COCOS 1111 100.70 Ini
5,01 to 151not m 133.56
El Audio end Stereo Systems" mei aim:rya 200.34
W d?menden means th cum o5 25b& .
El Burglar Ahum 25.01 to 50 kva 303.04 2
2...
D Garage Door Opener* sax!le 100 5s26 kit El
WO kva(lee hi
OAR 4 s52.26
2
O Healing,Ventilation and Air Conditioning 912-30040
saw geneentlen system in men of U leve:
SyStallk
EarAl additional ken eves 25 III 7,42 El
O Vacuum Systems' >100 klis-no addttienol dodge Ill 0,0 El
rob.additions!leapoction owe ellowattle in we ti the above:
El Other: _ , Seth additional inspection is ii6.25/10 I
I tit 1.:4111 • .J.L. •••■•••• .-
FRRREENIIIII sow itt
e.2 176..i'c'v4.:;:ii :".;:- IttititWienSDAVRA atiagi ct qgvik;F:v.TiialutahlezeMi
Fee for each commercial system.....----.-..... $75.00 Subtotal:
(SEE OAR 918409-0000) _Plan review,it mooted(25%of;tank fee): Nur
State curlew(12%dpennit foe):
Check Type of Work Involved: TOTAL PERMIT RE 111Matal
Tips pawn , .J ., ,,• . if a penett is net obtained .■-IRO
0 Audio and Stereo Systems dap area libse bcca mensal+a crptete.
6 linntbat aim/00Am Owed per penal
0 Boiler Controls
0 Clock Systems
Data Telecommunication Installation
O Fire Alarm Installation .
,
0 HVAC
•
El Instmmentation
O Intercom and Paging Systems
•
O Landscape Irrigation Control* •
O Medical .
. .
;
0 Nurse Calls
.•
O Outdoor Landscape Lighting" .
0 Protective Signaling • .
0 Other .
•
Total number of commercial systems: •
. :
*No licenses are required. Licenses are!required •
for all other installations
.:•
,,..u.geworr.kate_pc.sAnsut..ukthee 11.,MAZIRD13
From: 10/14/2013 09:47 #606 P.001 /005
PT�c
%,fle treae 74%re Mere aeArvoirAf oirs
facsimile
From:I P To:CC1Z1 ,C',- ...
20 NE Hogan Dr
Gresham, OR 97030 Fax 5°3" 59S-i9 6:20
Phone: 503.665.4900 i D t r I l 3
Fax; 503.665.4830 Date: `-C
kathyp@ptsc.biz
Pages: S ti C, Csciv-rjr—
Regarding:
Comments:
i I
OR CCB 150175
r
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10250 SW GREENBURG RD 110, TIGARD, OR,
97223
Commercial - Electricial Limited Energy
199 Electrical final
2013-10-30 (null)
ELR2013-00260
PASS - No C of O
Violation Summary:
Inspector Contractor