Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
1111. I: COMMUNITY DEVELOPMENT Permit#: ELR2013 00269
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/29/2013
Parcel: 1 S135AB01003
Jurisdiction: Tigard
Site address: 10330 SW GREENBURG RD
Project: Red Lobster Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Low voltage for fire alarm
Contractor: TYCO INTEGRATED SECURITY LLC Owner: LINCOLN CENTER LLC
2815 SW 153RD DR BY SHORENSTEIN PROPERTIES LLC
BEAVERTON,OR 97006 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503-469-7206 PHONE:
FAX: 503-469-7114
FEES
Description Date Amount
Specifics:, Restricted Energy Permit 10/29/2013 $75.00
12%State Surcharge-Electrical 10/29/2013 $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 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 -ccordance •ith approved plans. This permit will expire if work is not started within 180 days of ' • ce, or if work is suspended for more the 180
days. A' ENTION: Orego law requires you to follow the rules adopted by the Oregon Utility N•''cation Center. Those rules are set forth in OAR
952-001 0010 through OAR 95 ••• :'90. You may obtain a copy of the rules or direct questions to OUNC by calling .• L3'. •87 or 1.800.332.2344.
Issu=• By: ' AIL 1 Permittee Sign. • -• �i•L_ ri'_
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.
Fax: Oct 25 2013 07:42am P001 OOd
1:41104,1,111 111.•411/ .1 GA RilII tt1JNI11.:4111111 (i
EIVED h R OFFICE 1;5F.tiNl_Y
III City of Tigard t,'tc �� 1
,r DateJB : e 'Al Permit No.:EL,e £0l3-d0�l0 9
13I25 S W Hall Blvd-,Ti 7223
Flan Review
Phone: 503.718.2439 Fax: 503.598.1960 Datdb : Outer Permit:
I 1 t;.,,r:D Inspection Line: 503.639.417A r-,T 2 g 2013 Date Readyaty; 7wis: @ SRC Page 2 for
Internet: www.tigard-or.gov Notified/M tbod; Supplemental Inrormation
•1:;:l ' ICI M np�' ° 1 1� t s1� 9• ., W1,,r , : e.••la,I, :1' • .,.1ro -n 1<if si i ' . -Aiiii; 4 :K1{�� 1 7if7T; � �, ,4:Kwlr 1li:.y Nfill ;'� ! .41 i � 4
IE l r - nat!..ii"uit l•l ya.,;E 4Vi 3
❑New construction •21r l• g iPeulanetn ]t Please check all that apply(submit 2 stns of plans w/items checked below):
�' iryq(�,�U9YIJl�J
❑Demolition ❑ �•,���'''" ❑��or feeder�amps or more ❑Budding over three stones.
hh'[ ?�D `olio' 'Il.§l ji d l, r:. ,: �' Siy: nrm.a d:, .rxp}' o:rA,:,r, n , tyI,;,q:F whore the available fault current ❑Mantas sad boatyards.
j_� S l}�tJ1 !!11 !Yl�'1;, �l�'a':I, ,of .pay tl ; ft rr I fi ' ' ,. y'1 � I.!t4....i. �i,;., ,iI'al' exceeds 10,000 amps r 150 volts or ❑Floating buildings.
k : alai.,..r i,,. itj.j .,l
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fir?pump. ❑Installation of 150 KVA or
'I ,.1•-. r,, �l ,d 'llrP r {+'" b. err,; C� kt -:Iq: n' . -1 ❑Emer nC system.
1TM:;: ',l`1'r 11' r'r I�'. 1 y,t;r i r11 l • i 1' 3'�� (l i i rt 1 ! .I 1.TI R)i t 1 ge Y Y em. larger separately"1-3",d system.
l ,.� a.I I m 16i: aI a. tut s i _ motor load of
❑Mafiosi of now ❑"A","E",'•l-Z";"1-"a''.
Job no.: 0 1 S2-7 Job Site address:/0 3 3 0 S 0 4-gEd/r/e d l ooh or more. occupancy.
❑Six err more residential units. ❑Recreational vehicle parks.
City/State/ZIP: 7---/4-A d t✓,e ❑Health-care facilities. ❑Supply voltage for more than
❑Ha>ardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: W4-6 `0,6 7- -7 ❑$eryioe or feeder 600 am,s or more.
Cross street/directions to job site:
.11;:177.1.40V D 1; 1illik `i: tit.TAL ' !i.1i t.ri,q '.!tig9 ;al N �I
nexription oh. Fee Total r
New residential single-or multi-family dwelling unit.
includes attached garage.
Subdivision: Lot no.: _1,000 sq.S.or less 168.54 aµ
Tax map/parcel no.: Ea.add'1500 sq.1i.or portion 33.92 I
�'4r 1�,I &�� i.� li Il' y s� '4'a�4� ;1 I I t Limited energy,residential 75.00 2
itiiL e i^I IIII .li i 1 IIGU,:7 J' 1 7 i. fl 't I � l i.�..1��fl.� I Iii ih 1 Ii�14' (with above so-ft.)
I f/ Limitedenergy,multi-family 75.00 2
&/ {,e, Ni' /'i >2, #'�/// ` residential with above ..ft.
Rene ':ble nargY '❑,See Page 2.
Services or feeders rs installation, lteratl on,and/or
relocation
i1 r L! ,�19P IIr r a " t lt(a; a iiiiP , `1iI5 coed,;, .'I p 11 ' h ,.. 200 amps or less
a • l •, I , :.+ !4i1a «,, kil.
100.70 2
Name:
201 amps m 400 amps 133.56 2
401 tulips to 600 amps 200.34 2
Address: 601 anips to 1,000 amps 301.04 2
City/State/ZIP: Over 1;000 amps or volts 552.26 2
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
snips to 400 amps 125.0$ 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:
;4 r''°' i ` i�tl S I : "i ':Vv.,:,.; m Branch circuits-new,alteration or extension. 1 CC anel
t 1!i';'1 iii! al'r m i. 1" ! r 61'!' r,'i' I1, A.Fee for branch circuits with
n Y u �kI,... �' i�;9 t 31ii1� 1. ! r"I� L �' 'hj I '•r I, i �Il
x 6'.t e�t tk'.lI,.1 e . s 1 a Ih above service or feeder fee,
Business name: each branch circuit 7.42 2
B.Fee far branch circuits without
Contact name: service or feeder fee,first
Address: r1 a✓� branch circuit
56.18 2
/y,a' ay ._j., J 9a ,c Each addl branch circuit 7.42 2
City/State/ZIP: /A.'', % i 1/ it Miscellaneous(service or feeder not included)
..� �� �/ �fP Each Itianufactured or modular 67.84 2
Phone:( ) - ax: : ) 2., dwelling service and/or feeder
i
E-mail: ' Reconnect only - 67.84 2
o I I pt :,,,I J Pump Or irrigation circle 67.84 2
rl,,I:riii: �'`iI111I1Ni31;uli�.�ii 1•:I # ''1�'t,I lilt I:� @t? 1� t 1 �ti phi 111 !'..i 9 .:!'
i .rn� s� .,...evil I e� au' L�I�Ui I,,. '.:�I�.,� �I'. �,.o.�,�,��.:•!�;?l,l���i��1�:�.ih:�� Sign or outline ligh4A8 67.84 2
Business name;TYCO INTEGRATED SECURITY LLC 1 Signal circuit(s)or limited-energy See
/ panel,alteration,or extension. Page 2 75 2
Address:6305 RPSEWPPD ST. SUITE A. " Each additional inspection over allowable in any of the above _
Additional inspection(1 hr min) 66.25/hr
City/State/ZIP:LAKE OSWEGO OR 97035 lnvesti$atioa(1 hr min) 66.25/hr
Phone:(855)201-1482 4 Fax:(503)675-6521 Industrial plant(I hr train) 78.18/hr,
Inspections for which no fee is 90.00/hr
CCB Lic.: 197010 Electrical Lic-: CLE322 Suprv.Lie.: 1199LEA specifics]] listed(vz hr min)
Suprv.Electrician signature,requi .• �'""�'i � + 1 ;piiJa:• •.i ,
AN e-0:! , i /: v�
- . .. Subtotal: 75.00
Print name: LELAND SLAUGHTER T ER 1 i�t: j Plata review(25%of permit fee):
{ �� State surcharge(12%of permit fee): 9.00
Authorized signature: / TOTAL PERMIT FEE: 84.00
Print name:
This permit application expires if a permit is not obtained within 180
Date: days after it has been accepted AS Complete.
• Number of inspections allowed per permit.
t:5Buildingl'erroira1ELC,PamitApp ap eR.E.Ooc lute 0$/21/2013 440-46157(11/05/CONjMEB
Fax: Oct 25 2013 07:43am P002/004
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
1 P �Itf I!I'H Ikl����1p)I 1��l�Kl�SEW��¢�I i � li �� M „.
litu lid I'. i(1I .,: tt. 1 i y �rs ZLT r
Fee for all residential systems combined...,.,,, $75.00 Description . Qtr. Fee Total •
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems' 15.01 to 25 kva 200.34 z
El Burglar Alarm VI'ind generation systems in excess of 25 kva:
25,01 to 50 kva 301.04 2
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance with
Heating,Ventilation and Air Conditioning
OAR 918-309-Q040)
552?6 2
Systeltl* Solar,generatlon systems in excess of 25 kva:
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
Eacb additional In , ctiou over allowable in any of the above:
❑ Other: Each tidditional inspection is 6625/hr 1
charge}:1 at an hourly(1 hr min)
Inspections for which no fee is
1 nr r a 1, zq y� t7 rflrall listed /:
hr ruin 90.00/hr
E " Fi�iu k '.o : .' "' ;`. ti
ac u,3�....n,.L,a,w tip '... ...I,, � I x<,� t♦Ik,. �l� 'i��lu,� ...,�,.a..a�8 i,��. �n' a F;..:.. LRn
Fee for each commercial system $75.00 Subtotal:
(SEE OAR 918-309-0000) Plain review,if required(25%of permit fee):
State surcharge(12%of permit fee):
Check Type of Work Involved: TOTAL PERMIT,FEE:
FlThis permit application expires if a permit is not obtained within 160
Audio and Stereo Systems days after it bas been accepted as complete.
* Number of inspections allowed per permit.
n Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
Fire Alarm Installation
n HVAC
[] Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
n Protective Signaling
❑ Other •
Total number of commercial systems: I
*No licenses are required. Licenses are required
for all other installations
t^l3uildingTormittaLC PermitApp ltE,deo Rev 05h1t2013
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
10330 SW GREENBURG RD, TIGARD, OR,
97223
Commercial - Electricial Limited Energy
199 Electrical final
2013-12-10 (null)
ELR2013-00269
PASS - No C of O
Violation Summary:
Inspector Contractor