Permit (63) CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
III'� Permit#: ELR2019-00036
� COMMUNITY DEVELOPMENT
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/25/2019
T I t.�A I I-) 9 Parcel: 1S135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 571
Project: Trellborg Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Fire alarm.
Contractor: POINT MONITOR CORPORATION Owner: LINCOLN CENTER LLC
5863 LAKEVIEW BLVD STE 100 BY SHORENSTEIN PROPERTIES LLC
LAKE OSWEGO, OR 97035 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 503-627-0100
PHONE: 503-412-4800
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Restricted Energy Permit 03/25/2019 $75.00
12%State Surcharge-Electrical 03/25/2019 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 0
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 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 OAR
952-001-0010 through 0 52-00 090. You -v obtain .copy of the les or direct questions to OUNC by calling 5i .1987 or 1.800.33, .
/ /Issued By: p l 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 Application FOR OFFICE USE ONLY
Received
, Cityof Tigard Date/B : ,� ;. Permit#�
� /9..,,,e201:3,....
—OBD,3f
'I 13125 SW Hall Blvd.,Tigard,OR 972241Plan Review
Phone: 503.718.2439 Fax: 503.598. EC'EIVED Date/B : Related Permit# /e+2L)/9'(2��02 7
Inspection Line: 503.639.4175 Ready Date/By: Juris: 10 See Page 2 for
1
TI G A R D Internet: www.tigard-or.gov FFR Notified/Method: Supplemental Information
26 2019
TYPE;OF WORK " rte£.. PLAN REVIEW
❑New construction ®Addition/alteratidf;AIT la¢Cm l4t'ARD Please check all that apply(submit 2 sets of plans w/items checked):
BUILDING DIVISION ❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONS RUCTION g x f. ''''','":.1111 exceeds 10,000 amps at 150 volts or 0 Floating buildings.
0 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑commercial-use agricultural
amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE (FORMATION.AND LOCATIC ( / , Ad ,1 0 Emergency system. larger separately derived
0 Addition of new motor load of system.
Job#: Job site address: 10220 SW Greenberg Rd. IOOHP or more. ❑"A "E","l-2","1-3",
City/State/ZIP:Tigard,OR 97223 ❑Six or more residential units. occupancy.
0 Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#:571 Project name:Trelleborg ❑Hazardous locations. ❑Supply voltage for more than
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Descrigfion I Qty. I Each I Total I *
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 1
. DESCRIPTION OF AO:RK e9 ';''''/..P. # �":j Limited energy,residential
Fire Alarm Devices
(with above sq.ft.) 75.00 2
Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
Renewable Energy ❑ See Page 2
-0 PROPERTY OVER !... r3r,111; : ;
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: I
IrEE SCHEDULE
Description *
Fee for all residential systems combined: $75.00 n Qty Each I 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 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
❑ G• arage Door Opener* >100 kva(fee in accordance 552.26 2
with OAR 918-309-0040)
❑ 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 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed('/2 hr min)
CUM VIERCIA>,WORK ONLY: ,l TICAL PERMIT;FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Pagel):
* Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
® Fire Alarm Installation
❑ H• VAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ N• urse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems: 1
*No licenses are required. Licenses are required for all
other installations
I:\Building\Permits\ELCPermitAppELRERE.doc Rev 06/17/2015