Permit
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2010-00065
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/09/2010
Parcel: 1 S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW Greenburg RD 1250
Subdivision: LINCOLN TOWER Lot: 0
Project: Reinisch & McKenzie
Project Description: Add/alter (20) branch circuits for TI.
Owner: FEES
LINCOLN CENTER LLC Quantity Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL 21 crt Branch Circuits 02109!2010 $204.58
wo/Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 02/09/2010 $24.55
Electrical
Contractor:
WILLAMETTE ELECTRIC INC
PO BOX 230547
TIGARD, OR 97281
PHONE: 503-624-3631
FAX: 503-624-2938
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Tota 1 $229.13
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through O 952-001-0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.33223444..
Issued By: Permittee Signature: S- A_~ JV lU 10
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
02/09/2010 TUE .14:12 FAX 5036242938 Willamette Electric la 002 /002
Electrical Permit Application j?z - "; , ::. FOR OFFICE USE ONLY •- ::::. .
City of Tigard CE/ �t : ' _ ! •
I3125 SW Hall Blvd., Tigard, OR 97223 • •� 4
IN n R ev i ew
Phone: 503.639.4171 Fax: 503.598.1960 FE O Datc/By: Other Permit: S ( • r rf a , U .
a -, '
I I �; t RI) Inspection Line: 503.639.4175 9 ?0 Date Ready/By: t m : :-+ • ce Page 2 for
Internet: www.tigard or.gov Cf7, • - Notificd/Method: Supplemental Information
'AV M 2� r +�i:'A�o
, `,- ' +,:i'rl, P:"14s�, -:s; t '' ". 3':. ` 4 see y, s tr'i t ;• -xis Ls •,i:�4':.) ;'+'• -: ai i,•! q . +.4 ... , `: ,:., 1111 rfFFg �:: 4fr'
tN�Y , Fst; .. . f ..�a�%�•� -,�. .: ". • - �'.$f��.+�3 "��' � ^ 'e F ,��; 'T a.t�`� jkSll .�•., t'��� ,? w`3 •. �d�...� "�� � V os1 P -. V
❑ New construction - [St Addition/alteration/replacem r f Opr Please check all that apply (submit 2 sets of plans w/itcms checked below):
V
['Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
pJ P' 9 a s , u r 14 • exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
"' r "' " & z4 + �tri less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling Ce) Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
' ^ " 4 c n ir, s'; a. r s c E .si • •,, ❑ Emergcy system. larger separately derived system,
' i� aga � � a a'a1 n i ' 1 4 ❑ Addition en of new motor load of ❑ A », "E^ ^ L2 ^ i.3^
Job no,: ...6 4 Job site address: J® 100HP or more, occupation.
jai / (� /�QInb�a'1� ['Sin or more residential units. ❑ Recreational vehicle parks.
.7
City /State/ZIP: '' ; .4 J' 44 (1..... v ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
f ii bldg. /apt. no.: 49, Project name l • •seji W ' • ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: Ps7�lP ' `' Cak u%t fi ., �"'' 0a..: "`'
v' Fe - 1 Total . :c.•
Description I Qty. r Fen I Total
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: Ea. add•! 500 sq. ft. or portion 33.40 I
: r rrs fir; map/parcel / r a sfr a � ,y � yy y 5" ' _ -8j a li r F; Limited energy, residential
J r 'y3' � .... -`f# '� I '' r
::• �i��z, ddf ::�wrs_�::.e1��ar`'r.';w °=Aa�fs $�f�j�: y�'VOIl1C,��`, xtida�:r�, s's` ^agin with above sq. 0. 75.00 2
>a ,. - Limited energy, multi - family
i p .e' p.. 7 " - .... ,' R •• -, f;� ' :tr ', "rbe '"^> -'-`_•
residential (with above sq, ft.) 75.00 2
r`'
Services or feeders installation, alterat1on, and /or relocation
200 amps or less 80.30 2
MAX.. � }�+}r " , M , 4 . t }..T , .d• ,::% .Tw Lahr - +'�. .. 5 - ly.a r..' t . rl <.
,. lit•• .r. w .�e. X y2 • ':P•.., �Fi'3;: t .
�a. .�•�� . , .� �.� .. ;y;irM� t� „`<;� _ n_z. � •`y , . -: 2 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
Address: 601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) [ Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not • 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
.. Ow Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
n signature: {» .. t „ �, A. Fee for branch circuits with
° (` ,;. :.:; ' Ls'..t. 1PY'lG lCe . ,, , ; , i:+' _ r ', ; >Y ,: iai`. ,, qq ' , 4 d ,., ' : ; ..) :i ; ; _, : above service or feeder fcc
'k�r�x,t,.�s._ .. ............. :. av • . - +c::.; >, ..,1,.�,;�� , , Q�';A r � ; , t71� ;:� r '7 , 6.65 2
each branch circuit
Business name: B. Fee for branch circuits ,-.
Contact name: withou service or feeder fee, / 46.85 e, 2
first branch circuit r
Address: Each add'l branch circuit AO 6.65 `3 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: ( ) I Fax: : ( )
Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
ri ::q•s -rg$ °!: gl > ?: R)9) "' : j!)1 BACFlY1 ?; `iarsf'Kea }"3 : k:s; !ty�r's,:Fa ;t' Sign or outline lighting 53.40 2
Business name: Willamette Electric, Inc Signal circuits) or limited -
energy panel, alteration, or
Address: PO Box 230547 extension. Describe: Page 2 2
City/State/ZIP: Tigard, Oregon 97281 Each additional Inspection over allowable in an of the above
Per inspection i 62.50
Phone: (503) 624 -3631 I Fax: (503) 624 -2938 Investigation per hour (1 hr min) 62.50
CCB Lie.: 75059 Electrical Lic.: 34 -283C I Suprv, Lic.: 4226 -S Industrial plant per hour t� 0r.� j�� 73.75
Suprv. Electrician signature, required: � Subtotal: :�
2i [ ..‘'3..ii,:
/ � b o Plan review (25% of permit fee): ..--- Print name: David Fife Date: ' - State surcharge (12% of permit fee) Of •��
Authorized signature: TOTAL PERMIT FEE: : ,..„ ' . ,aac, • 13
Print name: I Date: This permit application expires it a permit is not obtained within 0
days after it has been accepted as complete.
• Number of inspections allowed per permit.
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