Permit
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit ELC2009-00598
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/05/2009
Parcel: 1 S 135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 465
Subdivision: Lot: 0
Project: Spec Space
Project Description: (2) branch circuits for TI.
Owner: FEES
LINCOLN CENTER LLC Quantity Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL 2 crt Branch Circuits 11/05/2009 $63.60
wo/Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 11/05/2009 $7.63
Electrical
Contractor:
COCHRANINC
626 SE MAIN ST
PORTLAND, OR 97214
PHONE: 503-234-6564
FAX: 503-238-2098
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $71.23
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 actor ce 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. ATTE ON: Or -,,,n I requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-00hrough OAR 2-00 1 0. You may obtain a copy of the rules or direct questions to OUNC by call i D3.246.6699 or 1.800.332. 344.,
f
Issued B(: Permittee Signatur • /c°
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' f 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.
-r'~ROM COCHRAN-BROADWAY (WED)NOV 4 2009 70: 53/ST. 10: 52/No. 7500000235 P I
,.p r
CEIVED
Electrical Permit A Plicati R r
City of Tigard NOV 0:3 2009 Received Permit No.:
,.?00 'Cb59g
3 4 9~t
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
= Phone: 503.639.4171 Fax: 503.5980YOF TIGARD Date/By: Other Permit. 1z t!Qd
O
Inspection Line: 503,639..4175 BUILDING DIVISION Date Ready/By: tuns: ® See Page 2 for
Internet: www.tigat-d-or.gov Notified/Method: SupplementalInfnrmalion
❑ New construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans wiitems checked below):
[J Service or feeder 400 amps or more [I Building over three stones.
El Demolition El Other: where the available fault current
❑ Marinas and boatyards.
- de rr
ss7y? exceeds 10.000 amps at 150 volts or ❑ Floating buildings.
M, less to ground, or exceeds 14.000 ❑ Commercial-use agricultural
❑ I -and 2-family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi-family ❑ Master builder ❑ Other: ❑Firepump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
34$ SITi IU2JvF!lTi(5N~1 aN ❑ Addition of new motor load of
Job no.17Y40q-2432/1 site address: /6,300 JCt) IOOHPormore. occupancy.
❑Six or more residential units. ❑ Recreational vehicle parks.
iff ❑ Health-care facilities. ❑ Supply voltage for more than
CI ty/State/ZIP:
❑ Hamrdous locations. 600 volts nominal.
Su iteJbldg./apt. no.: ~p Project Hartle: ❑ Service or reeder 600 amps or more.
Cross street/directions to job site: oeser ran Fee Torar
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Tax map/parcel no.: Ea. add'I 500 sq. ft. or portion 33.92 1
mow, Y~y_W` A
Limited energy, residential 67.84 2
{ssr
r s , i ._m _ _ !'L~t_'~ (with above sq. ft.)
2 o t Limited energy, above q
ft.) 67.84 2
residential (with th sq. ft
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
a P_111w?#i~_tV~' 201 amps to 400 amps 133.56 2
IOWA Name: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
CitytState/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 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: Branch circuits - new, alteration, or extension per panel
A. Fee for branch circuits with
C}pAFI t ' x ` J1 s above service or feeder fee,
cc) 1 7.42 2
Business name: G CL S TYl I T~G~D each branch circuit
B. Fee for branch circuits
(
Contact name: without service or feeder fee, / 56.18 Sit 2
! ► t first branch circuit (O
Address:. Each add'I branch circuit 7.42 %f- 4 2
Miscellaneous (service or feeder no included)
City/State/ZIP: Each manufactured or modular
67.84 2
dwelling, service and/or feeder
Phone: (sue) ej a-79 1 U Fax:: ( ) Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
Sign or outline Iighting 67.84 2
Business name: C och ra n I vie Signal circuit(s) limited-
energy panel, alteration, or
Address: I Z sE t_kgtn extension. Describe: Page 2 2
City/State/ZIP: fa w nd U~ q iii Each additional inspection over allowable in any of the above
Per inspection 66.25
Phone: ( '2-34- (a5(o~ Fax: 2255 ~d
Investigation per hour (I In min) 66.25
CCB Lic.: -T 29 42- Electrical Lic.: '3 4{o C Suprv. Lic.: al t 4'(,S' Industrial plant per hour 78.18
Suprv. Electrician signature, required: Subtotal:
Print name: y- Date: ~.f Plan review (25% of pennit fee):
ki'f) A C~~ State surcharge (12% of pennit fee): ~j
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print Hamc: Date: days after it has been accepted as complete.
' Number of inspections allowed per permit-
1: Building Perin its- F-LC'-PeimitApp.dnc 10'01+09 440-4615T(11,05-470M•wEB