Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2010 -00047
Date Issued: 01/27/2010
;TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S103BB11300
Jurisdiction: Tigard
Site address: 12135 SW 123RD CT
Subdivision: YE OLDE WINDMILL Lot: 32
Project: Flaming
Project Description: Add /alter (2) branch circuits to replace a/c and add GFCI outlet.
Owner: FEES
FLAMING, DAVID Quantity Description Date Amount
12135 SW 123RD CRT
TIGARD, OR 97223 2 crt Branch Circuits 01/27/2010 $63.60
wo /Purchase Service or
PHONE: 503 - 590 -2331 Feeder
1 ea 12% State Surcharge - 01/27/2010 $7.63
Electrical
Contractor:
HEBERLE ELECTRIC
29012 SW EGGER RD.
HILLSBORO, OR 97123
PHONE: 503 - 628 -2095
FAX: 503- 628 -3076
Type of Use: SF
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 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 •AR 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: et WA1 I ' 11 0 M , 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' � OL_ nr Date:
LICENSE NO. Apr
CaII 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.
ELECTRICAL RESTRICTED ENERGY PERMIT
1 CITY OF TIGARD
COMMUNITY DEVELOPMENT Permit #: ELR2010 -00047
Date Issued: 03/24/2010
T I G.A.1k 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 1 S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 500
Subdivision: LINCOLN TOWER Lot: 0
Project: Starbucks
Project Description: Install limited energy for horns and strobes for TI.
FEES
Owner:
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555 Restricted Energy Permit 03/24/2010 $67.84
CALIFORNIA ST 49TH FL 12% State Surcharge - Electrical 03/24/2010 $8.14
PHONE:
Contractor:
SAFE TECHNOLOGY GROUP INC
6400 NE HWY 99 SUITE 375
VANCOUVER, WA 98665
PHONE: 360 - 699 -2130
FAX: 360 - 719 -1527
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: N Fire Alarm: y
HVAC: N Instrumentation: N Total $75.98
Intercom /Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N Required Items and Reports (Conditions)
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N
Other Desc:
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 OAR 952 -0Q1 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: g (1 Q C l � Q �.L Q Permittee Signature: C oV '^ 2 J
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.
Electrical Permit Application r' S FOR O FFIC E 'USE O L Y. `
Received (* E + i VzOtO ' 1+7
City of Tigard Date /By: -�) Permit No. :E
1 n 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ('��
'
`TLGARD Phone: 503.639.4171 Fax: 503.598.1960 Date/13y: �
y: Other Permit: € (�
10�- "'
"''` , -' = J Inspection Line: 503.639.4175 Date Ready/By: 1 ' H See Page 2 for
r- N otified/Method: y Supplemental Information
�- : �:�- :.r;.: Internet: www.tigard-or.gov �'
TYPE OF WORK PLAN REVIEW
❑ New construction ®Addition /alteration/replacement
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB. SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "1 - ", "1 - ".
Job no.: Job site address: 10260 SW Greenburg Road Sr or more. occupancy.
❑ Six ix o or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 500 Project name: Starbucks ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 Total 1 *
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
fl..) 67.84 2
DESCRIPTION OF WORK ( with above sq.
Limited energy, multi - family 67.84 2
Install Fire Alarm Horn /Strobes For Tenant Improvement residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 100.70 2
❑- PROPER_ T OWNER Y N 0 TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and /or
City /State/ZIP: relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
'S APPLICANT ❑ CONTACT PERSON above service or feeder fee 7.42 2
• each branch circuit
Business name: Safe Technology Group Inc. B. Fee for branch circuits without
service or feeder fee, first
Contact name: Jason Sweet branch circuit 56.18 2
Each add'l branch circuit 7.42 2
Address: 6400 NE Hwy 99 Suite G375 Miscellaneous (service or feeder not included)
Each manufactured or modular
City / State/ZIP: Vancouver WA 98665 dwelling, service and /or feeder 67.84 2
Phone: (360) 699 - 2130 Fax: : (360) 719 - 1527 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail: sales @safetechnology.net
Sign or outline lighting 67.84 2
. , CONTRACTOR Signal circuit(s) or limited- energy
Business name: Safe Technology Group Inc. panel, alteration, or extension. 1 Page 2 67.84 2
Each additional inspection over allowable in any of the above
Address: 6400 NE Hwy 99 Suite G375 Additional inspection (1 hr min) 66.25/ hr
City / State/ZIP: Vancouver WA 98665 Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (360) 699 -2130 Fax: (360) 719 - 1527 Inspections for which no fee is
90.00/ hr
specifically listed (Vs hr min)
CCB Lic.: 173731 Electrical Lic.: CLE79 Suprv. Lic.: 4272LEA ELECTRICAL PERMIT FEES .
Suprv. Electrician signature, required: Subtotal: 67.84
Plan review (25% of permit fee):
Print name: Jason Sweet Date: 3 - - State surcharge (12% of permit fee):
TOTAL PERMIT FEE: ?5 . c E
Authorized signature: G Q - u This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Adam Sweet Date: 3 -22 -10 * Number of inspections allowed per permit.
I:\ Building \Permits\ELC - PermitApp.doc 10/01/09 440- 4615T(l1/05/COM /WEB 3 (' - 6t-
, . .
01/27/2010 11:19 5036283076 HEBERLE ELECTRIC INC PAGE 01
Electrical Permit A lic .F11/FD IIIIMIN=1111111111111
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City of Tigard Orito/Hz _ kjO Permit No. €1( z oi 0 0 oa ,„4-7_
.. 13125 SW Noll Blvd., Tigard, OR two 9
010
7 2
! - 11. ' Phone: 503.639.4171 - Fax, 503 196
.W1 -
Ill Plan Review
l'r ea : -
Other Permit:
R Sec Pao 2 ihr
-- Date Rcialy/Br ' los-
InsFection Line: 503.639.4175
Notified/Method: - T(6‘ Supplemental Information
- internee werw.tigard-or,gov CITY OF TiGARD
171 :: 1 : . 7 • ''...":".. :..,:.;',:. : •, 7 :.: - .:' 1 .',:.; . .: L:2 . ..LLL:: ;: : ; ;,', 2L211:e•LIOVIt,,. '0 . 1 .•1'. :.T.': l' . ..• ,
1 so chock en that apply (submit a WA of AVM VgiiretOR GhOtlked bektV):
O New construction psd Additiordaheration/replacement 0 Service or feeder 400 smite or more 0 Building over those stories,
0 Demolition 0 Other: where the romilablo &nit outran 0 Marinas mid boa/yaws.
:-.• ' '''' ''' ' '.• ' ' ' ,. exceeds 10,000 amps at 150 volts nr 0 Floating bnildinge.
• ' . ' .• :'!' .. ' ...' ' . , .,. , : • '.. ' - - -1.,:.., r‘P' , . ', ', • ' '--! , , t" , 444., - .4 - :-.: - .--■ less to ground, or oxateds 14,000 0 Cc 41111,4,41111 •mo ngficulturni
l eri":112-C-F;;;175--Oaing 0 Commercial/industrial I=1 Accessory building nevi for ea other installations. buildings.
OMulti-farnil ID Master builder 0 Other: 0 Fire pump, El tegtenerloo of 75 RYA or
. . ., .. .. . , . , . 0 Emargeney system. larger sepomtely derived system.
'.: lt i Otitt*S '10.041j1,.',1?0 ', ,' . - ':.' :: ' , 0 Addition of now motor1ond of 0 "yr, "F'. "1 '0".
100HP or moro.
Job no,: Job site address: ( 2.- - 55 - 5 Ii.-3 , C7T 0 Six or moro rceiclontial oohs. El Rccreational vehicle parks.
City/St/AC/ZIP: _rni:/ q - 7 1-7, -3 0 ficalth.core fhailities.
-- 0 Hazardous locations. 0 Supply voltage far MOM thnn
600 wilts nominal.
Suite/bldg./apt. 00.: Project name: ri i 11_1 ‘,--- El Service or Seeder 600 amps or more.
:,...
. ‘''' .r.- ' l ''''' ..414.■ ^"'"" . '''';
Cross street/directions to job site: 41 (&)-575-------S. v...2page . = ,,, ymi Foe .m 1 ^
- New residential single- or multi-family dwelling unit.
Includes attached garage,
--__
. IMI 131
Subdivisicm: Lot no,: 100O q. ft, Or IOSS 168.54. - -
- - ' - FA, add'i 500 sq. R. or portion
Tax map/parcel no,: -,.. Limited energy, residential ES 11.1
.--.........- •I.''''m
• ,•;,: , • : , ' : , - ' : I ., • .:, „, . ..: , • : ' . ' '0 9 OtAtOrtlOri ...•**(0W ': : . ., : •• , • . .. ;...L: . ' ,.. , , . . . : : , with abova l.. ft .
t„..., 1_413.1ited energy, multi-family 111
° '
67.84
2- . C"Clik".14-fi::7'- lt'''''C'-'- CA-64.44/ ServiCes :f ins alteration and/or relocation
1 7 6Fc ( (7 k, , 200 amps or loss 100.70
1,.. t
1
• y ,PIO,OPEIR,11/. .(191 .. ;; , , • . .-.. „.,:l&Ali ,. trANT. , .. . .. .. 201 ampa to 400 amps 133.56 2
Name -1-ft-klE, 4 '111.)ValP 401 amp tl to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1.,000 amps or volts 552.16 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP:
....,--- - - rdneation ......
Phone: ( ) 5 - 1:3-3 Fax: ( ) 200 amps or less II 59.36 MI
201 to 4 125
Owner installation: This installation is being made on property that I own which is not amps 00 amps .08
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701, 401 amps to 599 amps 168.54 _ El
- granch eircutt. - rim, alteradem, nr extension, per panel
Owner signature: Date:
- A. Fee for branch eirenits with
taVtg . . above service or feeder fel;
7.42 2
oaoh branch circuit _
Business name: ... 13. Fee for branch circuits
,...- 41NO2199, without scrvico or feeder foe, a
Contact name: ,, , % - 56.18 5 2
c
■ . A.** - Tiisineh ircuit t % - 7.42 - 7 , 1 4
• „ 21
Address! g \rr.1 ■ ' 10■-)
t ItL- Each addl branch circuit
111(Weelhuteous service or teeder not Included),
City/State/ZIP: Each manufactured or modular
67.137- 111
dwelling, service and/or feeder
Phone: ( ) Fax: : '. ) Recermect only In 67.84 2
_
E : _ Pump or irrigation circle 67.84 2
., ,:.' li ' . • :., ,•,, ,,':'!'•. !,.,,••,, • ' ,,,LLL. ,•:: tillt:40401 '', . , ,' , ,„ : ,. 7 .. '.: . '
-. ot outline 4hting 67684 2
Business name: HEBERLE ELECTRIC, INC Signal oircuit(s) or limited-
energy panel, alteration, or
Address: 29012 SW EGGER RD extension. Describe: Page 2 2
City/State/ZIP: HILLSBORO OR 97123 *-
Each additional inspection over allowst an
of in ay thi above
Phone: (503) 628-2095 Fax: (503)628-3076 Per inspection
_- 66.25
- Investigation per hour (1 hr min) 66.25
CCB Lic, 152342 Electrical Lie.; 34-160 C Suprv. Lie.: 3053-S Industrial plant per hour 78.18
L
Suprv. Electrician signature, required: I II ,, • - - --- - - 7 ,„ „'',, ,',..',41AtetPacitiLlvtAErriits. • •
..._ Subtotal: Gil ,, 6,
..___
Print name: JEFFREY L. REHERLE Date: ( -7_:- co I Plan rnvicw (25% of permit fee):
.--. -_
State surcharge (12% of permit fee):
Authorized
TOTAL PERNIfT FEE. 71, Z-3,
Print name: JEFFREY ' BE ' 1 . Date: This penult application i res if a permit 15 not obtained within 180
. _ (tar alter it to boon accepted fla coinp1cte.
runeadiegmeunical,C-PerrtZ-" - " Number 440-4613T(I1/05/COMMED of inspections allow per permit.
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