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Permit f " CITY OF TIGARD ELECTRICAL PERMIT � =-1 ; '',, COMMUNITY DEVELOPMENT Permit #: ELC2010 00179 1 3 125 SW Hall Blvd., Ti and OR 97223 503.639.4171 Date Issued: 04/20/2010 T .IGARD g Parcel: 1S135AB01002 Jurisdiction: Tigard Site address: 10220 SW GREENBURG RD Subdivision: LINCOLN THREE Lot: 0 Project: Waldron Project Description: Pull in 4 Data telephone lines and connect to patch panel Owner: FEES LINCOLN CENTER LLC Quantity Description Date Amount BY SHORENSTEIN PROPERTIES LLC, 555 CALIFORNIA ST 49TH FL 1 ea Signal circuit or Limited 04/20/2010 $67.84 Energy Panel PHONE: 1 ea 12% State Surcharge - 04/20/2010 $8.14 Electrical Contractor: CHRISTENSON ELECTRIC INC 111 SW COLUMBIA ST, STE 480 PORTLAND, OR 97201 PHONE: 503- 419 -3300 FAX: 503 - 419 -3695 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $75.98 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 wit 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 9 2- 001 -0100. You may obta copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: ��/ t, / "" Permittee Signature: Lr � U £� Q_/ Taro- _ y' I 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. APR -16 -2010 FRI 07:30 AM CHRISTENSON ELECTRIC, INC FAX NO, 95034193695 P. 01 iectrical Permit A licati _..__th DECEIVED FoR (11.1, i,..E (Is,: „N...,. City of Tigard • Received DatCB Permit No.' y` w 13125 SW Hall Blvd., Tigard, OR 972 1 1 Y C�/0~ U v I �� Phone: 503.639,4171 Fax: 503.598, R 6 2 U 10 flan Rcviow DnteB Other Permit: Inspection Line; 503.639.4175 Ready/By: ® See Page 2 for T 1( i ,1 .1) p Date furls: Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method: Supplemental (ninrmatinn ❑ New eonslraction 1— . Addition/alteration/replacement ..... .... . .. . :.. ... . o � ! 1 I 0 r * y Y ' { I . AN I yIDw I i .. 5 Please check all that apply (submit 1 sots of plans w /items checked below). ❑ Service or feeder 400 amps or more © Building over dune stories, ❑ Demolition ❑Other: where the available fault current ❑ Marina:: and boatyards. ' ' ` ' CAT,E,OQ1 V O)? OJ� 'N' • C ' ;:, . ,, acceeds 10,000 amps at 150 volts or ❑ Floating buildings. „ C r — �,/ lesa to ground, or exceeds 14,000 0 Commercial -use agricultural 111 I- and 2- family dwelling Commcrciallindustrial CI Accessory building amps for all other installations. buildings, El Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ lnstnllarian of 75 KVA or IO,II °9YCi • ATI ' .'—' ncysystem. larger separately derived system. r Emergency y QT ItRMATION : ' ANO LO CATI ON 0 Additi of new motor load of ❑ "A ", "E ", "1.2", "1 -3• .Iob n r o.: - I"I 04) Job site address; \D' etA 1001.11) or more. occupancy, (]--/ C i Six or more residential units. 0 Recreational vehicle parks, City /State /ZIP: � • ""L / e • ' t ' ' - I :) ❑ Health-care facilities. ❑ Supply voltage for more than °Hazardous locations, 600 volts nominal. Suite/ bldg. /apt.. n0.: 1 P roject name: Q,i p, it } ❑ Servtoa or feeder 600 amps or morn, / - J PEE SCFICDULF, Cross street/directions to joh site: a ' ci4 Description J try. 1 Err. I Total 1• 1 •Y New residential single- or multi- fantity dwetting unit - 5l ) Ci " 11y ( - Includes attached garage. — Subdivision: Lot no.; 1,000 sq. R. or less 168.54 4 — Ea, add'I 500 sq. R. or portion 33 1 Tax map /purecl no.: Limited energy, residential 1)I SGRIP`I'IUN OI 'WORK . t;'i (with above sq. It.) 67.8 2 11�� � �`` Limited energy, multi - family • ck. l.` - 1 - 0 ��}( L . >A, n d residential (with above sq. ft.) 6724 3 _ "( Services or feeders installation. litteratinn. rind /or relocation -I 11 jf 1 m Q L 200 amps or less 100.70 2 L r-- J t PROPiIR'1'Y OWNER • ' 0 TENANT:" 201 amps to 400 amps 133,56 2 Name: 401 amps to 600 amps 200.34 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 - City/State/ZIP: Temporary services or feeders installation, alteration, and /ur relocation Phone: ( ) Fax: ( ) 20U 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, Icasc, 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; - - .W. A. hce for branch circuits with Q.'. abOVe Service or feeder tee, ❑ APPLI ..CONTACT. .PERSON ,, 7.42 2 each branch circuit Business name: 13. Fee for branch circuits without T ' 4 — service or feeder fee, first 56.18 2 Contact name: branch circuit Each add'I branch circuit 7.42 2 Address: Miscellaneous (service or feeder not included) _ Each manut'acurred or n,ndulnr City /StftlelZlP: _ __. dwelling, Service and /or feeder • 67.84 2 Phone: ( ) Fax: ; ( ) Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 F. -Iasi I: Sign or outline lighting ' .CONTRACTOR 67,84 2 . - Signal circuit(s) Of limited energy 1 Business nanhe :� / "Alb� _ v ,/ panel, alteratinn, or extension. I Pupc2 04. Vei 2 r -• Each additional inspection over allowable 111 any of the above 0 Address: Additional inspection (1 hr min) 66.25/ br i bui e City/State/ZIP: Ill' •k .11./A 6 / °' 9D Investigation (1 hr min) ' 66.2SIhr - ^� n r > ti industrial plant (I hr min) 78.18/ hr PhonC: J' L,Lci�'-5- `-1 Fax: t Rr� 'l 1' - o15 Inspections for which no fee is 90,001 hr 1 r pc slot ('h hr rein) ,/ 4 CCB Lie.: Electrical Lic. J / _ Suprv. Lit .; a� s K s cifically l i V . . . ELECTRICAL PERMIT.. FEES:: P Subtotal: 'e Suprv. Electrician signature, required: / .-_ 4 t 1�) \�(��p��f / 1 . Plan review (2 % of permit tee Print name: . j . ,..-•-•' . Date _ „� �� S tale surcharge (12% of permit tee): I.\ f TOTAL PERMIT FEE: , cart Authorized signature: This penult application expires if pencil is not obtained within 180 days after it has been accepted as complete. Print name: Dale: • Number of inspections allowed per permit. 1 moihli ,■ PcrniltApp,doc 7 i1/O1 /a7 4 !I'l'f 11/01,0r1MMrFn APR -16 -2010 FRI 07:31 All CHRISTENSON ELECTRIC, INC FAX NO 95034193695 P. 02 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL VVORg`OI\TLY Fee for AI residential systems combined .. $67.84 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener-* ❑ Ileating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: _ COMMERCIAL WORK ONLY: • Fee for each commercial $67.84 `1 system I (SEE OAR 913 Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems Data Telecommunication Installation ❑ Fire Alarm Installation ❑ I-IVAC ❑ T.nstrumentation • ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* U Protective Signaling ❑ Other 'Total number of commercial systems; *No licenses are required. Licenses are required for all other installations 1, 10ui1din ¢11'c1n55511:C- P.1e5IA1j P.0e 10 /51/09