Permit q CITY OF TIGARD ELECTRICAL PERMIT
` COMMUNITY DEVELOPMENT Permit #: ELC2010 -00181
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/19/2010
Parcel: 1 S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 350
Subdivision: LINCOLN TOWER Lot: 0
Project: Clean Net
Project Description: Tenant Improvement
Owner: FEES
LINCOLN CENTER LLC Quantity Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL 2 crt Branch Circuits 04/19/2010 $63.60
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 04/19/2010 $7.63
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:
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 OAR 95 - 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: ■kc_- 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 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.
04/19/2010 MON 11:34 FAX 5036242938 Willamette Electric Z002/002
•
Electrical Permit Application RECEI
:,•.-;:•: .,.-:,:'•••;,:: .
.• .• •:....„........_••••.:••• • •• •::.....
...,.....:::, City of Tigard Received
Permit No.,e,a.........1010-60181
• 13125 SW Hall Blvd Tigard OR 97223
2 Phone.: 503.639.4171 Fax: ' 503.598.1960
IN APR 1 9 21 ty
ateil3y: Other Permit:
Ti G11 P. Inspection Line: 503 CITY OF TI
.639.4175 40 e Read
Juril: Vi See Page 2 for
' D GA fi
Internet: www.tigard-orgov 'hod: Supplemental Information
tYPCtiF....*0)1F( ..:;-.-.:::::'::::.....:,•,:,...,;:- :,:'," :;'','''.'":.:!:':'•-':'..':..'::'',::'..;'.:;.:-. .;-- .:, kiAIS:' :4Y-1`4) ).•:::
.,, .. .
0 New construction Eil Addition/alteration/roplacetnent Please check all that apply (submit 2 sets of plans wlitems checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
Ei Demolition p Other: where the available fault current 0 Marinas and boatyards.
exceeds 10,000 amps at 150 volts or 0 Floating buildings.
' • ';'• • I ''-'.:: ' ,' • "':',"•'...'•:"•:;': - • .'.; ;'.. '''J ::::?-'?..; V,;,,'
,-: ; - ,,j • :, . --: : r ,'"' " .. ' . ' ''' , . '. ' ..- ' . ' ' ' . . .' . • '" '' ' . ' ' ' ' ' ' '. ' .. ' less to ground, or exceeds 14,000 0 Commercial-use agricultural
0 I- and 2-family dwelling 0 Cornmercial/industrial 0 Accessory building amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or
larger separately derived system.
::;;:',,, ',•••••;.!:::::::. , 1 '.:,•,"•::::?:'; (4);',..Ats11:1 : . 1 ., , ,, :.
-. .- :..,' 0 Addition of new motor load of 0
10011P or nore, occupancy.
Job no.: • c . 2 - Job site address: /( h. f , e .,,, 4 / 2,"
./1. . .,.. ,- 0 Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: 7, t 4; r I e .,,K . D Health-care facilities. 0 Supply voltage for more than
0 Hazardous locations. 600 volts nominal
6 - uitglbldg./apt. no.: 3 - Project natne: ("? ,- -e ,71- 0 Service or feeder 600 amps or more.
'.';,::,.::'::.':.'':...;.-;:::::.]::,.:'..''''::''. ' ' ' #.E . S,0404- 1: :•: :. :,.' ' : I ' .: .' ' ' ''' ' • T " . ..., '''
Cross street/directions to job site: Description 1 Qty. I Fee. 1 meal I
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
67.84 2
lI)1EScRIPITAION::OF..::.* :,:..,, ::..,.._:, ...:.::::' y,...,::: (v..ith above sq. 0.)
Limited energy,inulti-family,
, .........- 67.84 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
:' . ,.t*itopOttie:::ip:y0W.y5',': : :. : i :; 1;:::: , ::: . :•: : :: : ::::I r :::... 0 :',ItNA)NT '::: ::";:r1' 201 amps to 400 amps 133.56 2
Name:
401 amps 10 600 amps 200.34 2
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/or
:
relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 I
1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 25.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 70!. 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
.. ' - . a O[iSTACI ':,-.':: ::': above service or feeder fee,
742 2
Business name: B. Fee for branch circuits
without service or feeder fee, / c1 /-%
Contact name: 56.18 2
,,
rust branch circuit
Address: Each add'l branch circuit / 7.42 7 7 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
67.84 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
CONTRACTOR :. •: -';.' :: ::.1 -:::: : .; , :;,:;:' , j:::. , .. Sign or outline lighting 67.84 2
-
Business name: Willamette Electric Inc Signal circuit(s) or !United
energy panel, alteration, or
Address: P.O. Box 230547 extension. Describe: Page 2 2
City/State/ZIP: Tigard, OR 97281 Each additional inspection over allowable in any of the above
Per inspection 66.25
Phone: (503) 624-3631 Fax: (503-) 624-2938 .
Investigation per hour (I hr min) 66.25
CCB Lic.: 75059 Electrical Lic.: 34 Suprv. Lic.: 4226 ..C. Indusuial plant per hour 78.18
ti.:WilION
Suprv. Electrician signature, requircd ----.. Subtotal: 4.
Plan review (25% of pcnnit fee):
Print name: David Fife Date:
State surcharge (12% of pcnnit fee): 7 ..,_-....i.
Authorized signature: TOTAL PERMIT FEE: 9/ ,"::....7- 11.23
This permit application expires if a permit Is not obtained within 180
Print name: Date: days after It has been accepted an complete.
' Number of inspections allowed per permit.
1:139ilding .Pclinits Apo dos 10'01 09 440-4615 11 05 WEB