Permit CITY OF TIGARD ELECTRICAL PERMIT
= COMMUNITY DEVELOPMENT Permit #: ELC2010 -00149
Date Issued: 04/01/2010
T [ G ARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 1S135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 305
Subdivision: LINCOLN THREE Lot: 0
Project: Comsys
Project Description: Add /alter (13) branch circuits for TI.
Owner: FEES
LINCOLN CENTER LLC Quantity Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL 13 crt Branch Circuits 04/01/2010 $145.22
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 04/01/2010 $17.43
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 $162.65
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 thr sigh OAR 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
r 1
Issued By: \ Lc c,LV1J. / \ \ 1 f ) , I �' Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' fl n ), /� Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
04/01/2010 THU 10:19 FAX 5036242938 Willamette Electric I7L.j002/002
Electrical Permit A licatian -r "' sE•012 OFF`IC'E °:li$G'O`L'ti'. ,,. %.::.,:;,,
City of Tigard
2 010 Received
:
'"'''''....',/.;,',75;....'f..., .. .,
W I Penni' No.:'t ,. / ` 00
N. • 13125 SW Hall Blvd., Tigard, O 2 Plan Review
■ : Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Olhcr Permit:
T f G A RD Inspection Line: 503 Date Ready /By: Ea See Page 2 for
• Internet: www.tigard or.gov, ..k Notifed'Mcthod: Supplemental Information
'' '',TYPE OF PLAN RI NIFTY
❑ New consttvction IA Addition /alterationlreplacement
Please check all that apply (submit 2 sets of plans w %items checked below):
❑ Service or (ceder 400 amps or more ❑ Building over three stories,
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF' CONSTR UCTION':. exceeds 10.000 amps at 150 volts or ❑ Floating buildings.
• "' less 10 ground. or exceeds 14,000 ❑ C:omnere,al -usc agricultural
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: 0 Fire pump. 0 Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB •-S1TE INFORMATION AtND LOCATION Q Addition of new motor load of
10011P or more. occupancy.
Job no.: -,•3 /l / Job site address: /67-2:2,e) - � < / ��/Le� /,)�K�(C�'�' , eC
—( / ` ❑ Six or )Wore residential units. ❑ Recreational vehicle parks.
\ / ❑ Health -care facilities. ❑ Supply voltage for more than
y / / T�
City/State/ZIP: /State/Z,IP: n � ‘ \ O .
❑ Hazardous locations. 600 volts nominal.
i /bldg. /apt. no. f ) /� Project name: C'.. .� O Service or feeder 600 amps or more.
F'ER SCHEDULE
Cross street /directions to job site: Description Y qt,. 1 Fee. l •ro1a1 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'l 500 sq. ft. or portion 33.92 1
Tax map /parcel no. Limited energy, residential
DESCRTPTIOiV OF' VnORK (with above sq. R.) 67.84 2
- y /'G Limited energy, multi - family
- 7 - -(4-A, 1 -/- / ' - it /72 w residential (with above sq. fl.)
67.84 2
- 7 �1^ Services or feeders installation, alteration, and /or relocation
200 amps or less 100.70 2
0 PROPE1RTY .OW' 1 : ❑ TENANT 201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
601 amps to 1,000 atnps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City/State/ZIP: 7'emporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or Icss I 59.36 1
Owner installation: This installation is being made on property that 1 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. Fcc for branch circuits with i
❑„ APPL8CtiNT >I ❑ . CONTACT PERSON ' above service or feeder fce, 7.42 2
each branch circuit
Business name: 13. Fec for branch circuits
without service or feeder fee, 1
Contact name: .
/ 56. I8 2
first branch c
Address: Each add'l branch circuit /0, 7.42 9 C,._ -/ 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
•e: , •.;'CONTRACTORS..' . Sign or outline lighting 67.84 2
Business name: Willamette Electric inc Signal panel, er or limited -
/ energy p 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 (1 hr min) 66.25
CCB Lic.: 75059 Electrical Lic.: 34 -283C Suprv. Lie.: 4226• .5 P P r 78.18
Industna plant hour
,PEItiM11T FEES i
_ .._ ....... ELEC )
Suprv. Electrician signature, require' Subtotal / ' -
d -
Print name: David Fife Date: Plan review (25% of permit fee):
/ , / C / Statc surcharge (12% of pennit fee): /7 u --
Authorized signature: TOTAL PERMIT FEE: J.., --
Print name: Date: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
* Number of inspections allowed per permit.
l: Bu,Idingd•crn its 01.C•PenniIApp.doc 10'01 440.4615T(11 ('OM WEB