Permit ' '-r" a ELECTRICAL PERMIT
=:'W' CITY OF TIGARD
•
a COMMUNITY DEVELOPMENT Permit #: ELC2010 -00115
Date Issued: 03/11/2010
T t GRRD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 1 S 135AB04500
Jurisdiction: Tigard
Site address: 10250 SW GREENBURG RD 200
Subdivision: LINCOLN BUILDING Lot: 0
Project: Spec Space
Project Description: (4) branch circuits for spec space prep wiring.
Owner: FEES
LINCOLN CENTER LLC Quantity Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL 4 crt Branch Circuits 03/11/2010 $78.44
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 03/11/2010 $9.41
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 $87.85
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in cordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ENTION: Orego law equires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -00 -0010 through OAR 95 '01 -c• • You may obtain a copy of the rules or direct questions to OUNC by callin. • 46.6699 or 1.800. 32.4344.
Iss d By: lk ' / Permi Signa _. . A ' NWT/
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' 0 , „` /�, �.�s -- Date:
it
LICENSE NO.
CaII 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each Inspection.
MAR-10-2010 WED 03:31 PM C lj.. ,645IC,INC FAX NO. 95034193695 P. 01/02
Liiectricai rermit A 1 111C: ii i v l i ' , 1 - E FoR 01..vrcE 1 !SE ()NIA
City of Tigard A , n iteceived
Decay: 1/4/ la 1.6 ' 4 PrnMrNa4 Eke-0,00-ex)//S
1 11125 SW Hall Blvd., Tigard, OR miAl 1 u ', 7_ , 0
Plan Rov
: 0 PhOne: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
InSpeetion Line: 503.639.4175 CM! OF TiGARD Date Ready/By; .11/TiS1
TIGAilD El See Page 2 for
Internet: www.tigard-or.gov
,. 'VISION Notified/Method: Supplemental Information
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1 . ,..,,, ‘., ,d;,:-,$;!,::4., ,7 .,,•■•• ;e4'7 !• • . • • • ,• , 1 ', ... . ,1 , .•:' , "•1 '',,•'.' 7■1'.,..,1,•'•'1 q
few construction XAddition/alteration/replacement Please check all that apply (submit 2 MS of plans odium checked below);
0 service or feeder 400 amps or more 0 Building over alICC 910Tics.
, 0 Demolition 0 Other;
where the available fault current 0 Marinas and boatyards.
;ii , i'...,, -, =4. 4 . , roi ,, :;.,:;„;
1 j' - , 's ',; 44cceds 10 amps at 150 vala or 0 Hwang aMIdin
- • ' "••••"" - ' ' • "-- •• ' ' ''' ' .- ••• '• •••••• •'" ' ' ' '" ' "'" ." •• '"' '' • 1ess to ground, OT exceeds 14,099 0 Commercial-use agricultural
n 1- and 2-family dwelling eCommercial/indust 0 Accessory building MPS far all other insMIlatious. buildings.
0 Multi-family 11 Master builder 0 Other: 0 Fire pump. iNk
ii 0 Installation of 75 KVA or
:-i *ti t oot,t
tifficii+46:4iiil
.- "yi:pcop:; ,, i:,:*,,:3 . ,t,i4 . ,i , i;, , , slEm9-cy 0,14TIL larger separately derived system.
....,'t , .,,;, . 6 , , ,, ,., , , ,.., ..,.. ,,,,, . r, • ••;, ' ;J Addition of new motor
100HP or more. occupancy,
Job no.: Job site address: .. 76 S i lel Ark is el I: Six or more residential units. 0 Recreational vehicle parks.
City/State/Z1P: 1.. litt • 6 • do' ivi A 4 I:Health-care facilities. 0 Supply voltage for more than
0 Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.9t do Project name: m . Spo , \D oservie. Or feeder 690 amps or mote. , .. . .
N '/Utigi44+E'Vi,i*,A4W.411:'
Cross street/dircctions to job site: b 36 Wm- bl')3- — 7 2 104(
( 0 Description 1 git 1 li'm 1 Totsi 1 ... "
New residential single- or multl-famlly dwelling unit.
includes attached garage.
Subdivision: Lot no.: 1,000 so. R. or less 145.15 4
...
— • Ea- add'l 500 sq. ft. or portion 33.40 1
Tax map/parcel no.:
. Limited energy, residential
1 '.:' ::4 _ with above sg. 113 75.00 2
Limited energy, multi-family
.1 lo....4. _ _At' ..,P 4 1 1.1 r 1 residential (with above sq. ft.) 75.00 2
t
— Services or feeders installation, alterationond/or relocation
IIESMII 1 (., 200 amps or less 80.30 2
*,00:0..430:._■.:. Ok?. ' ..tiM'A l . 1 . : ',.Y :7: ..!;!:‘ , ... '7 ii, 201 amps to 400 amps 106.85 . .
2
Name: 401 amps to 600 amps 160.60 2 .
---- 601 amps to 1,000 amps 240.60 2
—
Address:
Over 1,000 amps or volts 454.65 2
r' - /State/ZIP: Temporary services or feeders Installation, alteration, and/or
_ relocation _ _._
r,ne: ( ) Fax: ( ) 200 amps ar loss 66.85
1
Owner installation: This installation is being made on property that 1 own which Is not 201 amps 10400 amps 100.30 2
intended for sale, leas; rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits- nel•adonor extension per panel
Owner Signature: Date:
— A. Fee for branch circuits with
OKft.Ot tC , *. - ,ONi!' ,' +;'':'..!;. above service or feeder fee,
6,65 2
each branch circuit ..
Business name:
B. Fee for branch circuits 0 1
without service or feeder fee, i ei /4
Contact name: 51..85" 7y • 2
rust branch circuit
Address: Each addl branch circuit 2 vit z r c - ?Q.A61 2
- . — Miscellaneous (service or feeder not Included) ___
City/State/Z1P: Each manufactured or modular
40.90 2
,dwelling. service and/or feeder
Phone: ( ) F'ax: ; ( )
,, Reconnect only 66.85 2
E Pump or irrigation circle 53.40 2
::,:11 .r: . i:: Sign or outline lighting 53A0 2
Signal circuit(s) or limited-
Business name: Christenson Electric, loc.
energy panel, alteration, or
Address: 111 SW Columbia, Suite 480 extension. Describe: Page 2 2
. . . - .
City/State/Z1P: Portland, OR _ 97201 Each additional inspection over allowable in any of the above
Per inspection . 62.50
.....Phort19-e..4) ; (503) 5 0 S
....wei Investigation per hour (I hr min) 62.50
CCB Lie.: 458 Electrical Lic . 26- .4C Suprv. Lic.:5I5 S Industrial plant per hour 73.75
,?:2!!':'•:%
Supr
uprv. Electrician signanne, required: All. . r _ Subtota I: 7 ff . (et/
—
61,„,_,Im.r ,_
„All ie25% of permit fee): --151-•
. ..iorized Signature:
Print name: •
' r. • eLilt (1lP Ai 'JEfillIMMIM il t •
State surcharge (12% of permit fcc): 9.e.0
_ . Plan revw (
...—
TOTAL PERMIT FEE: g 7 . 47
- Tbls permit applkadon expire. 1r permit is not obtained within 180
Print name: Date:
days after it hat been accepted as complete.
' Number of inspcctio allowed per permit.
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