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Permit r'V ""' " "`r`'`_ ELECTRICAL PERMIT . , : . ...` :.. '' q CITY OF TIGAR® ph 1 ', a COMMUNITY DEVELOPMENT Permit #: ELC2009 -00653 t G AR O 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/10/2009 T Parcel: 1 S 135AB03400 Jurisdiction: Tigard Site address: 10260 SW GREENBURG RD 400 Subdivision: LINCOLN TOWER Lot: 0 Project: Regis HQ Global Project Description: Add /alter (2) branch circuits. Owner: FEES LINCOLN CENTER LLC Quantity Description Date Amount BY SHORENSTEIN PROPERTIES LLC, 555 CALIFORNIA ST 49TH FL 2 crt Branch Circuits 12/10/2009 $63.60 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 12/10/2009 $7.63 Electrical Contractor: COCHRAN INC 626 SE MAIN ST PORTLAND, OR 97214 PHONE: 503 - 234 -6564 FAX: 503- 238 -2098 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 D OAR9522- 001- 011 Y 952-001-0100. You 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: r 1 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' Cp . Date: 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. • PITON COCHRAN— BROADWAY (WED)DEC 0 2000 15: 17 /ST. 15: 10 /No. 7500000700 P 1 Electrical Permit ApplicREC City of Tigard 9 2009 Rece! l �l Z>9t • ©0(0 • [ ( Pcnnit No.: Fy1 .� Other Permi: 1 3125 S W Hali vd., Tigard, OR 91/}23 Phone: 503.639.4171 Fax: 503.59R.19�( .C,G Date/By: AV P2 o c co 22.0 T 1 G a R C) Inspection Line: 503.639.4175 �1� /-� O ltl Date Ready /By: nris: ®see Page 2 for Internet www tigard or gov ��„ .DING ��� is Noufied/Method T t Supplements! Information 1_ TYPE oS1 '* _ -,�- . _- to "l::: : "' "�"'' l ❑ New construction .1' • ddition /alteration /replacetnent Please check all Thal apply (submit 2 sets olplans 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. ,.,..,, f c M g - t `'' y ?.w „ ,__ - ,_n exceeds 10,000 amps at 150 volts or [,:l Floating buildings. '° " `"� -^�^ less to ground. or exceeds 14,(00 ❑ Commercial -use agricultural ❑ 1 and 2- family dwelling_ 1;3 /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or larger separately derived system. JOB Sfy'l iNECORM�K' ION I > A .1l U N x ❑ Amergen system. 9 t`d _, 1 1 D � � �� G N P, P r b ti ^ CI Addition of more. tnr load of ❑ " c Job no X1�0(° J Job site address: I QOHP or more. occupancy. I�C� ❑ Six or more residential units. ❑ Recreational vehicle parks. `� ` f ❑ Healthcare facilities. ❑ Supply voltage for more than City / State/ZIP: - '�� !,� Q r� Gi r) 22� ❑Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: N I Project name: l e (l. S 1 ` ❑ Service or feeder 600 amps or more Cross street/directions to job site: Description , Qty. I Fee 1 Total I • New residential single- or multi - fancily dwelling unit. Includes attached garage. 1,000 sq. ft. or less 168.54 4 Subdivision: Lot no.: Ea. addl 500 sq. ft. or portion 33.92 1 fax map /parcel no energy, residential Y -. fir "".r -ii Limited id :.c-- ,w-. _ • _ 6 ?,. s r *f (with above sq. fl.) 67.84 2 n Limited energy, multi - family 67.84 2 �„` ot 5 ry 1 c eg t 1 �I 1,, _ residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation 200 arnps or less 100.70 2 " -s_001 _ _ _ _- o a �' 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps orvolts 552.26 2 City /State /ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) Fax: ( ) 200 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, 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 ]��4 APPEIC� x � _ ` j . 1[ ° � above service or ('ceder fee. 7.42 2 r} each branch circuit Business name: Mc a s Co ntraCtt r B. Fee fo•branch circuits Contact name: without service or feeder fee, j 56.18 56 rg 2 first branch circuit _ I Address: Each add] branch circuit 1 7.42 '7, VLi 2 Miscellaneous (service or feeder not included) City / State/ZIP: Each manufactured or modular dwelling, service and/or feeder 67.84 2 Phone: ( ) Fax: : ( ) Reconnect only 67.84 2 E -mail: Pump or irrigation circle 67.84 2 �-- c --.. =a=x * 4 .' Sign or outline lighting 67.84 2 1 Signal circuit(s) or limited - Business name: 0c_h rail f Vl C - energy panel, alteration. or Address: ( Z4 SE Nom) S #, extension. Describe: Page 2 2 City /State/ZIP: p . c 4 . t c x 9 4 Each additional inspection over allowable in any of the above Per inspection 66.25 Phone: ( ) 2_34- ( 5 04 _ Fax: (, ) Z3 $ 2-c Investigation per hour (1 hr min) 66.25. ,- CCB Lic.: 1 29 42_ Electrical Lic 3154 `' Suprv. Lic.: 3441,5 Industrial plant per hour p ��� 7 � 8 . 1it 18 p Wit 4 �•' AVetig�4 a r'f Ns Suprv. Electrician signature, required: ,� c(,....DA Subtotal: 63 (4, 7 Print name: 1‹,..1 h -�' [Date: {' 1 q log Plan review (25% of permit fee): L ( l State surcharge (12% of permit fee): 1 . (1)" Authorized signature: TOTAL PERMIT FEE: 7 (, 23 This permit application expires if a permit is not obtained within 180 Print name: Date: days tiller it has been accepted as complete. • Number of inspections allowed per permit. Building Periods' ELC- PermiiApp.doc 1001.09 440- 1615T(I 1'05•COM•WEB Q jQV rav\ ,le\,-Q--'