Permit 1 CITY OF TIGARD ELECTRICAL PERMIT
` COMMUNITY DEVELOPMENT Permit #: ELC2010 -00362
Date Issued: 07/16/2010
T,1GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 parcel: 1S1 6/2010 004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 410
Subdivision: LINCOLN CENTER/TWO LINCOLN Lot: 0
Project: EXTERRO
Project Description: (8) branch circuits and (1) data telecommunications
Owner: FEES
LINCOLN CENTER LLC Quantity Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555 8 crt Branch Circuits 07/16/2010 $108.12
CALIFORNIA ST 49TH FL wo /Purchase Service or
PHONE: Feeder
1 ea Signal circuit or Limited 07/16/2010 $75.00
Energy Panel
Contractor: 1 ea 12% State Surcharge - 07/16/2010 $21.97
CHRISTENSON ELECTRIC INC Electrical
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 $205.09
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 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.
Issued By:
d- - Permittee Signature: oil( v �/ �� ` C`5 2 7- /0,00
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.
JUL -15 -2010 THU 07:56 AM CHRISTENSON ELECTRIC,INC FAX NO 95034193695 P, 01/03
IVI111.t ()t1llI1.01)NI1
Electrical Permit Applicat'_� Permit / /� o,� C, / / ,e,,, -
I 5 " ''
' City of Tigard I � 1 f Qi@ np 1eJ° � / — 00/3 � �
:-., -,i.i..:: a 13125 SW Hall Blvd., 1'i6ard, OR 9
plan Review Other Perm) 1 Q
Phone: 503.639,4171 Fax: 503.5, 1 2�U F TIGARD f�rlo I I� m see Pagt 2 for
((1 l 1 vV Cato Ready/By: � ■la
Inspection Line: 503 - 639.x N otified/Method: Supplemental information
- � .: Internet: www,tigard- or.gov BUILDING DIVISION
+E OF WORK - REVIEW
Please check all that apply (submit 2 sets of plans w /items chocked below);
❑ New construction Addition/alteration/replacement ❑ Service or feeder 400 amps or more GI Building over three stories.
where the mailable fault current El Marinas and boatyards.
Demolition titer: exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
CATEGO Y 01? CONSTRUCTION agricultural
loss to ground, or exceeds 14.000 ❑ Commercial ngr
Accessory bud
(] 1- and 2- family dwelling ConhmercisUindttsuial ❑ A I'Y s nmps for ull other installntions, buildings.
El Fire pump. ❑ lnetallntion of 75 KVA or
[] Multi- family ❑
Master builder ❑ Other; 0 rr agency system. larger separately derived system.
" ••1 -2° " .3 "
JOB SITE INFORMATION AND LOCATION ❑ Addition of ne motor loud of 0 "A occupsticy,
`' 100HP or more
i' l. Job si te address: I Q C) ` —.k �J y am` Y )V`� ( ❑ Six or more res identia l nnita. ❑ Recreational vehicle parks.
Job no.. j � ` 1 I �� % _ ❑ Supply voltage for Moro than
City /State/ZIP:
_ [f Health -are fucilitiaa, 600 voll9 nominal.
. .n .,� ..� ❑HIwardoua iocntiana.
�L' i L
❑ Servko or feeder 600 amps or Moro.
Suite /bldg. /apt. nl� ) ' ojeet name: t.-_-, e.,,,Nu --:.-4,, , tA `i _ --r. FEE SCHEDULE Oa Mon
�DU pie. 'Enrol "
O . site:
Crossccl/dirc J ( - Nov residential s or multi - family dwelling unit
I y Z l j` -- �L! In cludes attachedgar'age.
— _. — — j(:17 (.)! � C� 7.t..., 7�. 1,000 s q. [t. or less 166.54 4
I Lot no.:
Subclivisi0n: _ 1. --- Ea. add'! 500 sq, ft. or portion 33.92 l
Tax map /parcel no.: - Limited energy, residential 75.00 II
_ with above ft. OF WORK energy, mu
hi- family 75.00 2
- � rr1 I f / :L �- residenual (wtQ, above .-..it.
III
C . FI �, � ,��G ilk S ervices or feeders installation alteration and/or relocation
+ 200 amps or less 11®33.75°6 N
,y ,• 1 \ rti l.Y 1 ( 201 amps to 400 amps
ti l )� R� �` ''� d 'I NANT 8
Q PROPERTY OWNER _ . - 401 amps to 600 amps II 200.34
Name: 601 amps to 1,000 3 01.04 2
00 amps 2
Over 1,000 amps or volts 552.26
Address: _ Temporary services or feeders Installation, alteration, and/or
relocation 1
City/State /Z1P: - 200 amps or less 59.36
Phone: ( ) 1 l' ) 201 amps to 400 umps _ 125.08 _ 1 Owner installttion: This installation is being made on property that i own which is not 401 amps l0 599 amps
168.54 1 2
intended for stile, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Ilrnnch circuits- new alteration, or extension, per panel
Date: A. Fee for brunch circuits with
Owner signature: above service or feeder fee, 7.42 2
D _,PLICAN'T 0 CONTACT PERSON each branch circuit
/� H, Pea for branch circuits without C - /
Business name: / , / r1/ - 4.. ./ ,(•! Fe f or fader fc i first 5 6 . 18 J�'
' branch circuit
f/ t.
Contact name: Fach add'1 branch circui
Miscellaneous (service or feeder not Included - / .
Address: ^ rush martufhctured or modular 11. 67.
City /State /ZIP: - _ dwellin- service and/or feeder
_ I Reconnect only 67.84 Phone: ( ) _ l rte:: ( - Pump or irrigation circle c 67.84
• Sign or outline lighting 67.84
E - mail: - Si circuit(s) or limited energy • C
Mill
r ONTRACTOR
/Y a„ol, alteration, or e x ansian . Pa. 2
Business name: A V. - - \ %\ ' ' , 1. ,_ ., Each additional inspection over allowable in an of the above
1 Additional inspection (1 hr min) 66.25 / hr
,1 1
/ , 1 1 i ii I/��i LLB , ( - L' � '
Address: � -
- 66,25/ hr
1 \ �� i l/ I (� t y SnVCatigltlon (1 Ihr Mtn)
1 �' 61 0 1 Industrial pl ant (1 hr min) 78.181 hr
• City /State/ZIP: (,\-\ (,.0(\(:) \: ;, r
_ � � jC ! Inspections for which no fan is 90,001 hr MR Phone: 8,/ j� ' C - l _) ^ 7 - i � q: J - D s itiCal! listed h hr min
' i t . rv. Li ELECTRICAL PERMIT PEES t' r
CCB Lic.: Electrical Lic.: r � > > Subtotal: !.ry7
of fee): ,
— Pla revi (25%o pe ,R __
Suprv. Electrician signature, required: /FM A n �illiit�li
} p ate: / /n of permit fee):
Print name: ) , ! l l,� �' i 1 / I ` s State surcharge (12 TOTAL PERMIT FEE : „... try lgrd
Tbia permit application expires if u permit is nut obfnrne . wl t in 180
Authorized signature: days after it has been accepted as complete.
Date: • Number o f inapecti one allowed per permit. A � 5 '' O
Print name: _---- _---- (tj I l c�
n �.
.... ...--- :...gar r_n..mirAmr.dac 07I01 /10 440- 4615r(11 /05 /COM/WEO
77e-/"-S7 f�TC' �� /
JUL -15 -2010 THU 07:56 AM CHRISTENSON ELECTRIC, INC FAX NO. 95034193695 P. 02/03
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIA WO RK'ONLY: $
Fee fot a ll residential systems combined ..•
Check Type of Work Involved:
0 Audio and Stereo Systems*
0 Burglar Alarm
a Garage Door Opener*
❑ Heating, Ventilation and Air Con.diLioning System*
❑ Vacuum Systems
Other;
COMA W ORR ONLY: $75.00
Fee for eac commercial
sy stem .......................
(SEE O.AIR 918- 309 -00
Check Type of Work Involved;
0 Audio and Stereo Systems
0 Boiler Controls
Q Clock Systems
i' - ,, jU,._a Telecommunication Installation
(„ R
. E Alarm Installation
❑ [VAC
0 Instrumentation .
0 Intercom and Paging Systems
0 Landscape Irrigation Control*
Medical
a Nurse Calls
0 Outdoor Landscape Lighting
a Protective Signaling
Ejl Other
Total number of c systems:
*No licenses are required. Licenses are required
for all other installations
• .. _ a mh1UIU