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Permit • x CITY OF TIGARD a ELECTRICAL PERMIT ' te COMMUNITY DEVELOPMENT Permit #: ELC2010 -00377 r :' Date Issued: 07/22/2010 7 jGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S135AB01003 Jurisdiction: Tigard Site address: 10300 SW GREENBURG RD 410 Subdivision: LINCOLN ONE Lot: 0 Project: Buckendorf Project Description: (1) branch circuit for new receptacles. • Owner: FEES LINCOLN CENTER LLC Quantity Description Date Amount BY SHORENSTEIN PROPERTIES LLC, 555 CALIFORNIA ST 49TH FL 1 crt Branch Circuits 07/22/2010 $56.18 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 07/22/2010 $6.74 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 $62.92 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 ap•'. =ble 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 's -usp nded for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Thy-- rul= are set forth in OAR 952 - 001 -0010 through • r 952-001-0100. You obtain a copy of • • -s or • irec • . estions to OUNC by calling 503.246.66• • .32. 344. Issued Permittee Signature: _ 1w 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. 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. Electrical Permit Application FOR OFFICE USE ONLY City of Tigard e cteived `r g te / 29/ O Permit No.: faK_ 1c) q 13125 SW Hall Blvd., Tigard. OR 97223 C IN t X 7 7 an Review = Phone: 503.639.4171 Fax: 503.598.1960 Q DateiBy: Other Ferric Q T I G A K D Inspection Line: 503.639.4175 l` . ale Ready/By': Jm is V ® See Page 2 for Internet: www.ligard - orgov 11 ll a 2 7. i ililiediMethod: TTC0 Supplemental Information TYPE OF WORK v 11CiA PLAN REVIEW ID New construction ddition /alteration /replayfi�i�t 3 o ivlSlO Please check all that apply (submit 2 sets of plans wiitems checked below): 0 gUlL�1N�' ❑ ❑ Service or feeder 400 amps or more ❑ Building over Three stories. Demolition El Other: where the available fault current Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑ Floating buildings. Tess to ground. or exceeds 14.000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling .`ommmercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency' system. larger separately derived system ❑ Addition of new motor load of ❑ "A" "[' "I -2" 1 -3 Job no.: ��o(b@ ��lttt �� ��•��� lob site address: 10300 5W &fee h!( or Rd I(1(I or mare occupancy. n I `'µ � ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State /ZIP: Ir a n// 9 72-2 ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: Project name: sbuek era 0 i t ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street /directions to job site: Description 1 * P 1 Qtr. 1 Fee. 1 Total 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. fl. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential ' DESCRIPTION OF WORK (with above sq. ft.) 75'00 2 Limited energy, multi-family 2 1 residential (with above sq. ft.) 75.00 I � STu �� (�c�J (�ec e ( u. Services or feeders installation, alteration, and /or relocation 200 amps or less 100.70 2 ❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2 Name: 401 anps to 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 1 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps (68.54 2 Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with APPLICANT above service or feeder sec, ❑ ❑ CONTACT PERSON each branch circuit 7.42 2 Business name: G�C M� �S C 1 (\- fa_ , -- 13. Fee for branch circuits without � "� v` service or feeder fee, first ) 56.18 , it 2 Contact name: - � t „, "_ , e branch circuit ` Each add'l branch circuit 7.42 2 Address: Miscellaneous (service or feeder not included) Each manufactured or modular City /State /ZIP: dwelling, service and /or feeder 67.84 2 Phony (3 (ip ) Q !� I v `15233 Fax: : (.03 ) 235- 2_09e Rcconnect only 67.84 2 E -mail: Jc(' \i 1G i GJ'\ Pump or irrigation circle 67.84 2 CQJ — �`� (hG . G M Sign or outline lighting 67,84 ., CONTRACTOR Signal circuit(s) or limited- energy Business name: ` v panel, alteration, or extension. Page 2 2 can `c., Each additional inspection over allowable in any of the above Address: ' 5 50 5W 1 ec_h Ce_nker *22o Additional inspection (1 hr min) 66.25/ hr - ©(� (1 7 2. Investigation (1 hr min) 66.25/ hr � City /State /ZIP: l6 .0 „ `( Industrial plant (1 hr min) 78.18/ hr Phone: 503) 2_3q /056, (I Fax: (j3 ) 23 LDa $' Inspections for which no lee is specifically listed (Y hr min) 90.00 / hr CCB Lic.: 12 cic_iZ Electrical Lic.:375L6 Suprv. Lic.: ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: \( ...k— \c, Subtotal:. 5.42'14/ 1 / Plan review (25% of permit fee): JO .74/12 • Print name: yt p o�* Ka-A-0 Date: State surcharge (12% of permit fee): ' \ TOTAL PERMIT FEE: (v2 9Z Authorized signature: This permit application expires if a permit is not obtained within 18(1 days after it has been accepted as complete. Print name: Date: * Number of inspections allowed per permit. Ir Ru ildinp l'ermns F l _C-Pc, InilApp.doc 0 ' 440- 46151(11,054'0M,