Permit CITY OF TIGARD ELECTRICAL PERMIT
.71
COMMUNITY DEVELOPMENT Permit #: ELC2010 00528
T I G A R. D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/28/2010
Parcel: 1S 135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 200
Subdivision: LINCOLN TOWER Lot: 0
Project: Comsys
Project Description: Electrical for TI.
Owner: FEES
LINCOLN CENTER LLC Quantity Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL 21 crt Branch Circuits 09/28/2010 $204.58
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 09/28/2010 $24.55
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 $229.13
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 0 952- 001 -0100. You may obtain a copy o le direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued B 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' 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.
09/24/2010 FRI 8:36 FAX 5036242938 Willamette Electric Ij002 /002
•
Electrical Permit ApplicatioRECEJVED FOR OFFICE USE ONLY
City of Tigard Received Date/B : e l ail Permit No.: — • O
'r 13125 SW Hall Blvd., Tigard, OR 972235 EP 2 4 2010 Plan Review
II ! .. Phone: 503.639.4171 Fax: 503.598.1960 D Other Permit:
TIGARD Ins ctionLine: 503.639 Date Rcad /B Juris. 0 See Pa e 2 for
Internet: www. tigard•or.gov CITY OF TIGAR Notified/Method: 7yrc Supplemental Information
BUILDING DIVISION
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition /alteration /replacement Please check all that apply (submit Z sets of plans wfilems checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling 51 Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or .
JOB SITE INFORMATWO ❑ Emergency system. larger separately derived system.
—° o��(oo ❑ Addition of new motor load of ❑ "A", "E", "1-2", "1.3"v,
Job no.: > lob site address' 100HIP or more. occupancy.
��'4f t� ti 7 ^YY Ph t. ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: 7.1 �, �, ❑Heahh -care facilities. ❑ Supply voltage for more than
G ❑ Hazardous locations. 600 volts nominal.
cite/ ldg. /apt. no.: %L f , r Project name: ` e - ❑ Service or feeder 600 amps or more.
,-..,-,5",,,, J FEE SCHEDULE
Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 Total 1 •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. fL or less 168.54 4
Ea. add'I 500 sq. ft or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi- family
75.00 2
--.1.
2°,14, rrn "ton/.e .-r�.t0it residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or Icss 100.70 2
❑ PROPERTY OWNER l ❑ TENANT 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 or volts 552.26 2
City/State/ZIP: /State/ZIP: — Temporary services or feeders installation, alteration, and /or
t3 relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 I
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
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee 7.42 2
each branch circuit
Business name: 13. Fee for branch circuits without
service or feeder fee, first 7 56.18 l� 2
Contact name: branch circuit
Each add'I branch circuit PO 7.42 4... 2
Address: Miscellaneous (service or feeder not included)
City /State /ZIP: dwelling, servicec andor modular
/or feeder 67.84 2
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail: Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited - energy
Business name: Willamette Electric Inc. panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: P.O. Box 230547 Additional inspection (1 hr min) 66.25/ hr
City/State/ZIP: Tigard, OR 97281 Investigation (1 hr min) 66.25 / hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 624 - 3631 Fax: (503) 624 - 2938 Inspections for which no fee is
90.00/ hr
specifically listed ('h hr min)
CCB Lic.: 75059 Electrical Lic.: 34 -283C Suprv. Lic.: 4226 -S ELECTRICAL .PERMIT FEES
Subtotal: ,20% �_
Suprv. Electrician signature, require - " o
Plan review (25% of permit fee):
Print name: David Fife Date: State su rcharge (12 %ofpermit fee): 4/ r
l
9 " /v a
TOTAL PERMIT FEE: a 29 /3
Authorized signature: This permit application expires if a permit is not obtained within 180
Print name: Date: • days after it has been accepted as complete.
Number of inspections allowed per permit.
t' 1BuildingWcrmitAELC •PermitApp.doc 07/01/10 4404615T(I I /05 /COM/WF.a