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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2011 -00083 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/07/2011 Parcel: 1 S135AB01003 Jurisdiction: Tigard Site address: 10300 SW GREENBURG RD 270 Project: Silverado Funding Subdivision: LINCOLN ONE Lot: 0 Project Description: Electrical for TI. Contractor: WILLAMETTE ELECTRIC INC Owner: LINCOLN CENTER LLC PO BOX 230547 BY SHORENSTEIN PROPERTIES LLC TIGARD, OR 97281 555 CALIFORNIA ST 49TH FL SAN FRANCISCO, CA 94104 PHONE: 503 - 624 -3631 PHONE: FAX: 503 - 624 -2938 FEES Quantity Description Date Amount 4 crt Branch Circuits wo /Purchase 02/07/2011 $78.44 Specifics: Service or Feeder 1 ea 12% State Surcharge - 02/07/2011 $9.41 Type of Use: COM Electrical 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 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 -0090. You ma ob.:'• • •y oft • r direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: !% � ����� Permittee Signature: /IP 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 the next available inspection date. 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. 02/04/2011 FRI 15:07 FAX 5036242938 Willamette Electric Iii] 002/002 Electrical Permit Applieatio r p! FOR OFFICE USE ONLY City of Tigard Received 1 i)ateR3 : /y ��� 1 Permit No.: , _ n 13125 SW Ball Blvd.,'Pigard,OE 97223 Plan Review ' C : Phone: 503.639.4171 Fax: 543.598,196 4 2011 Da te/l3 : Other Permit: f t A P t a iii.....c o u T i G A RD Inspection Line: 503,639.4175 Date Ready/By: kris: See Page 2 for Internet: www.tigard or.gov CITY 0` i p , Notifed/M �" ethod: ' e Supplemental Information (? ` TYPE OF NB ' A PLAN REVIEW P lease check all that apply (submit 2 sets of plans w / items ch ecked below): ❑ New construction X Addition /alteration /replacement ) 0 Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF .CONSTRTICTiON exceeds 10,000 amps at 150 volts or 0 Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ I- and 2- family dwelling 0 Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. 0 installation of 75 KVA or JOB SITE INFORMATION AND LOCATION © Emergency system. larger separately derived system. 0 Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.: Y 77 Job site address: � /1 N ca /� ® 1 ix or a. occupancy. �' 1` z° P lI �l •r-i /4 Gf ❑ Six or more more residential units. © Recreational vehicle parks. City /State/ZIP: / / l) - 4Y c, e.2 ,4 �j 7 7 _ 57 ❑ Health -care facilities. 0 Supply voltage for more than / ❑ Hazardous locations. 600 volts nominal. UI ldg. /apt. no.: 76 Project name: ---- ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description . I Orry. I 1 Fee. I Total 1 New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 4 168.54 I 4 Ea. add'I 500 sq. ft. or portion 33.92 I Tax map /parcel no.: Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) -� Limited energy, multi - family C n H residential (with above sq. ft.) 75.00 2 r �i�vt �rCi i1 P rY(, �: , l Services or feeders installation and/or relocation 200 amps or less 100.70 2 ❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 Name: 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 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 0 APPLICANT I ❑ CONTACT PERSON above service or feeder fee, each 42 2 each branch circuit Business name: B. Fee for branch circuits without service or feeder fee, first / 56.18 re,: !e ' 2 Contact name: branch circuit Each add'1 branch circuit 3 7.42 ;. ? 4. 2 Address: Miscellaneous (service or feeder not included) City / State/ZIP: Each manufactured or modular 67.84 2 dwelling, service and/or feeder Phone: ( ) Fax:: ( ) Reconnect only 67,84 2 Pump or irrigation circle 67.84 2 E -mail: CONTRACTOR Sign or outline lighting 67.84 2 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: F.O. Box 230547 Additional inspection (1 hr min) 66.25/ hr City /State/ZIP: Tigard, OR 97281 Investigation (I hr min) 66.25/ hr Industrial plant (I hr min) 78.18/ hr Phone: (503) 624 -3631 Fax: (503) 624 -2938 inspections for which no fee is 90,00/ hr specifically listed1/ hr min) CCB Lie.: 75059 Electrical Lie.: 34- 283C Suprv. Lie.: 4226 -S ELECTRICAL PERMIT FEES Suprv. Electrician signature, required:' —• Subtot Plan review (25% of permit fee): Print name: David Fife Date: !' r l State surcharge (12% of permit fee): / r� TOTAL PERMIT FEE: l 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. 1: 1Nuiiding1l 'ermits5ELC.PcrmitApp.doc 09/01 /10 440.4615T01/05/COM/WE6 L