Permit CITY OF TIGARD ELECTRICAL PERMIT
11111 COMMUNITY DEVELOPMENT Permit #: ELC2011 -00445
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/05/2011
Parcel: 1 S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD
Project: One Lincoln Subdivision: LINCOLN ONE Lot: 0
Project Description: Install outlet for alarm system.
Contractor: FRONTIER ELECTRIC OF WASHINGTON INC Owner: LINCOLN CENTER LLC
7217 NE 99TH STREET BY SHORENSTEIN PROPERTIES LLC
VANCOUVER, WA 98662 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 360- 892 -4342 PHONE:
FAX: 360- 892 -1559
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 08/05/2011 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 08/05/2011 $6.74
Type of Use: COM Electrical
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 applicable law. All work will
be done in acc ance h 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. ATTE ION: Orego la. - quires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -00 thro gh OAR 9", #01 -00• a. You may obtain a copy of the rules or direct questions to OUNC by ca,, a 03.232 1987 or 1.800. 2.2344.
Issued B • _ / / �1 Permittee Signat 1111W
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.
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Electrical Permit Application FoR omer. t'si: ONl.\
City of Tigard AUG 0 5 2011 Received d #11---1WarN Permit No.: --
eLe a) .5
!.. 4
. • 13125 SW Hall Blvd., Tigard, OR 97223
iii Date/B : D 1,„,•/'
,_ Plan Review
' 2 Phone: 503.718.2439 Fax: 503.598.196 IN OF TIGAilD Date/13 Other Permit: / 95 siod-aocy A
T1 GAl21.3
Anspection Line: 503.639.4175 R eady/By: tuns: lii See Page 2 for
BUILDING DIVISIOI\ D No at ti e fi R e
Internet: www.tigard-or.gov Supplemental Information
Y Ii . i' l : F74.at./ .. i i " 145 7% 7 0 45 T1.4 1 . 1 WM 71 ? *- 4 'WS:4* , 0* . t - 4 # - .;:: : " . tr=7:K.4iiiv i:w'
0 New construction EZ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w/items checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
*1g 0 1 1 1W, j ZW.TatriM exceeds 10,000 amps at 150 volts or 0 Floating buildings.
:.:-Y2Y - ,-; 'f•V , - ..:-.* '42"1,. - .V,i'-' ' , . `-- ' -4- ... ; ' ', ",* ,:: .•_,;, less to ground, or exceeds 14,000 0 Commercial agricultural
0 1- and 2-family dwelling 1:81 Commercial/industrial 0 Accessory building amps for all other installations, buildings.
El Multi-family 0 Master builder 0 Other: El Fire pump. 0 Installation of 75 KVA or
- ,-, 0 Emergency system. larger separately derived system.
?%.P"-tUViblirr,N11104%*re ; : .. '......'''..di
0 Addition of new motor load of 0 A E 12
,, .+1,7Mx,i,: , ,,. -... ......7,V.....-- 't, ,:. .: :-',. ,-.. ', . '71t, 'i -;,,. ..`.4. "", "", " - "
Job no.: ' I Job site address: 10300 SW GREENBURG RD 100HP or more. occupancy.
0 Six or more residential units. CI Recreational vehicle parks.
City/State/ZIP: TIGARD, OR 97223 El Health-care facilities. 0 Supply voltage for more than
ID Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: I Project name: SHORENSTEIN TIGARD 1 LINC El Service or feeder 600 stops or more.
efLAR
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single- or multi-fatuity dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'l 500 sq. ft. or portion 33.92 1
Tax map/parcel no.: Limited energy, residential 75.00 2
Wa : ' a ' a •141.0a1 (with above sq. ft.)
Limited energy, multi
INSTALL OUTLET FOR ALARM SYSTEM residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
,: I'VrOlOrMiltIAAM ":1i. , .. - .141 201 amps to 400 amps 133.56 2
-..wx
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
Temporary services or feeders installation, alteration, and/or
City/State/ZIP: relocation
Phone: ( ) I 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 10 599 amps 168.54 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
1 ,0234 % ='' ' '' ` .IZatterattli1 v,eatrii-WilaArgp: :xx..,4*0 „'--: above service circuit or feeder fee,
7.42 2
each branch
Business name: B. Fee for branch circuits without
service or feeder fee, first 1 56.18
56.18 2
Contact name: branch circuit
_
Each add'l branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular
City/State/ZIP: 67.84 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E-mail: . Sign or outline lighting 67.84 2
"IWW,,4 :- AW V. ktn Signal circuit(s) or limited-energy
Business name: FRONTIER ELECTRIC panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 7217 NE 99 STREET Additional inspection (1 hr min) 66.25/ hr
City/State/ZIP: VANCOUVER, WA, 98662 Investigation (I hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (360) 892 Fax: (360) 892 Inspections for which no fee is
90.00/ hr
specifically listed OS hr min)
CCB Lie.: 64005 2/11.6$.1 Electrical Lie.: 37-436C I hit 1 Supr : 3367S 4-a7gadrAttenlICAL VERMrT TEES
«'/ // 5 Subtotal: 56.18
Suprv. Electrician signature, ta ' red: c -":"-- ,,, - / Plan review (25% of permit fee):
,
Print name: LARRY GIBSO _ P 1Date: I : i' 0 . State surcharge (12% of permit fee): 6.74
TOTAL PERMIT FEE: 62.92
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: LARRY GIBSON Date: 08/04/2011 * Number of inspections allowed per permit.
IABuildtnePermits 1 ELC-PermitApp doc 07/01/10 440.1615T(1 1 /05/COM/WBB