Permit CITY OF TIGARD ELECTRICAL PERMIT
' , COMMUNITY DEVELOPMENT Permit #: ELC2011 -00446
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/05/2011
Parcel: 1S135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD
Project: Two Lincoln Subdivision: LINCOLN CENTER/TWO LINCOLN 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 is • . -ct 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 <ccordance with a• •roved 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. A ENTION. Oregon law \re es ou to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -00 0010 throu h OAR 952 -001- 90. Yo / a /y y obtain a of the rules or direct questions to OUNC by calling 51 - '2.1987 or 1.800.33 .2344.
Issu• • By: /X4af- py " of Permittee Signatu
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.
AUG-0 5-201 1 0 : 013 FRONT Ip n. FliEITRA01 r ! ,
ikiLl 74 '
Electrical Permit Application . 1 OFFICE I'Sf: °NIS
11 Re"ived ? 5111,1 per 44
City of Tigard AUG 0 5 20 ,
Daten3 :
1 : 1 ,1 4 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
' 111 Phone: 503.718.2439 Fax: 503.598.1960 CITY OF TIGARE Date/13 • Other Pannit: P vee6/ 5
TIGARD
Inspection Line: 503.639.4175 BUILDING DIVIgl rate Ready/By: Juris. 61 See Page 2 for
Internet: www.tigard i... "INotified/Method: Supplemental Information
,.:. ct. _`' ....7!.:': - :
4? TAZ:0,:tWi ., '!'.?':.4' r.. I Ei. .: '. : PIN gEYSW ' ...'."
0 New construction rgi 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.
O Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
l i .: Witi4-MtiVtailiii7-0 1 # - .0 ,;:1".;7t:t70,71g.V exceeds 10,000 amps at 150 volts 0 g bungs.
less to ground, or exceeds 14 or Floating
,000 D Commercial agriculmral
O 1- and 2-family dwelling isi Commercial/industrial 0 Accessory building amps for all other installations, buildings.
o Multi-family 0 Master builder 1:1 Other: 0 Fire pump. 0 Installation of 75 KVA or
--- ,k , ,2it,:tf.„. :_k, - 4.:„.1 . e ... ; ,=,<..,%. • - -.,,,.,;: ,-- .001`.,°' TneStryi .TRA
t d6 ,,,.. 0 Emergency system. larger separately derived system.
it'17 ZIX;;.71rAW! !--.. t 4 4..:1 ? V*If 1'.,....40.... Arg, , a Addition of new motor load of
Job no.: 1 Job site address: 10220 SW GREENBURG RD I0OHP or more. occupancy.
0 Six or more residential units. 12 Recreational vehicle parks.
City/State/ZIP: TIGARD, OR 97223 0 Health-care facilities. 0 Supply voltage for more than
In Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: I Project name: SIIORENSTEIN TIGARD 2 LINC 12 Service or feeder 600 amps or more.
SCHEOtItE
Cross street/directions to job site: Description I Qty, I Fee. I Total I
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. Li. or less 168.54 4
Ea. add'l 500 sq. ft. or portion 33.92 I
Tax map/parcel no.: Limited energy, residential
Ral. ‘I V.T4Y (with aboves.9. ft.)
75.00 2
Limited energy, multi-family
INSTALL OUTLET FOR ALARM SYSTEM residential twith above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
,:!: gir,r1 201 amps to 400 amps 133.56 2
Name 401 amps 10 600 amps 200.34 2
:
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 I
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 168.54 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
44X ;1440ARCINMP,r;:liir.VRifilinal above service or feeder fee,
each branch circuit 7.42 2
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'I branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular
City/State/ZIP: 67 2
dwelling, service and/or feeder
Phone: ( ) I Fax: : ( . ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E
Sign or outline lighting 67.84 2
. V:44.7,RIVIr.4- 4 P-VNglin-,AM:ntAtItge.WAAPS.ftkaTPVWene 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
' Investigation (1 he mm) 66.25/ hr
City/State/ZIP: VANCOUVER, WA, 98662
Industrial plant (1 hr min) 78.18/ hr
Phone: (360) 892 I Fax: (360) 892 Inspections for which no fee is
90.00/ hr
specifically listed CA hr mm)
CCB Lic.: 64005 Electrical Lic.: 37-436C Suprv. ' 367S ri . ;t•i':1,7:.,!EEROPRICAL PERMIT FEES
_,...._.._ :
Suprv. Electrician signature, re red:
i Subtotal 56.18
Plan review (25 of permit fee):
Print name: LARRY GIBSON ate: 08 1 State surcharge (12% of permit fee): 6.74
TOTAL PERMIT FEE: 62.92
Authorized signature:
This permit application expires ifs 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 pennit.
1:11iuddingTermas\ELC•PermitApp.doc 07/01/10 440-4615T(11/05/COM/WEB