Permit CITY OF TIGARD ELECTRICAL PERMIT
1111 * COMMUNITY DEVELOPMENT Permit #: ELC2011 -00524
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/23/2011
Parcel: 1513 5AB01003
Jurisdiction: Tigard
Site address: 10350 SW GREENBURG RD
Project: Gustav's German Pub & Grill Subdivision: METZGER, TOWN OF Lot: 9
Project Description: (2) branch circuits for prep tables.
Contractor: WEST SIDE ELECTRIC CO INC Owner: LINCOLN CENTER LLC
1834 SE 8TH AVE BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97214 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503 - 231 -1548 PHONE
FAX 503 - 736 -0677
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 09/23/2011 $63 60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 09/23/2011 $7.63
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71 23
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 may o. -'. - .. of the rules or direct questions to OUNC by calling 503.232 1987 or 1 800 332 2344
iamb
Issued By: 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 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.
Sep 22 2011 6:15PM West Side Electric 503 - 736 -0656 p.2
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Electrical Permit App1icatibn 4 ., L , . , . . . . ,
1,01 OF 1 .1 'i S.L.(i ).Fta
City of Tigard SE? 2011 E*ew 131SW Hall Blvd, Tigard, OR 97223 Phone' 53.639.4171 Fax: 503.598.1960
11: ' Dote/El : Other Femur
Line 503 634.4175
Internet- Cal �% a � ( +'. `Date Ready/By
www.tt and or gov ��/ 11 1Z See Page 2 for
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❑ New construction Addition /alteration /replacement Please check all that apply ( submit 2 sets of plans w /items checked below)
E] Demolition ❑ Service or feeder 400 amps or more ❑ Building over three stones.
OtheY where the available fault current
„•:,: =,m.�i "' * >s �¢l ,_
r u . r a �- ❑ Mannas mdboatyards
1 -f.;i. , H. x i s t' ��" a (' `. t . �( r , , l s 1 am m 150 -r �-t s.'l,•4 •. , w?,�n, ��k ..,�,.p�'. Ji 4 ^r?'�,•.3�,.,�.��I ;.�.;•'1�r':� °a§•i.S eRC 10.0 ps or ❑ Floating buildings.
less to ground. or exceeds 14,000 ❑ Commercial-use agncultural
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building amps for all other installations buildings.
❑ Multi - family Master builder ❑ Other: ❑ Fire pump ❑ Instal lation of 75 K V A or
-, ,, r x ' eN i .; r . r a eatls,:rtiut r ,wit. i -
t 1 u 1 , : ;y�a> 9 ,)1 1 + w atT a s ° l V( : t : k his e 1� w� t t � ❑ Etnereeno systerz� larger separately derived system.
- i, S . „.400. , p -. . . - "F ❑ Addition of new motor load of ❑ "A ", "E' "1 -2" "1.3" ■
Job no.: J Lf31 ? I Job site ss: / S 0 S �) 6 , !h t , i . I OOHP or more occupancy. p
li C_s l v / "'� ❑Six or more residential units ❑ Recreational vehicle s.
City /State)ZIP: I / , ?, ❑ Health -care facilities ❑ Supply voltage for more than
7 ❑ Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: Project name: 6 4 , s /- 4v � ❑ Service or feeder 600 amps or more
Cross street/directions eet/directions to job site:
Description a {; , Mr. i 9< ` � ii' e+'i!' �1 a r aelw .
.... I Qo• Pee. I Told 1
New residential single- or multi - family dwelling snit
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft or less 168 54 4
Tax map /parcel no.:
Ea add'1500 sq. ft or portion 33.92 1
r * a t r au„ t= t... Limited energy, residential
e�'? a: w1e st 5»: � � `"ti` 'i il �7� r.p; %t'ts (with .
rte. ...i.sks ^i:i15f "C. 99 ;i` -. ^.:� %-i_': : �:.rir ;: ' ( above 5q. fl.} 7500 2
-5.. ✓.si.: ..� �n ";;� _
/ Limited energy, multi- family
2 ( /!C- i / 6 /ca- p11.ep / R y/�; a h - ` kJ . residential (with above sq. ft) 75,60 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 100 70 2
' t ' is „ xass 11sea �rmre i, r .l "a,," • 21ti., . j , v M1 .r 4 a. �'; °. .. a
F ( .. r . . 9 " i)"�3a. % v „ ra axe N .e ,.Ia a y �:'x 5,;u } 201 amps to 400 amps 133 56 2
Name: 401 amps to 600 amps 20034 2
601 amps to 1,000 amps 301 04 2
Address: Over 1,000 amps or volts 552.26 2
City /StatelZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax; ( ) 200 amps or less 59 36 1 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 168.5a 2.
S g Branch circuits- new, alteration, or extension, per panel
Owner signature; Date: . Fee for branch circuits with
T�3�rt3 T d 1 �; ll`�" ss '. )Ora r w xvx S+' arc r -z „ > "': , fly ill' ti ` • i , - t above service or ft eder fee,
P w �r.,`xd' ik'� "-fir; a . , i each branch circuit 7.42 2
Business name: B Fee for branch circuits wuhotu
service or feeder fee, first 56 18 / -- k 2
Contact name: branch circuit
Each add'l branch circuit / 7 42 7 1......--2
Address: Miscellaneous (service or feeder not included)
City /State/ZIP: Each manufactured or modular 67 84 2
dwelling, service and/or feeder
Phone: ( ) I Fax: , ( ) Reconnect only 67.84 2
E-mail:
Pump or imgation circle 67,84 2
t re s , �t n dlr * s i > �, .s ..4 , ;u;. i ta;flyL „ Sign or outline lighting 67 84 2
µ , a; , a.t .�t',�. ,, . ::,_ r Q . i s, ";,?v--•,, , ..ls•:. , ,i, .t 7a.�,. kb;! signal eireim(s) or limited- errer•gy
Business name: panel, alteration, or extension. Page 2 2
West Side Electric Co. r Inc. Each additional inspection over allowable in any of the above
Address: 18 3 4 SE 8th Ave . Additional inspection (1 hr min) 06 25; hr
City/State /ZIP: Portland /OR/97214 Investigation (lhrnun) 66.25/ hr
Industrial plant (1 hr min) 78.18; hr
Phone: (503) 231 - 1548 Fax:(503) 736 -0677 'raped ions for which no fee is
90 s •ecificall hated Vi hr min 00. hr
CCB Lic.: 13 3 0 6 Electrical Lic.: 2 6 — 5 C ( Suprv. Lic.: 4 654 — 5 .;7' = a °mtm ;:
Suprv. Electrician signature, required: , _ Pla review (25% of permit fe Subt fe e e).
).
Print name: Randall F Roberts ! Date: - / l State surcharge (12% of permit fee): 7 L
TOTAL PERMIT FEE r 3
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: • Number of inspections allowed per permit
I \Bwld,ngWennitstELC- PermMpp doc 07'01/10 440.4615T( 1 1/05 /CO41/WEB