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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2011 -00612 Date Issued: 11/03/2011 I1GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 parcel: 1S135AB00900 Jurisdiction: Tigard Site address: 10200 SW GREENBURG R 150 Project: Corvel Subdivision: METZGER, TOWN OF Lot: 9 Project Description: TI 11/23/2011: REPRINTED with correct suite address. 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: PHONE: 503 - 624 -3631 FAX: 503 - 624 -2938 • FEES Quantity Description Date Amount 13 crt Branch Circuits wo /Purchase 11/03/2011 $145.22 Specifics: Service or Feeder 1 ea 12% State Surcharge - 11/03/2011 $17.43 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $162.65 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 2 -00 - 90. ou may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: ems/ /97 /t) A1 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. CITY OF TIGARD ELECTRICAL PERMIT :111 ": •• CO MMUNITY DEVELOPMENT Per mit #: ELC2011 -00612 Date Issued: 11/03/2011 TIGARD- 13125 SW Hall Blvd., Tigard OR 97223 503 718 2439 Parcel: 1S135AB00900 Jurisdiction: Tigard Site address: 10200 SW GREENBURG RD 180 Project: Corvel Subdivision: METZGER, TOWN OF Lot: 9 Project Description: 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 13 crt Branch Circuits wo /Purchase 11/03/2011 $145.22 Specifics: Service or Feeder 1 ea 12% State Surcharge - 11/03/2011 $17 43 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $162 65 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 obtai - .. • the rules or direct questions to OUNC by calling 503 232 1987 or 1 800 332 2344 Issued By — — — — Permittee Signature: AP, 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. 11/01/2011 TUE 15:07 FAX 5036242938 Willamette Electric V1002/002 �', Electrical Permit Application e � ; : ° F TOR OFf ICC USE OiVLY `kl Recetved City of Tigard ' � ‘ Date /B , / I Mil i�� Permit No.. t �� i/ i 1:„.(x) e ill M 13125 SW Hall Blvd., Tigard, oil 972 ! % \\ Plan Review S ( Other Permit: Phone: 503.639.4171 Fax: St •8'1960\' 0, Date/B TIGARD Inspection Line: 503.639.4175 OV Date Ready/By: RI See Page 2 for Internet: www.tigard- or.gov \V f��� , NotifiedlMethod: FM Supplemental Information ' ` o� Weida ‘` Q\,�`"' ', REVIEW . .S a i l y Please check all that apply (submit 2 sets of plans w /items checked below): ❑ New construction Addition /alterpilor�(eplacement ❑ Service or feeder 400 amps or more �tDD''``'' P ❑ Building over three stories, ❑ Demolition ❑ Other; where the available fault current 0 Marinas and boatyards ' CATEGORY OF - CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 FIoating buildings, less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ i - and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations, buildings. ❑ Multi- family ❑ Master builder ❑ Other: 0 Fire pump. ❑ Installation of 75 KVA or • .I013 SITE jNFORMATICIN AND LOCATION' 0 Emergency system. larger separately derived system. ❑ Addition of new motor load of 0 "A ", "E ", "1 -2 ", "1 -3 ", ` J ob site address: j 100IW or more. occupancy. (�j Job no.: C, ( �, r C'e� 6,. re: - �/l ,, ,,,- j C � 0 Six or more residential units. 0 Recreational vehicle parks. City /State /ZIP: - / - G � �_ ❑ Health -care facilities. 0 Supply voltage for more than F P © Hazardous locations. 600 volts nominal Suite/bldg. /apt no.: 49 (} Project name: C- --O ,c, Ue�--- ❑ Service or feeder 600 amps or more. IEEE . SCIIEDULE Cross street/directions to job site: nrsenmiun I Qty. I Fe e. I Total I • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: 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 DESCRIPTION OF WORK • _ (with above sq. ft.) 75 00 2 Limited energy, multi - family 75.00 2 ` residential (with above sq. ft.) 1'k Gif 1 � r� 1 a l°) v C T � 1 �,..-,>--- Services or feeders installation, alteration, and /or relocation 200 amps or less 100.70 2 0 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 Temporary services or feeders installation, alteration, and /or City /State /ZIP: relocation Phone: ( ) 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 401 amps to 599 amps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 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: B Fee for branch circuits without service or feeder f e e , first / 56,18 ' = 2 branch circuit Contact name; Each add'l branch circuit / ;a.- 7.42 5-9 2 . Address: Miscellaneous (service or feeder not included) Each manufactured or modular 67.84 2 City /State /ZIP: 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 ' ' 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 Investigation (1 hr min) 66.25/ hr City /State /ZIP: Tigard, OR 97281 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 listed (16 hr min) CCB Lie.: 75059 Electrical Lie.: 34-283C Suprv. Lic.: 4226 -S . • ELECTRICAL PERMIT IVES . ' • Suprv. Electrician signature, required. — — ` _ e Subtotal: y = Plan review (25% /0 of permit fee): _ Print name: David Fife Date: State surcharge (12% of permit fee): / 9 .y / TOTAL PERMIT FEE: ! /2 2.-- S 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. N um b er o inspections allowed per permit 1'\ Building \PermitOOELC.PcrmitApp.dse 07/01)10 440- 4615T01 /05 /COM/WEE