Permit . ' g/N 9 7 �, � 404.e.,
74 � • CITY OF TIGARD ELECTRICAL PERMIT
' COMMUNITY DEVELOPMENT Permit #: ELC2009-00480
T i C ARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/11/2009
. N . Parcel: 1 S135AB00900
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD
Subdivision: LINCOLN CENTER /FIVE LINCOLN Lot: 0
Project: Lincoln II
Project Description: (6) branch circuits and (1) fire alarm installation for fire alarm upgrades in Lincoln II building.
Owner: FEES
LINCOLN CENTER LLC Quantity Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL 1 ea Limited Energy 09/11/2009 $75.00
PHONE: 6 crt Branch Circuits 09/11/2009 $80.10
wo /Purchase Service or
Feeder
Contractor: 1 ea 12% State Surcharge - 09/11/2009 $18.61
Electrical
COCHRAN INC
626 SE MAIN ST
PORTLAND, OR 97214
PHONE: 503 - 234 -6564
FAX: 503 - 238 -2098
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $173.71
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 ae rdac� 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. ENTION: Oregon I. requires you . to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -0 -0010 through OAR 952 -00 • 110 You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Is ued By: � 4 - / ►
� / 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 an inspection that business day.
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
COMMUNITY DEVELOPMENT Permit #: ELC2009 -00480
1 3125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/11/2009
T ltr4RD Parcel: 1 S 135AB00900
/09-PO Jurisdiction: Tigard
Site address: 'p290 GREENBURG RD
Subdivision: LINCOLN CENTER /FIVE LINCOLN Lot: 0
Project: Lincoln II
Project Description: (6) branch circuits and (1) fire alarm installation for fire alarm upgrades in Lincoln II building.
Owner: FEES
LINCOLN CENTER LLC Quantity Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL 1 ea Limited Energy 09/11/2009 $75.00
6 crt Branch Circuits 09/11/2009 $80.10
PHONE: wo /Purchase Service or
Feeder
Contractor: 1 ea 12% State Surcharge - 09/11/2009 $18.61
Electrical
COCHRAN INC
626 SE MAIN ST
PORTLAND, OR 97214
PHONE: 503 - 234 -6564
FAX: 503 - 238 -2098
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $173.71
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 95 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: L Permittee Signature: &A / 70/1
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 an inspection that business day.
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.
FROM COCHRAN- BROADWAY (WED)SEP 9 2009 15: 00 /ST. 14: 59 /No. 7500000353 P 1
•
Electrical Permit Application FOR OFF ICE USE ONLY
City of Tigard ' Dafe 3 'N B 1 /s/ Ib7 _ 62009 pptip
Permit No
71 Y'
13125 SW Hall Blvd., Tigard, OR 972 Plan Review
C Phone: 503.639.4171 Fax: 503.598.19 ection Line: 503.639.4175 9 Date/By: Other Permit:
Inspection OJ Q� Date Ready/By: funs: ® See Page 2 for
TI GA it, D p V 2
Internet: www.tigard- or.gov SE) p Notified/Method: Tieff S up p le m en ta 1 Information
TYPE OF WORK. 001 ' ikR • .: • .. ` . .PLAN REVIEW : .
❑ New construction Ill Add ition/alteratioartt + � " }i DI�1S snore check all that apply (submit 2 sets of plans w /items checked below):
V ❑ Service or feeder 400 amps or ore ❑ Building over three stories.
❑ Demolition ED Other: BU L where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 0 Commercial -use agricultural
❑ 1- and 2- family dwelling ❑ Commerciallindustrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: 0 Fire pump. ❑ Installation of75 KVAor
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "l -2 ", "I.3 ",
Job no.: 1'' i Job site address:
3 1/ 61 ZiI 44 I001-1P or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
Ci /State /ZIP: - /1 t 17I Health-care facilities. ❑ Supply voltage for more than
sti"N d ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: fA■Ato t, '' ❑ Service or feeder 600 amps or more.
FEE SCHEDULE .
Cross street/directions to job site: Descri j Qty. I Pee. I Tout 1 •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot too.: 1,000 sq. ft. or less 145.15 4
. Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
. , . DESCRIPTION OF WORK. (with above sq. ft.)
J Limited energy, multi - family
P trb V1 `�1� V t ti y L/ �' • c I. L• residential (with above sq. ft.) 75.00 2
a1-1 0-1,11 1 , . Set or feeders installation, alteration, and/or relocation
1 200 amps or less 80.30 I 2
❑ PROPERTY R .. I • . • ' ❑ TENANT" • • 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or.volts 454.65 2
City/State/ZIP: • Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) . Fax: ( ) 200 amps or less . 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100,30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits — new, alteration, or extension, er panel
Owner signature: Date: A. Fee for branch circuits with
' ❑ APPLICANT . • ' • . • . ' . ❑ CONTACT PERSON : ' . above service or feeder fee
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, / 46.85 `>O 2
�0 �( YI��,Q6Y1 first branch circuit
Address: �J Each add'1 branch circuit 5 6.65 3 6 2
Miscellaneous (service or feeder not included)
City /State /ZIP:- Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: (cam - 3) a t ' __c j 5 7 Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
. CONTRACTOR . . . Sign or outline lighting 53.40 2
1 ��`` ,, .j Signal circuit(s)'or limited -
Business name:
I.�o r1(' _ ` ( -- -A ' Prf kx d CL L t ;�nergy panel, alteration, or
Address: OZ i extension. Describe: / Page 2 "W-- 2
City/State /ZIP: `t' - C- 7 2(4 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( =r7) a 3L( — (.i.,) LnC.-(- Fax: ( 6 3 - 2_Oci investigation per hour (1 hr min) 62.50
��
CCB Lic.: S ``
3 I SyI�G Su Electrical Lic.: 1 I ~_ l C 9__C,✓ Industrial plant per hour • 73.75
Suprv. Lic.: . ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: , �� . 1 O
` t Plan review (25% of permit fee):
Print name: \L�w � v Date: 5- q
C ` State surcharge (12% of permit fee): I t� 6
Authorized signature: TOTAL PERMIT FEE: ( 3 17 1 ✓
Print name: Date: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
• Number of inspections allowed per permit.
I • Building \Permits\ELC- PermitApp.doc 05123706 440.4615111 I/OS /COM/WEB
FR0f.1 COCHRAN- BROADWAY <WED)SEP 8 2008 15 :00 /ST. 14:58/No. 7500000353 P 2
0 1'18/2004 17:13 FAX 5035981960 CITY OF TIGARD 21 002
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
Fee for all residential systems combined ... 575.00
Check Type of Work Involved:
Audio and Stereo Systems*
E Burglar Alarm
Li Garage Door Opener
11 Heating, Ventilation and Air Conditioning
System*
Vacuum Systems'`
T Other;
.COMA WICI:A <WORKONLY: ..
Fee for each commercial system S75.00
(SEE OAR 918
Check Type of Work Involved:
D Boiler L.ontroIs .
G Clock Systems
Li Data Telecommunication Installation
Fire Alarm Installation
. • I-IVAC
[1 Instrumentation
E Intercom and Paging Systems
E Landscape Irrigation Control*
(1 Medical
❑ Nurse Calls
7 Outdoor Landscape Lighting*
Li Protective Signaling
O Other _
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
3...id..4`?crms.\ELC- Perm:L.4,p ea: O.!.)3