Permit _CITY �K OF TIG ELECTRICAL PERMIT ��� � � PERMIT #: ELC96-0212
COMMUNITY DEVELOPMENT DEPARTMENT
DATE ISSUED: 694/10/96
1o1uumw Hall Blvd. Tigard, Oregon 97223°8199 (503) 639-4171
PARCEL: 1S135AB-01002
SITE ADDRESS...: 10220 SW GREENBURG RD #350
SUBDIVISION....: ZONING:R-12
BLOCK..........: LOT.............:8
Project Description: Install ten branch circuits.
________ _ _ _
---RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS---- MISCELLANEOUS
1000 SF OR LESS ^ 0 0 — 200 amp.......: 0 PUMP/IRRIGATION : 0
EACH ADD'L 500SF. . . : 0 201 — 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY ^ 0 401 — 600 amp ^ 0 SIGNAL/PANEL : 0
MANF. HM/ SVC/FDR..: 0 601+amps-1000 volts.: 0 MINOR LABEL (10)...: 0
----SERVICE/FEEDER---- ----BRANCH CIRCUITS ---ADD'L INSPECTIONS---
0 — 200 amp ^ 0 W/SERVICE OR FEEDER: 0 PER INSPECTION ^ 0
201 — 400 amp......: 0 1st W/O SRVC OR FDR.: 1 PER HOUR ^ 0
, 401 — 600 amp......: 0 EA ADD'L BRNCH CIRC: 9 IN PLANT : 0
601 — 1000 amp.....: 0 —PLAN REVIEW SECTION-------
1000+ amp/volt.... . : 0 >=4 RES UNITS.. ... ... : > 600 VOLT NOMINAL..:
Reconnect only.....: 0 SVC/FDR >= 225 AMPS..: CLASS AREA/SPEC OCC.:
Owner: — ------- FEES -- -------
COMBINE INSURANCE type amount by date recpt
10220 SW GREENBURG RD SUITE #350 PRMT $ 80.00 B 04/10/96 96-277993
5PCT $ 4.00 B 04/10/96 —
TIGARD OR 97223
Phone #:
•
Contractor: —
CHRISTENSON ELECTRIC INC $ 84.00 TOTAL '
10250 SW GREENBURG ROAD
REQUIRED INSPECTIONS -------
TIGARD OR 97223 Ceiling Cover Elect'l Service
Phone #: 503-241-4812 Wall Cover Elect'l Final
Reg #..: 548
~
This permit is issued subject to the regulations contained /rWL���L�
� io the ( _
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee Signature
applicable laws. 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 ��` MAlikair L,
than UW days. Issued By
---- — — --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'N: /� ��8! ~
- �' f) ~ J DATE: �f--//) 41
LICENSE NO:
Call for inspection — 639-4175
•
/ — — -
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # ELC46 -0 a.) a
/ t�B, I N �61" .; Date Issued 1 /- /0 - 96
�' I I Phone (503) 639 -4171
"'' FAX (503) 684 -7297
CITY OF TIGARD - ' ' .TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development LINCOLN CENTER II SOUTH Number of Inspections per permit allowed
Address SUITE 350 10220 SW GREENBURG ROAD Service included: Items Cost(ea) Sum
PORTLAND OR
City /State /Zip 4a. Residential - per unit
COMBINE INSURANCE 1000 sq. ft. or less $110.00 4
Name (or name of business) Each additional 500 sq. ft. or
portion thereof $25.00
Commercial H Residential ❑ Limited Energy $25.00 1
Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
ROSS CROSBY 4b. Services or Feeders
Electrical Contractor ELECTRIC, INC. Installation, alteration, or relocation 2
200 amps or less $60.00
Address 111 SW CULUMEIA, 5 U 1'1'K 4r3U 201 amps to 400 amps $80.00 2
'1'LAN OK 9 / ZU 1 -.: S6 4 01 amps to 600 amps $120.00 2
Cit� OR State Zi $180.00 2
601 amps to 1000 amps
Phone No. 241 -4812 Over 1000 amps or volts $340.00 2
Job NO. 222 -4886 Reconnect only $50.00 2
contractor's license NO. 26 - 34C
Contractor's Boar eg. o. 00 8 4c. Temporary Services or Feeders
Installation, alteration, or relocation
Signature of Supr. le ' 1 � ' il • 200 amps or less 2
201 amps to 400 amps $50.00 2
License No. 8735 " ,Il Phone No. 241 -4812 401 amps to 600 amps $75.00 2
Over 600 amps to 1000 volts $100.00
. 2b. For owner installations: see "b" above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane
Address a) The fee for branch circuits with
purchase of service or feeder fee. 2
City State Zip Each branch circuit $5.00
Phone No. b) The fee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder fee. 2
not intended for sale, lease or rent. - Eat ddch ca br 1 $35.00 35.
Eacch a additional l branch circuit q $5.00 45.
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40.00
4 or more residential units in one structure Minor Labels (10) $100.00
Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.C. Chapter 5 Per inspection $35.00
Per hour $55.00
In Plant $55.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
5a. Enter total of above fees $ 80.
NOTICE 5% Surcharge (.05 X total fees)
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ Ildill
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ 84 .
COMMENCED. worthcomdeWelec- ❑ Trust Account #
$
prm.app
Balance Due $ 84.
•
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /Flr /Slab Plbg. Top Out Insulation
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other: 4. _11.- , :1 i � __,.../A...1.- Date: _ 0 A. . P.M. )C En : $
Address: r 2- • 1 1 ! 14 , A .4 s
Tenant: Ste:..5 MST:
q BUP:
Con /Own: q 3 e -- c. 4n I MEC:
, PLM:
ELC:
THE FOLLOWING CORRECTIONS ■ - E REIN I RED: ELR:
f
G p o c do r . ,a71 '• 0 c
‘fic— - , -c. -- C,-, r k", r mat r't
6 _ — f `�' G` / / k i s / f
I ;'
j�
-
7> r C I ja7. -f ( R c(e
Inspector: Dater A
X APPROVED DISAPPROVED /CALL FOR REINSP. CO
e-5