Permit { : *1�7 CITY OF TIGARD
ELECTRICAL PERMIT
PERMIT #: ELC2008 -00291
COMMUNITY DEVELOPMENT DATE ISSUED: 5/22/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S 135AB -01004
SITE ADDRESS: 10220 SW GREENBURG RD 600 ZONING: C -P
SUBDIVISION: LINCOLN CENTER/TWO LINCOLN LOT : JURISDICTION: TIG
PROJECT: FARMERS INSURANCE
Project Description: TI.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 19 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
SHORENSTEIN REALTY SERVICES WILLAMETTE ELECTRIC INC
ONE SW COLUMBIA #300 PO BOX 230547
PORTLAND, OR 97258 TIGARD, OR 97281
Phone: 503 - 412 -4800 Contact #: PRI 503 - 624 -3631
FAX 503 - 624 -2938
FEES
Description Date Amount Reg #: ELE 34 -283C
[ELPRMT] ELC Permit 5/22/2008 $173.20 LIC 75059
[TAX] 12% State Surchar 5/22/2008 $20.78 SUP 4226S
Total $193.98 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By:
• _ ` P ermittee Signature: �J��4 4A -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'N: 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.
2008 WED lV'54 FAX 5036242938 Willamette Electric �0VVz/ooc
' .: . / "�~ -
R E C E IVE '
Li New construction ZAddition/alteration7rep I Please check all Iliot apply (submit 2 sets of plans whitems checked below)i
0 Service or feeder 100 amps or more 0 Building over three stoiacr.
0 Demolition rj Other: 1 where the available fault cui rent 0 Marinns and boatyards.
. CATEGORY OF CONSTRUCTION exceeds 10.000 amps ot 150 volts or 0 Floating buildings.
_______ less to ground, ol exceeds 14,000 0 Commercial-use agricithmal
ED 1 and 2 dwelling E n Accessory building amps foi all other installatio»s. buildings.
Eil Multi-family El Master builder 11 Other: 0 Vile pump, 0 Installation of 75 KVA or
— D Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION 0 Addition of new motor load of
1001-1P or mote. occupancy.
City/Slate/ZIP: -- . , 0 Healthmare facilities. 0 Supply voltage for mom than
Suite/bIdglapt. no.: 61d0 Project name: v" . --i's .- - , , - - 0 Service or feeder 600 amps or mom_
. FEE SCHEDULE
" New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot --' Ea. mm'|nm sq. ft. *portion 33.40 1
Tax map/parcel no.: Limited --
energy, 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi-family
____ — 1 - 7 - 1- 1,-,3e..) , _-��'u«^t�l��` `�`" "o , «J ���____ / - Services or feeders installation, alteration,
r- [] PROPERTY OWNER -- O TENANT ----- 2 0 0 amps or less _80.30 i 2
_
Name: _^o/�p'mouo���__ 160.60
------- ---
601 amps to 1,000 amps 24060
Address: ______ _____ o,�//��^�xv,wv� L____*w�u | 2
� _________ ____ |
Temporary n,�,�o,mmus/wm/un alteration,
C/ relocation
Phone: ) Fax: ( ) ( -�� xmp��� 66.85
201 400 /oom z
Owner i bb�og made on � �m| own which �not
amps amps
intended for sale, lease, nm\v, exchange, according m ORS *47.*19,cm. and 7o/ 401 amps to 599 amps 133.75 2
Branch circuits - new', alterati o, extension, per panel
Owner signature: Date: ______________ A. fo ranch circuits sell/i
[] APPLICANT [] CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: a�F� for branch circuits .
— -- '------ ,,�wm feeder service �
Contact ont^mnm���_ i 46.85 tu 2
Address: m^xxommnm�nnux )� 6.65 |a���2
- Miscellaneous *,u,, not included)
Ci/y�m�a|P� ea�mmnoommeomm^o"/m 90.90 ro 2
---� —'--'---------- -----------' ovmxou. �r��nnum,�mor
Phone: ( ) Fax: : ( ) Reconnect —''----- 2
______ _ __ __
E'moil: pumpwi,r��oua/ao o�^n 2
_ _
CONTRACTOR Sign outline lighting 53.40 2
__- _-
nu,invpnmn":vvix^mnuem^"ri^xn� -=-�`' or --
__ m ruam�miov,m
Address: yO Box J3V54? extension ooc/ibc Page 2 2
-- Each additional / u allowable / - no u �---
City/State/ZIP: _��Lu�»cc inspection o,x/w���o�
vz�
_v� inspection __
(503) 624-3631 -____ |'^x�)�-_____________ investigation 62.50
� Cca uo�: 75059 Electrical �^�: 34-283C Sup,'�[io.: 4226-S mo"w,imvmntpxhour _ __ rx 75
-----' - ---' ----- -.-�` -'—~ ----- - ELECTRICAL PERMIT FEES
S"pm Electrician signature, required: < •
__ _ __ Subtotal: ��_ •
/ � David c��� ~~''~~~^�^``''``^
Print uuv � ���� _
__ - ---_ ,~..^._"`-~.,--.-`
Authorized signature:
— — -------
`.`'`^.~~,^.^^ - __ i
��������-----' ---- ----- m*„c=^",*wo^" e"if permit v Hof obu/=a within ISO
Print name:
� ' � -----� ___ _-- _—_L� Date: ���___� I o"�,m,^ has m,""^",x* """""p«�.
' Number " inspections allowed ,o,=*^
,
CITY OF TIGARD
BUILDING DIVISION . ;, PERMIT #: ELC2008-00291
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5,
Phone: (503) 639-4171 OP hit 1
Inspection Requests (24 Hrs.): (503) 639-4175 , )
IL.
INSPECTION WORKSHEET FOR DATE: 6/12/20013 TIME: 7:02AM PAGE: 35
SITE ADDRESS: 10220 SW GREENBURG RD 600 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/TWO UNCOLN LOT #: TYPE OF USE:
PROJECT NAME: FARMERS INSURANCE
DESCRIPTION: TI.
OWNER: SHORENSTEIN REALTY SERVICES, PHONE #: 603-412-4800
CONTRACTOR: WILLAMETTE ELECTRIC INC PHONE #: 603-624-3631
Inspection Request Scheduled For: Date: 6/12/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
130 Ceiling cover 071279-01 603-624-3631 N
___
Corrections/Comments/Instructions:
c ... ZcA - S s i) I I PARTIAL APPROVAL El CANCEL pi NO ACCESS
I FAIL r7 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: C3' -- t /11 CP 1E - Date: 6 1 1 -706 Phone #: (503) 71-.2/9
. .
CITY OF TIGARD
BUILDING DIVISION •
PERMIT #: ELC2008-00291
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/22/2008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: U30/2008 TIME: 7:01AM PAGE: 38
SITE ADDRESS: 10220 SW GREENBURG RD 600 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTERfrwo LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: FARMERS INSURANCE
DESCRIPTION: TB.
OWNER: SHORENSTEIN REALTY SERVICES, PHONE #: 603-412-4800
CONTRACTOR: WILLAMEITE ELECTRIC INC PHONE #: 503-624-3631
Inspection Request Scheduled For: Date: 5/30/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough-in CAIS Mt - 070576-01 503-6243631 N
ZS" WIM-1.- Cr:NAM-, Neil
Corrections /Comments/ Instructions:
fl PARTIAL APPROVAL fl CANCEL El NO ACCESS
pi FAIL 1 CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: 3 (1.1 (S 6 Date: 6-ilkob. Phone #: (503) 718- 1)114110
CITY OF TIGARD
BUILDING DIVISION
PERMIT #: ELC2008-00291
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/22/2008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 IL
INSPECTION WORKSHEET FOR DATE: U25/2008 TIME: 7:00AM PAGE: 10
SITE ADDRESS: 10220 SW GREENBURO RD 600 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/TWO LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: FARMERS INSURANCE.
DESCRIPTION: TI.
OWNER: SHORENSTEIN REALTY SERVICES, PHONE #: 503-412-4600
CONTRACTOR: WILLAMETTE ELECTRIC INC PHONE #: 503-624-3631
Inspection Request Scheduled For: Date: 6125/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 071836 503-624-3631
Corrections/Comments/Instructions:
ro,1
IN "A S S fl PARTIAL APPROVAL 7 CANCEL fl NO ACCESS
7 FAIL 7 CALL FOR INSPECTION pi ADDITIONAL FEES ASSESSED
Inspector: (Je) LE Date: Es Phone #: (503) 718- NW°
„ .