Permit { � CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
41.
,^ COMMUNITY DEVELOPMENT Permit #: ELR2010 -00028
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/09/2010
Parcel: 1S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 590
Subdivision: Lot: 0
Project: ID Expert
Project Description: Low voltage for voice /data cabling.
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555 Restricted Energy Permit 02/09/2010 $67.84
CALIFORNIA ST 49TH FL 12% State Surcharge - Electrical 02/09/2010 $8.14
PHONE:
Contractor:
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
Total Number of Systems: 1
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: Y Fire Alarm: N
HVAC: N Instrumentation: N Total $75.98
Intercom /Paging: N Landscape /Irrigation: N Required Items and Reports (Conditions)
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N
Other Desc:
The 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. ATTENTIS. S - .on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-001 hrough OAR 9' -001 -s 00. Yo • ay obtain a copy of the rules or direct questions to OUNC by calling 5. . • 6.6699 or 1.800.332.2344.
Issued : (I i/ 11 ( - 4A - 4 1 Permittee Signa e: _ �G iQTh
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.
1 •„40M COCHRAN —BROADWAY <MON)FEB 8 2010 14: 03 /ST. 14: Oa /No. 7500000448 P 1
Electrical Permit Application gp� I Olt f •iufi: ( tit ta ; - , .
C of Tigard g `ECE gp VED Received L)�
N.
7Z Date/B r , Permit No.:� / 0 / r ���� g
■ 13125 SW Hall Blvd., Tigard, OR 9 23 Plan Review
11 Phone: 501639.4171 Fax: 503.598.1960 r Date /By: Other Penult:
TI GAR D Inspection Line: 503.639.4175 FEB 0 8 Lo '( 1 Date Ready /By: Juris: ' B! See Page 2 for
Internet: www.tigard-orgov Notitiied/Method: Supplemental Information
*j::: a - ,.
❑ New construction ,a 1 # • 'Si • M e111lent Please check all that apply (submit 2 sets of plans wlilems checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current
❑ Marinas and boatyards.
- - " - W V ° - exceeds 10,000 ain sat 150 volts or ❑ Floating buildings.
• � � u _, - '" •` ' less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ I- and 2- family dwelling ommercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: 0 Fire pump. ❑ Installation of 75 KVA or
- _ - - em, derived system.
,,,., , _ Emergency system. larger e
£n
*19 _ l7' = lT ! i QRiVli4 1()1 _: t1lVD -- C AT - ::ma - '
. � .. .. - x� n.. � x � ,� -� _ �`; — `.;�":d� � .. ❑ Addition of new motor load of
❑ ,. ,£., ..I 2 ,. I_J ..
^, , , /34 I00HP or more. occupancy.
lob no. : f e� ° ' Job site address: /O �L(J ❑Six or more residential units. 0 Recreational vehicle parks.
City /State/ZIP:j? r 1 ok
❑ Health-care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
❑ Service or feeder 600 amps or more.
Suite/bldg./apt. no.: �" Q Project name: ID _
Cross street/directions to job site: Description -1 qty. I Fee. 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
Tax ma / ircel no.: Ea. add'I 500 sq. ft. or portion 33.92 1
P Pi .. -_ ., :.— � residential
Lim ited energy, resid
afro t, » .�, ' °-a ® 1 �{� i -:: ~- ` , px4.1. �...'-..= iI" - i.`ra`°e with above fl) 67.84 2
... :it: ;w r.._ °� o''t�,:.w_� ;.,..,_ - _. �.. " .-4_ -+,- �..., q°- ea z= �+.. �. r. , . , aar-- -- •.'. �.°.cc_.._- �^.�e: ��'" -
{- / Limited energy, multi- family 67.84 2
V Y I 6k ( do.t. ca (/)1 fn residential (with above sq. ft.) _
�✓ Services or feeders installation, alteration, and/or relocation
UUU _ 200 amps or less 1 00.70 2
,.,• , .—'Z'Z'rt:: • - . -._ , : f. -. tee:
- r Y _ , ^ .9 = "•:r. - __ _ :; ;` "•r :, -- - 20 amps to 4 00 amps 1 3.56 2
- :.::.: ^ Yea. :.s:,:: �.,•s�:�„
s 3
Name: 401 amps to 600 amps 200.3 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 59,36 I
Owner installation: This installation is being made on property that 1 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 168.54 2
Branch circuits - new alteration, or extension, per panel
Owner signature: Date:
A. Fee for branch circuits with
rzqijp,#j?{ a r ,_(�j€ above service or feeder fee,
7.42 2
each branch circuit
Business name: Sa 1(y) a S Oo G^tb%-- B. Fee for branch circuits
without service or feeder fee,
Contact name: first branch circuit • 56.18 2
Address:
Each add'I branch circuit 7.42 2
Miscellaneous (service or feeder not included)
City /State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 67.84 2
Phone: (ocy, -1 01._t I Fax: : ( ) - Reconnect only 67.84 2
E - mail: Pump or irrigation circle 67.84 2
w:.— r ,.
e z� == II = .- "_ II`. :.- t= ; Sign or outline fighting 67.84 2
Business name: 0 0c h rare 1 V\ C Signal panel, er or limited
energy panel, alteration, or
Address: W 2 jtc, LSE Maki) S extension. Describe: / Page 2 6 S T 2
City /State /ZI Po {1. ta O<.. GI -- /z1 4 Each additional inspection over allowable in any of the above
/ Per inspection 66 °25
Phone: ( ) - Z-3 4 (5(04 Fax: ( j) 23 $ -L" g .
Investigation per hour (I hr min) 66.25 i
CCB Lie.: 12.9 42_ Electrical Lie.: 3/544, c Suprv. Lie.: 3491 Industrial plant per hour 78.18
= W4:z;
°" ='� ` "= l 1r1?4Tdtl P2iP RMFt m' EES g' m = r= W'
om':. ' b. -,.
Suprv. Electrician signature, required: v , L _ ' IA '.� ��:: � Subtotal: (p7 y
Print name: x -1-1 i f � C" U Date: ��l Plan review (25 % of permit fee): `
t t'l 1 State surcharge (12% of permit fee): Q.
Authorized signature: TOTAL PERMIT FEE: 7 y . 9
This permit application expires if a permit is not obtained within
Print name: Date: days after it has been accepted as complete.
^ - _ * Number of inspections allowed per permit.
I' Building Points 'PLC- PerwitApp.doc 10'01'09 440- 4615TI I I.O5 -COM. WEB