Permit CITY OF TIGARD ELECTRICAL PERMIT
`A7 COMMUNITY DEVELOPMENT Permit #: ELC2012 -00088
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/08/2012
Parcel: 1 S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 555
Project: West Coast Careers Subdivision: METZGER, TOWN OF Lot: 9
Project Description: Electrical for TI.
Contractor: COCHRAN INC Owner: LINCOLN CENTER LLC
7550 SW TECH CENTER DR. #220 BY SHORENSTEIN PROPERTIES LLC
TIGARD, OR 97223 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503 - 234 -6564 PHONE:
FAX: 503 - 238 -2098
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 201 to 02/08/2012 $133.56
Specifics: 400 amps
5 crt Branch Circuits w /Purchase 02/08/2012 $37.10
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 02/08/2012 $20.48
Electrical
Type of Const:
Occupancy Grp:
Total $191.14
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. Yo may obtain a copy of the r - or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
_ • 1
Issued By: Permittee Signature: - ,/. — i «.114111
4.11.1
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 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.
01 R 10:56:35 02 -06 -2012 1 /2
Electrical Permit Application � @ :,�A roR oliFic ; I�SI•: ()NIX
City
Ci}� of Tigard an' 1\11 Received ( oZ \ I �
0
Date/By: ? 6Ar ' Permit No.: V
13125 SW. Hall Blvd., Tigard, OR 7223 Plan Review
III
Phone: 503.639.4171 Fax: 503.598.1.96.1 R Q Date /By: Other Permit: 86�'� I J.—C.)0 (d
■ Inspection Line: 503.639.4175 c •\ \ \ ' \ O '4Date Ready /By: kris: El See Page 2 for
TIGARD .,.., L
Internet: www.tigard- or.gov r ..�1 v .., \ Notified/Method: � Supplemental information
.. , . ..: -...4?“1. i... :. .
\' . .: :.PLAN : :REVIEW:;; - . .. • .. .
['New construction z Addition /alterationheplacetnent Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition lOther: where the available fault current 0 Marinas and boatyards.
' CATEGORY . `OF CON `'y : , f'. -, ..1] . .,.•: , . , ; . exceeds 10,000 amps at ISO volts or ❑ Floating buildings.
less to ground, or exceeds 14.000 0 Commercial-use agricultural
1- and 2-family dwelling olnrnercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder 0 Other: ❑ Fire pump. 0 Installation of 75 KVA or
- I .N; ; . Emddergency of sysnew tem. tor I d of ❑ larger se y der system
Job no.: 544.( y Job si te address: SC7 „ , .: O .:.', . ` ; - : . [9 Aition mooa "" "' "-2" " '
JOB. SITE.`•., IIvFORMATION,'AND', LOCAT
toss: er1bu rq V/1, imp more. occupancy.
MMM », ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: ❑ Health-care facilities. ❑ Supply voltage for more than
1 t�f-�, o R 7 zz
❑ Hazardous locations. 600 volts nominal.
$ulte/bld ./a t. no.: 5 I
g p 5 Project name: D S ervice or feeder 600 amps or more.
j l� Q srOoas l a rear p
�
Co c ri :'':: F $ C H ED . 1 Fe e. 1 Total ;:-'•; t •:
Cross street /directions to job site: ScO ._
I Q�,Q. Description 1 Qty. 1 Fe
lll������ New residential single- or multi - family dwelling unit.
Sin I� n lC s'Y 1 uA P r Includes attached garage.
Subdivision: ((�� Lot no.: 1,000 sq. fl. or less 168.54 4
Ea. add'I 500 sq. ti. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION ;OE; WORK (with above sq. R.) 75.00 2
15051 Limited energy, multi- family
Z --11.1203 ' - Move, l Ltc �L - 41K17/1-.. , b \ residential (with above sq. ft.) 75.00 2
3 C \ L /� � r p / ` Services or feeders installation, alteration, and /or relocation
e ) Oik N , - (2) =1 °L L {� 200 amps or less 100.70 2
: ❑ PROPERTY : ":'• %` ` ,; :❑,TENANT. 201 amps to 400 amps 1 133.56 t33, 2 •
Name: 401 amps to 600 amps 200.34 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 /o
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
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
0; APPLICANT: ''; • :: ' , : .'' `.: II ; : PERSON' 7 above service or feeder fee,
-e each branch circuit 1 7,42 7 q-z 2
Business name: G0, , c S Con -t-'- a-0..„--
& - B. Fee for branch circuits without
J" service or feeder fee, first 56.18 2
Contact name: branch circuit
Address: Each branch circuit 7.42 �,57 /F ■ 2
Miscellaneous (service or feeder no included)
• City/State/ZIP: Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
E -mail:
Pump or in•igation circle 67.84 2
Sign or outline lighting 67.84 2
. . .CONTRACT.OR `. . ,.. Signal circuit(s) or limited- energy
n � panel, alteration, or extension. Page 2 2
Business naive:
l_ 1 C�� can Each additional inspection over allowable in any of the abov
Address: J0 ,SW L C .-n or r # Z,� [� Additional inspection (I hr min) 66.25/hr
City /State/ZIP: "l l a ( - A O R 72 Z C71 Investigation (1 hr min) 66.25/ hr
` � 1\ I industrial plant (I hr min) 78.18/ hr
Phone: 503) 2-3�- L (i Fax: ( ) 23g- ZO 9g' inspections for which no fee is
�- �. �� specifically listed (' /: hr min) 90.00 / hr
�� CCB Lie.: �2 Lic.: 75 C •'Su Irv. Lie.: 31-47,5,./4 > -" '
,,'; ECCT 'R
EI;CAL';PERM1.T
Suprv. Electrician signature, required: V� ~='\ � Subtotal: . { `"jO r (D �A
l {K ` Plan review (25% of permit fee):
Print name: e — \ nom . k Date: 2_ & — Z._--- State surcharge(12 %ofpennit 20,yLv
i \ TOTAL PERMIT FEE:
Authorized signature: fJ/�y w hin 181 ►i'� �. I 1
U
U j' Q This pe application expires if a permit is not o ed within 1St
Print name Li-) 1 days after it has been accepted as complete.
9 l�n ' .� f�G_ \- Date: 2 ( .../ e s Number of inspections allowed per permit.
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