Permit •
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 00466
T E GARE) 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/06/2012
Parcel: 1 S 135AB04500
Jurisdiction: Tigard
Site address: 10250 SW GREENBURG RD 200
Project: GTS Subdivision: 1991 -055 PARTITION PLAT Lot: 1
Project Description: (21) branch circuits for TI
'REPRINT 8/7/12 correcting proper form"
Contractor: WILLAMETTE ELECTRIC INC Owner: LINCOLN CENTER LLC
PO BOX 230547 BY SHORENSTEIN PROPERTIES LLC
TIGARD, OR 97281 5335 MEADOWS ROAD, SUITE 300
LAKE OSWEGO, OR 97035
PHONE: 503 - 624 -3631 PHONE: 503 - 619 -3200
FAX: 503 - 624 -2938
FEES
Quantity Description Date Amount
21 crt Branch Circuits wo /Purchase 08/06/2012 $204.58
Specifics: Service or Feeder
1 ea 12% State Surcharge - 08/06/2012 $24.55
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
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Total $229.13
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 - 0 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: OA 4ALJCgf nokl
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.
CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
0 COMMUNITY DEVELOPMENT Permit #: ELC2012 -00466
T t G A R O 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/06/2012
Parcel: 1 S135AB04500
Jurisdiction: Tigard
Site address: 10250 SW GREENBURG RD 200
Project: GTS Subdivision: 1991 -1• PARTITION PLAT Lot: 1
Project Description: (21) branch circu r TI
Contractor: WILLAMETTE ELECTRIC INC Owner: LINCOLN CENTER LLC
PO BOX 230547 BY SHORENSTEIN PROPERTIES LLC
TIGARD, OR 97281 5335 MEADOWS ROAD, SUITE 300
LAKE OSWEGO, OR 97035
PHONE: 503 - 624 -3631 PHONE: 503 -619 -3200
FAX: 503 - 624 -2938
FEES
I escripti. Date Amount
Specifics: Branch Circui . wo /Purchase Service or 08/06/2012 $204.58
Feeder
Type of Use: COM 12% State Surch • • e - Electrical 08/06/2012 $24.55
Class of Work: ALT
Total Number of Systems:
Audio & Stereo: N Boiler Cont •Is: N
CCTV: N Clock Systems: N
Data & Telecommunications: N Fire A : rm: N
HVAC: N Inst mentation: N
Intercom/Paging: N Landscape /Irrigation: N
Landscape Lighting: N edical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N Total $229.13
Other Desc: Required Items and Reports (Co • itions)
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 - 01 -009 You may obtain a copy of the rules or direct questions to OUNC by calling �� 503.232.1987 or 1.800..
Issued By: Permittee Signature: O' V, f I 6 6 ILL
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. •
08/03/2012 FRI 13:54 FAX 5036242938 Willamette Electric 81002 /002
•
Electrical Permit Application i�,'�D OFFICE USG ONLY
City of Tigard Date/Bea gLe �t1
/-' I I " Received
: .ie� Permit No . D.. /_
I
r 13125 SW Hall Blvd., Tigard, OR 97223 2012 Q� 2 Plan Review hA 1C
`l Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Penni "d t7-v i d. v e ((,e
T I C A RD inspection Line: 503.639.4175 CITY OiFTIGARD Date Ready/By: le . z 61 See Page 2 for
Internet: www.tigard- or.gov 'LU/ Notified/Method: Supplemental Information
. : .
.�I�1 DIVISI ®N .. 7 - - ___
❑ New construction IN Addition /alteration /replacement Please c all that apply (submiti seta of plans w/items checked below):
❑ service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
7 ',t - 0N 1)C '1S91V' • exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
• .,__ . _. , -, k: .; : less to ground or exceeds 14,000 C
00 ❑ ommcrcial -ase agricultural
❑ 1- and 2- family dwelling fid Commercial /industrial 0 Accessory building amps for all other installations. buildings.
El ❑ F ire pump. Multi- family 0 Master builder ❑Other: ❑ Installation of 75 xvA or
y �� y :.. /. y � ( � T _ • ❑ Emergency system. larger separately derived system.
', O '=S .?4,, ''A " A' x ❑ Addition of new motor o
t load of ' -..._ � " Fi' if!frl�' .., -,. -,��r,.'�, ` : • ": :.;�: � ` ❑ -3 „
Job site address: JJ // A49.4 100HP or more. occupancy.
Job no.:
7 address:/0 ( p'I ^cv Pr ,i,iCar 0 Six or more residential units. 0 Recreational vehicle parks.
City /State /ZIP: �(� �� /� < •' / ❑ Health-care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 1...0 v i Project name: _ - 7 5 0 or feeder 600 amps or more.
- l;_a;EE SC"iREtitLE.
Cross street/directions to job site: neteriMton I Qrv. r Fee. I Total I
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'1500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
. 75.00 2
• DESCRIPTION. OF WORK above (with sq, ft.)
.. ' Limited energy, multifamily 75.00 • 2
residential (with above sq. R.)
/'' ' e ` ,'• £ 4.0r"r Services or feeders installation, alteration, and/or relocation .
200 amps or less 100.70 2
❑ PROPERTY OWiNER : : ;TE 1'
NAN' 201 amps to 400 amps 133.56 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
Temporary services or feeders installation, alteration, and /or
City/State/ZIP: relocation
Phone: ( ) I Fax: ( ) 200 amps or less 1 59.36 I 1
Owner installation: This installation is being made on property that I own which is not tot amps to 400 amps 125.08 1 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 ex tension, per panel
Owner signature: Date: A. Fee for branch circuits with
1.ARrI:lirAf!Tl ''CONIAtI P RSON • above service or feeder f 7.42 2
fee,
. : - ,- �::.... :,, • each branch circuit
Business name: B. Fce for branch circuits without
service or feeder fee, first G' 56.18 .5-4 2
Contact name: branch circuit
. Each add'! branch circuit 2cr 7.42 _ `y; Y 2
Address: Miscellaneous (service or feeder not included)
Each City/State/ZIP: dwelling, service a and/or fe eder 67.84 2
Phone: ( ) I Fax: • ( ) Reconnect only 67.84 2
E -mail. Pump or irrigation circle 67.84 2
- :: �. :., .;;:.. : ::. : ..: ::: ' . , ; �: : : :. . , . . : Sign or outline lighting 67.84 • .. g
Vol lt� , Signal circuit(s) or limited- energy
Business name: Willamette Electric Inc. panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: P.O. Box 230547 Additional inspection (1 hr min) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
City/State /ZiP: Tigard, OR 97281 industrial plant (I hr min) 78.18/ hr
Phone: (503) 624 -3631 Fax: (503) 624 -2938 inspections for which no fee is 90,0W hr
specifically listed '/o fir min •
r 2CB Lit: 75059 I,- i?lectrical Lic.: 34 -283C prv. Lit: 4226 -S .::. . ' 'Ply ` <; >H`L/F i:
Subtotal: e c/
Suprv. Electrician signature, requi e
Plan review (25% of permit fee):
Print name: David Fife I Date: State surcharge (12% of permit fee): 07 t.
Authorized signature: TOTAL PERMIT FEE: ;i 2-7 —- -
This permit application expires Ira permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
N umber of inspections allowed per permit.
r: tBuitding\PeanitslELC- PermitApp .doe 07/01/10 440- .615T(11/05/COM/WEB
Inspections Required for Permit No.: � 0 Z. -- o D ((p(
IVR Permit Permit Permit Description IVR Permit Permit Permit Description
Code Type Code Type
01 BUP Building — structural 07 SIT Site Work
02 ELC Electrical 08 SWR Sewer Connection
03 ELR Restricted Energy 09 FPS Fire Protection
04 MEC Mechanical 10 RER Re -Roof
05 MST Master — residential combination 11 CMS Commercial Manufact. Structure
06 PLM Plumbing 12 SFM Single- Family Manufact. Structure
✓ Reg Insp Inspection Description ✓ Reg Ins Inspection Description
Inspection Code Inspection Code
Building (structural) inspections Electrical inspections
205 Footing 105 Underground/slab cover
210 Foundation walls 110 Temporary electrical service
215 Footing drain 115 Electrical service
220 Slab V 120 Electrical rough -in
225 Post/beam structural 125 Wall cover
230 Underfloor insulation 130 Ceiling cover
235 Shear walls /anchors 135 Low voltage
240 Exterior sheathing 140 Sign installation
242 Interior shear walls 145 A/C or heating unit circuit
245 Firewall _ 150 Hot tub /spa/pool
250 Roof nailing / 195 Misc. inspection
255 Wtr proofing basement walls ,/ 199 Electrical final
260 Tilt -up panel
265 Masonry Mechanical inspections
270 Reinforcing steel (rebar) 605 Post/beam mechanical
275 Framing 610 Gas line
280 Insulation 615 Mechanical rough -in
285 Drywall nailing 620 Hydronic piping
287 Suspended ceiling 625 Duct work
289 Approach/sidewalk 630 Fire damper
295 Misc. inspection: 635 Smoke detector shutdown
299 Final inspection 640 Exhaust hood
695 Misc. inspection
Fire Protection System inspections 699 Mechanical final
905 Sprinkler underfloor /slab
907 Sprinkler hydro test Plumbing inspections
910 Sprinkler rough - in/test 305 Plumbing underslab
915 Fire alarm rough -in 310 Crawl drain
920 Suppression trip test 315 Post/beam plumbing
995 Misc. inspection 320 Plumbing rough -in
998 Alarm fmal 322 Shower pan
999 Sprinkler final 330 Water service
335 Rain drain
Site Work inspections 340 Storm drain
405 Excavation 345 Culvert/catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection
420 Sprinkler supply lines 399 Plumbing final
495 Misc. inspection
498 Grading final Sewer inspections
499 Final inspection 505 Sanitary sewer
585 Misc. inspection
Erosion inspections 599 Final inspection
750 Initial erosion control
755 Regular erosion control Manufactured Structure inspections _
798 Final erosion control 805 MFG - Structure grading/footing
810 MFG - Structure set -up
I: \Building \Inspection Cards \AOP Insp Card By Case\ InspCard_AI1_070112 899 MFG - Structure final
1 11 CITY OF TIGARD RECEIPT
2 : . 13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
TIGARI)
Receipt Number: 187892 - 08/06/2012
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
ELC2012 -00466 Branch Circuits wo /Purchase Service or 220 - 0000 -43103 $204.58
Feeder
ELC2012 -00466 12% State Surcharge - Electrical 100 - 0000 -24001 $24.55
Total: $229.13
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Credit Card 81603 STREAT 08/06/2012 $229.13
Payor:
Total Payments: $229.13
Balance Due: $0.00
61 13 1 25 SW HALL
TIGARD, OR. 97223
4 i' TERMIiIAL I:D:i 0017340808800313065801
MERCHANT H: 8003138658
VIS
SALE
t
RECORD 0: 16 INU: 080017
DATE: AUG 86, 12 TIME: 14 :54
BATCH: 970
' AUS RESPONSE: V AUTH: 816836
CUU2 RESPONSE: P
ADDRESS AHD 5 DIGIT ZIP MATCH
TOTAL $229.13
ACCORDING ISSUER
(MERCHANT AGREEMENT IF CREDIT VOUCHER)
CUSTOMER COPY
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