Permit CITY OF TIGARD fir:' ELECTRICAL PERMIT
•
13 .Y - COMMUNITY DEVELOPMENT Permit #: ELC2013 00157
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439
� Date Issued: 03/11/2013
Parcel: 1 S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 265
Project: Reliance Subdivision: METZGER, TOWN OF Lot: 9
Project Description: (4) branch circuits for TI. 3/27/12, reprinted to correct suite number from #285 to #265.
Contractor: WILLAMETTE ELECTRIC INC Owner: LINCOLN CENTER LLC
PO BOX 230547 BY SHORENSTEIN PROPERTIES LLC
TIGARD, OR 97281 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
•
PHONE: 503 - 624 -3631 PHONE:
FAX: 503 - 624 -2938
FEES
Quantity Description Date Amount •
4 crt Branch Circuits wo /Purchase 03/11/2013 $78.44
Specifics: Service',or Feeder
1 ea 12% State Surcharge - 03/11/2013 $9.41
• Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $87.85
• 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 is - • - , if work is suspended for more the 180
days. ATTENTI : Orego aw requires you to follow the rules adopted by the Orego. Wtdity enter. Those rules are set forth in OAR
952- 001 -0010 rout h OAR 952 -•' 1 -00• •. ou ma obtain a copy of the rules or direct questions t. OUNC by calling • or 11..800.332.2346.
Issued By: �_ �!L _ Permittee Sig • � Y i
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 PERMIT
' ! COMMUNITY DEVELOPMENT Permit #: ELC201300157
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503.718.2439 Date Issued: 03/11/2013
Parcel: 1S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 285
Project: Reliance Subdivision: METZGER, TOWN OF Lot: 9
Project Description: (4) branch circuits for TI
Contractor: WILLAMETTE ELECTRIC INC Owner: LINCOLN CENTER LLC
PO BOX 230547 BY SHORENSTEIN PROPERTIES LLC
TIGARD, OR 97281 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE 503 - 624 -3631 PHONE:
FAX: 503 - 624 -2938
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo /Purchase 03/11/2013 $78 44
Specifics: Service or Feeder
1 ea 12% State Surcharge - 03/11/2013 $9 41
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $87 85
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 52-- 00111- -090 You may obtain a copy of the rules or direct questions to OUNC by calling 503 232.1987 800 332 2344
Issued By: J4J t t Permittee Signature: D�I r I f PLA C ( 0 kI
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.
03/11/2013 BON 14:21 FAX 5036242938 Willamette Electric lj002 /002
1
Electrical Permit Application F O R OFFICE USE ONLY I
RE CEIVE I � � . =- ;
City of Tigard Received
„ Tigard, OR 97223 MAR 1 0 3 y' ii I I L • • Permit No.: L ga 3 — 00/ 5 -1
• 13125 S4/ Hall Blvd., P lan Review Other Permit:
Phone: 503.634.4171 Fax: 503.598.1960 Date/By:
T I G AR D Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Sari : 63 See Page 2 for '
Internet: www.tigard- or.gov Notified/Method: • 1 6 Supplemental Information
ILDING DIVI3I !:11,414 gy y
❑ New construction ®Addition/alteration /replacement
Please check all that apply (submit 2 sets of plans wilteuns cbe eked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories. '
❑ Demolition ❑ Other where the available fault current ❑ Marinas and boatyards.
. f :• it ry,,hl { }: 4 - 6N4r 4 • . 1: _ exceeds 10,000 at 150 volts or ❑ Floating buildings.
`T^ - '° less to ground, or r exceeds 14,000 .
❑ 1- and 2 - family dwelling �Commercial/industrial ❑ Accessory building amps for all other installations. O Commercial-use agricultural
❑ Multi family 0 Master builder 0 Other: ❑Fire pump. ❑ I nstallation of 75 KVA or
�m ❑ Emergency system, larger separately derived system.
. _ i „ r. ' "7 � 11�T';' O Addition of new motor load of ❑ "A”, " 1 - p. , .. -3 ,.
., // 10011P or more. occupancy.
Job no.: 7 , L Job site address: lv 3 G S s ; i9__ ,1^Pr!h 46r� /tee ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: r, ti - e •n 9 ' 7- ❑ Health -care facilities. ❑ Supply voltage for more than
L✓ e 3 ❑ Hazardous locations. 600 volts nominal.
Uite ld t. no.: Project name: /2_,,,A,,,,..,,,,,,,,.. ❑ Service or feeder 600 amps or more.
g' /a p .2 J '
'4 ,'ti ic4rtr ,
.'•_:i hJ4$G ULE.... , • , ,. 1.
1 Qty. ( re*, „ I � � Total Cross street/directions to job site: Description ' '
ee
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 (with above sq. ft.)
Limited energy, multi- family
'` residential (with above sq. ft.) 75,00 2
� e'''___4 / A C, 1i`� ii✓i y. . Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
0 pF' tiviatta ii ;�
• • , 201 amps to 400 amps 133.56 2
• 401 amps to 600 amps 200.34 2
Name: 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 59.36 1 i
Owner installation: This installation is being made on property that I own which is not 20 amps to 400 amps 125.08 2 i
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, Qer panel
Owner signature: Date: A. Fee for branch circuits with
- APPLR M I T ) �' i :OPI'f# 1'r''i'i 1 above service or feeder fee, 7.42 2
• , each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, fits/
/ 56.18 S� � � 2
Contact name: branch circuit
. Each add'l branch circuit .3 7.42 A a... UU.. 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufbctvred or modular
67.84 2
tY dwelling, service and/or feeder
Phone: ( ) I Fax: : ( ) Reconnect only 67.84 2
E -mail' • Pump or irrigation circle 67.84 2
? .1.. -
Signor outline lighting 2
,1• - e , Signal cirmit(s) or limited 67.84
Business name: Willamette Electric Inc. panel, alteration, or extension. Page 2 2
. Each additional inspection over allowable in any of the abov
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 (1 hr min) 78.18/ hr
Phone: (503) 624 - 3631 I Fax: (503) 624 - 2938 Inspections for which no fee is 90.00 / hr
specifically listed (V] hr min) _ Y
CCB Lie.: 75059 I Electrical Lic.: 34 -283C Suprv, Lic.: 4226 -S ■:; .'4 7 (F1'sE a' , -- 'T. '• "` :rl„1�.;: : •< " '
Subtotal:
� tL_
Suprv. Electrician signature, rec Plan review (25% of permit fee):
Print name: David Fife Date: �//7`- State surcharge (12% of permit tare): 7
7 TOTAL PERMIT FEE: fj' •7 0
Authorized signature:
This permit application expires ir permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
Number of inspections allowed per permit.
1: 1Buildingt Petmiu\ELt.PermhAppdoc 07 /01 /10 440- 4615T(il /05/COM/Wan