Permit CITY OF TIGARD / /1 0 ELECTRICAL PERMIT
li
° VV PERMIT #: ELC2006 -00644
COMMUNITY DEVELOPMENT DATE ISSUED: 11/9/2006
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135AB-01003
SITE ADDRESS: 10330 SW GREENBURG RD RED LOBSTER ZONING: C -P
SUBDIVISION: LINCOLN CENTER/ONE LINCOLN LOT : JURISDICTION: TIG
, Project Description: RED LOBSTER. (1) branch circuit for rooftop HVAC.
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: 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:
EQUITY OFFICE PROPERTIES TRUST BOB'S ACTION ELECTRIC INC
ONE SW COLUMBIA ST #300 2700 NE BURTON ROAD #A
PORTLAND, OR 97258 VANCOUVER, WA 98662
Phone: Contact #: PRI 360- 254 -7200
FAX 360 - 254 -8219
FEES
Description Date Amount Reg #: ELE 37 -43IC
[ELPRMT] ELC Permit 11/9/2006 $46.85 LIC 53136
[TAX] 8% State Surcharge 11/9/2006 $3.75 SUP 4322S
Total $50.60 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: 2 23 Permittee Signature: t" , - 31 Q . C/ .. .e l ,.. / ------
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.
ctrical Permit Appl',�,, l.'-rt, FOR O FFICE U SE Ele ONLY
°- ����® Received
City of Tigard Q Date/13y: —/ Q ► , 4- -
13125 SW Hall Blvd., Tigard, OR 97223 NOV iy ZOO' Plan Review ,
Phone: 503.639.4171 Fax: 503.598.1960 ,
Date /B other Permit:
Inspection Line: 503.639.4175 C OF TIG' _ e` ' I� Date Ready: /By. luris H See Page 2 for
Internet: www.ci.tigard.orus g�1�D%NG D • V • ' Notified /Method: ! Supplemental Information
.: •TYEE.OF . .WORK ..:
: 'PLAN REVIEW .
❑ New construction ❑ Addition /alteration/replacement Please check all that apply
10 Demolition ❑Other: ❑Service over 225 amps, comm 'I ❑Hazardous location
1 , t amps - rating ❑Bu ldng over 10,000 sq. ft.,
1'.. -; • ;`•••';'' ..•.CATEGORY:E OF ' CONSTRUCTION . • of - and 2- family dwellings 4 or more new residential
. ' ..
❑ 1- and 2 family dwelling ® Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
EBuilding over three stories EFeeders, 400 amps or more
❑ Multi - family 0 Master builder
99 99 rsons r to red persons structures or
Other:
['Occupant load over nu
,
:; _.:.:•..::` ` ::.; ; .. ':TOB SITE: °.:`AND , • : LOCATION:::.: , :: .:r. ., ' :r ❑Egress /lighting RV pal:
e str -
Job no. 06-994 Job site address: 10300 SW Greenburg
❑Health -care facility ❑Other:
Submit 2 sets of plans with any of the above.
City /State /ZIP: Tigard, OR 97223 The above are not applicable to temporary construction service.
o.: Project FEE* • SCHEDULE.
Suite/bldg./apt. g' /a t p I Po ect name: ) Red l obster r' Description Qty. I Fee. Total
Cross street/directions to job site: New residential single - or multi dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 I I 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion . 33.40 l
Limited energy, residential 75.00 2
Tax map /parcel no.:
Limited energy, non - residential 75.00 2
.,. , ...:..:...
.1 DESGRIP.TION:w:OF WURK;.:: ::: .� 'it...:
, _ .., ... .. - - - Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Roof top HVAC connection. Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
...
..TE NANT. ': " :: = ".:
01 amps to 400 amps 106.85
. °: ' ' ::::.::.: :::...:P ROPERTY:OWIVER; ;,� ; - >,; ..• •'`,.:: ; , :?'� :: -;; .< .::. .::..... �
401 amps to 600 amps 160.60 ; 2
Name: Red Lobster 601 amps to 1,000 amps 240.60 2
Address: 10300 SW Greenburg Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 I 2
City /State /ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( )
200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not I 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 I 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
:.v,: , -: A. Fee for branch circuits with
>;..: ::. ';❑ APPLICANT ' 'i .i. . .: s . .
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
Address: each branch circuit 1 46.8 46.85 2
Each add'l branch circuit 6.65 I 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle I 53.40 ' 2
Phone: ( ) Fax: : ( ) •
Sign or outline lighting 53.40 . 2
E - mail: Signal circuit(s) or limited-
,...:,... .,.. , •. -
: 'CONTRACTOR'. '•.,••:: j:, energy panel, alteration, o r
extension. Describe: Page 2 2
Business name: Bob's Action Electric
Address: tt rt Each additional inspection over allowable in any of the above
2700 NE Burton Rd. "A" Per inspection 62.50 I I— -
City /State /ZIP: Investigation per hour (I hr nun) 62.50
Vancouver, WA 98662
Industrial plant per hour
Phone: ( 360) 254 -7200 Fax: ( 360 ) 254 - 8219 73.75
: '.• : ''',;;;'.` '.•ELEC`TRICAI,:PERMIT - FEES*
CCB Lie 53136 Electrical Lic.: 337 - lc Suprv. Lic.: 4322S Subtotal 46.85
Suprv. Electrician signature, required: . / Plan review (25% of permit fee)
Print name: Kevin Broselle 11/1 Date: State surcharge (8% of permit fee) 3.75
TOTAL PERMIT FEE 50.60
Authorized signature: This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete
Print name: Date: • Fee methodology set by Tn- County Building Industry Service Board
' ** Number of inspections per permit allowed.
r\ Bui rdin¢\Permits \ELC- PermitAsp.doc 12/03 440 4615f(10 /02 /COMLWEB