Permit CITY OF TIGARD ELECTRICAL PERMIT
s.; COMMUNITY DEVELOPMENT Permit #: ELC2013 00222
T [ G .R.D 13125 SW Flail Blvd.. Tigard OR 97223 503.718.2439 Date Issued: 04/16/2013
Parcel: 1S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD
Project: Lincoln Center Subdivision: METZGER, TOWN OF Lot: 9
Project Description: (5) branch circuits to remodel lobby's on floors 2,8,9,10 and 12 new lighting
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
5 crt Branch Circuits wo /Purchase 04/16/2013 $85.86
Specifics: Service or Feeder
1 ea 12% State Surcharge - 04/16/2013 $10.30
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $96.16
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 52 001 -009 . You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1 or 1.800.332.2344.
Issued By: Permittee Signature: 011 "PPL-' rnO .
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.
04/15/2013 MON 16:50 FAX 5036242938 Willamette Electric 11002/002 ,
Electrical Permit ApplicatifiEcEIVED FOR OFFICE USE ONLY
City of Tigard 1��1 X111 ll..lJ Received U S/ • Date/By: 1 b 1 3 Permit No.: ts'(,L.o20 j:_6p0
I/ " 13125 SW Hall Blvd., Tigard, OR 97223 R 1 5 2013 Plan Review
a Phone: 503.639.4171 Fax: 503.598.19 Date/By: Other Permit:
[' i G A R D Inspection Line: 503.639.4175 Date Ready/By: 68 see Page 2 for
Internet: www.tigard•or.gov CITY OF TIGARD Not ifiedJMethod: Supplemental Information
• TYPE OF tikilifiDtNG DIVISION
PLAN Riv1'71;W r- --•.�
❑ New construction 10 Addition /alteration /replacement Please check all that apply (submit; sets of plans w/iterns checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
• exceeds 10,000 tun al 150 volts or
.'• • G - Xt'Sf '. COWS U . .N .... - ; is ❑Floaling
less to ground, or exceeds 14,000
❑ 1 and 2 family dwelling [Commercial/industrial ❑ Accessory building amps for all other installations. ❑ buildings.
atina agricultural
❑ Multi - family ❑ Master builder ❑ Other: 0 Fire pump. ❑ Installation of 75 KVA or
. ❑ E gency system. mo y em
larger separately derived s st
SOB S>I`1'E Op f siWa -,� si AND • LOCATION U Ad ition of ne w for load of p " A ", "B " °1 -2 ", "1 3 ",
Job site address: i,.../....,0,..,‘ 100HP or more. occupancy.
Job no.:
7 �9 /6 /.1 5 A > it , . ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: --te Cp' . ^� O Health -cue facilities. ❑ Supply voltage for more than
-- / - 4, cr , a--E 0, ! / ❑Hazardous locations. 600 volts nominal,
Suite/bldg./apt. no.: Project name: / / -- ❑ Service or feeder 600 amps or more.
/_ E' Cj /! 1"r 7(� Y � � C •: 'FEE SCIEDULE • Cross street/directions to job site: Description • ( iption .. `.• . i oil 4.. I T aw 1 •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft or less 168.54 4
Ea, add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
:DESCRIPTION OF WORK (with above sq. fl.) 75.00 2
• Limited energy, multi- family 75.00 • 2
r
/ ' r S / r <i 9. /0. /2-- residential (with above sq. ft.)
i r• Services or feeders installation, alteration, and/or relocation
/V 't . A ., / / - r l l c ,-, c - / i� fi� A h y 200 amps or has 100.70 2
❑ PROPERTY :OWNER 0'. TENANT / 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
City/State/Z1P: Temporary services or feeders installation, alteration, and /or
ty 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 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. -
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
APPLICANT aboveserviceorfeederfee,
0 CONTACT. • PERSON
each branch circuit 7A2 2
Business name: B. Fee for branch circuits wfrhout
service or feeder fee, first / 56.18 , .5 r, 2
Contact name: branch circuit
Each add'l branch circuit 7.42 z'9 • 2
Address: Miscellaneous (service or feeder not included) _
Each manufactured or modular
City/State/ZIP: dwelling, service nd/or feeder 67.84 2
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
E -mail: Pump or irrigation circle 67.84 , 2
Sign or outline lighting 67.84 2
CONTRACTOR
Signal circuits) or limited energy
Business name: Willamette Electric Inc. panel, alteration, or extension. _ Page 2 2
Each additional inspection over allowable in may of the abov
Address: P.O. Box 230547 Additional inspection (1 hr min) 66.25/hr T
Investigation (1 hr min) 66.25/hr
City/State/ZIP: Tigard, OR 97281 Industrial plant (t hr min) 78.181 hr •
Phone: (503) 624 -3631 Fax: (503) 624 -2938 Inspections for which no fee is 90.00/hr
specifically listed (t/r hr min)
CCB Lic.: 75059 Electrical Lic.: 34 -283C Suprv. Lie.: 4226 -S ELECTRICAL :PERMtr::FE1 K .
�_ Subtotal: c
Suprv. Electrician signature, requ •
Plan review (25% of permit fee):
Print name: David Fife Date: L -Z State surcharge (12%ofpermmit fee): / Ca •j
// .,
/ TOTAL PERMIT FEE g W .
r
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: I Date: • Number of inspections allowed per permit. /9
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