Permit y v _ CITY OF TIGARD ELECTRICAL PERMIT
` ` • a COMMUNITY DEVELOPMENT Permit #: ELC2013 -00273
T EG AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/14/2013
Parcel: 1 S135AB01004
Jurisdiction: Tigard •
Site address: 10220 SW GREENBURG RD 570
Project: Wave Connex Subdivision: METZGER, TOWN OF Lot: 9
Project Description: (11) 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
11 crt Branch Circuits wo /Purchase 05/14/2013 $130.38
Specifics: Service or Feeder
1 ea 12% State Surcharge - 05/14/2013 $15.65
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $146.03
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 OA t9 2 -001 -0 90. You ma obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
r"
Issued By: Permittee Signature: l/ Pre—(C411 Ok.
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.
•
05/14/2013 TUE 10:21_, FAX 5036242938 Willamette Electric. 002/002_ , ..,. ... r EI VE FOR orrtcr USE. o
Electrical Permit Applic NLl
U Rccewed
City of Tigard DaterBy: �/t y 1 3 Pe rmit No.: E 0( D U a73
t " 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Q
1 14
Phone: 503.639.4171 Fax: 503. •064 4 2013 Date/By: Other Perrnit:f�e(� - a'j((
TIGARD Inspection Line: 503.639.4175 Date Ready/By: orris: Iii See Page2 for
Internet: www.tigard or.gov CITY OF TIGARD Notified/Method: -riG Supplemental Information
❑ New construction ® Addition /alteration /replacement 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 0 Other: e fault current Marinas and boatyards.
: CO aGd)ftft CONS'TRI)C'F .
• .:. , . ; . tort � or •. • exceeds d e o 000
cee s amps a
cu
1 t 150 vo lts o 0 buildings.
less to ground, or exceeds 14,000
❑ Commercial -use agricultural
❑ 1- and 2- family dwelling 0 Commercial /industrial 0 Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
fi ❑ Addition system.
0)8: 1'I`E '� ) : :, load
• - larger se awte derived �c15u::�tic�
...,.:... ... .: . .. .... : .... ..... ._ .. of new motor oad f ❑ .. py d l - 3 e
:. ::. system.
❑ ition
100HP or more, occupancy.
Job no.: 0 Job site address: n , � 4✓., ❑ Six or more residential units. ❑ Recreational vehicle parks.
L� �G' a G . rte✓ f rYP,! '
Dueri
City /State /ZIP: - ption 1 Qty. 1 Fee. I T otal I
❑ Health -care facilities. ❑ Supply voltage for more than
/ (' ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: � r' t' G C% G -'L e C Project name: oi rl r , x
❑ Servicc or feeder 600 amps or more.
Cross streetldircet' s to job site: ' ' ' ClfC ALE.:::;. ' •:
� n () 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'l 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
'DESCRWI'ION - WOE - (with above sq. fl.) 75.00
2
r Limited energy, multi - famil 75.00 2
residential (with above sq. R.)
f"f1 C h T �1's n V ....0 j Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
0 PROPERTY :'OWNER ]: :x'ENANT . 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: ( ) Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 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 extension, per panel
Owner signature: Date: A. Fee for branch circuits with
.AP.PLICANT . : 1,:l 'CONI,;i:iC1' :. . , , 7.42 2
above service or feeder fee
each branch circuit
Business name: 13. Fee for branch circuits without
service or feeder fee, first / 56.18 .5 `/ / �.r2
Contact name: branch circuit
Each add'/ branch circuit a 7.42 2 � ' 2
Address: Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
67.84 2
dwelling, service and/or feeder
Phone: ( ) Fax:: ( ) Reconnect only 67 2
E - mail Pump or irrigation circle 67.84 2
___ _ . , . Sign or outline lighting 67.84
.. • .. -.... .•:: :_.:::. _COr 'RA 2:; . -• - ; Signal ci rcuit(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 (I 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 90.00/ hr
- specifically listed ('A hr min)
CCB Lie.: 75059 Electrical Lie:: 34 -283C Suprv. Lie.: 4226 -S '':: ;` ELECTRICAL . PERMFF'FEES _ :
- J Subtotal: / 30 . 3 &
Suprv. Electrician signature, requ• Plan review (25% of permit fee).
Print name: David Fife Date: 09/i State surcharge (12% of permit fee):
Authorized signature: TOTAL PERMIT FEE: / �/Gr c,='l
This permit application expires if a permit Is not obtained within 180
Print name: days after it has been accepted as complete.
Date: • Number of inspections allowed per permit.
1:1 BuildingWermit s\ELC- PcrmilApp.doe 07/01/10 440- 4615T(11 /05 /COMJwEn
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10220 SW GREENBURG RD 570, TIGARD, OR,
97223
Commercial - Electrical
199 Electrical final
06/26/2013 00:00
ELC2013-00273
PASS - No C of O
Violation Summary:
Inspector Contractor