Permit CITY OF TIGARD ELECTRICAL PERMIT
r • COMMUNITY DEVELOPMENT Permit #: ELC2013 -00330
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/13/2013
Parcel: 1 S135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 135
Project: AmCheck Subdivision: METZGER, TOWN OF Lot: 9
Project Description: Add (1) new circuit and modify (2) circuits, and low voltage for fire alarm.
Contractor: COCHRAN INC Owner: LINCOLN CENTER LLC
7550 SW TECH CENTER DR #220 BY SHORENSTEIN PROPERTIES LLC
TIGARD, OR 97223 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503 - 234 -6564 PHONE:
FAX: 503 - 238 -2098
FEES
Quantity Description Date Amount
3 crt Branch Circuits wo /Purchase 06/13/2013 $71.02
Specifics: Service or Feeder
1 ea Signal circuit or Limited 06/13/2013 $75.00
Type of Use: COM Energy Panel
Class of Work: ALT 1 ea 12% State Surcharge - 06/13/2013 $17.52
Electrical
Type of Const:
Occupancy Grp:
Total $163.54
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 a •-• • ance with = • •roved • • . This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. AT ' TION: Oregon law • uires you • follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001 -• 010 throu „ h OAR 952 - 00,5!090. •btain a copy of the rules or direct questions to OUNC by callin 503.232.19;7 or .800.33 344.
�% � i
Issu • By: Permittee Signature:
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 INSTAL TION ONLY
SIGNATURE OF SUPR. ELEC' /, , , 01 ,! ( � � _ Date:
LICENSE NO.
Call 503.839.4175 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.
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard Date/B ; ®��` P ermit No.: Lie��3 -00 3
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
I I I Phone: 503.718.2439 Fax: 503.598.1960 Date /B : Other Pennit:, PAD/ 5 - DD /3 e
TIGARD Inspection Line: 503.639.4175 Date Ready /By: rum: ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK • PLAN REVIEW
El New construction SI Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w/iteins checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION
/3_4' ❑ Addition of new motor load of ❑ "A ", "E ", "1- 2 ", "1 -3 ",
Job no 00 Job site address: M7261 ��� :��,r 7�x IOO or more. R occupancy. Recreational .C.�� � /u� ❑ Six or more residential units. ❑Recreational vehicle parks.
City/State/ZlP: lPA,zO 0 9 7 7� ❑ Health-care facilities.
❑ Supply voltage for more than
9 ` / ❑Hazardou locations. 600 volts nominal.
Suite/bldg. /apt. no.: 136 I Project name: kyl eheer ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: 14.961rei bur ' A,„� KC Description I Qty. I Fee. I Total I
�, New residential single - or multi - family dwelling unit.
,.(,t) LQOAsh SQu�ep Includes attached garage.
Subdivision: 7 I Lot no.: 1,000 sq. ft. or less 168.54 4
Tax map /parcel no.: Ea. add'l 500 sq. ft. or portion 33.92 1
,t��_ ' /. � Limited energy, residential
DESCRIPTION OF WORK 40/0 V 9-I re1 i (with above sq. ft.) 75.00 2
Ieu) !
/� '' l Limited energy, multi - family
l Ct90/¢D•&. Ph? 4 4 — Amdleek - 4 i n , 6 5 residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation
( — go 1, F' ( z, )0_ rbohou - .11 j &.) 200 amps or less' 100.70 2
❑ PROPERTY OWNER 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
Temporary services or feeders installation, alteration, and /or
City/State/ZIP: relocation
Phone: ( ) I 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
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
❑ AP LICANT I CONTACT PERSON above service or feeder fee, 7.42
each branch circuit
Business name: �/ ❑ �/ p B. Fee for branch circuits without
�` /TNTn C > service or feeder fee, first / 56.18 � ��r/ Q
Contact name: m 1 i pe�Pj branch circuit / 2
CC C Each add'I branch circuit a 7.42 / L/ • 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: 3) 730 -7 Q1 2 I Fax: : @71 ) 2 1 ) Li� 8 Reconnect only 67.84 2
E -mail (b�h �C Oft n , Co - Pump or irrigation
tlineti lighting 67.84 2
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited- energy
Business name: COCHRAN INC panel, alteration, or extension. l Page 2 7S 2
Each additional inspection over allowable in any of the above
Address: 7550 SW TECH CENTER DR. SUITE #220 Additional inspection (I hr min) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
City/State/ZIP: TIGARD OR 97223 Industrial plant (I hr min) 78.18/ hr
Phone: (971) 205 - 4242 I Fax: (971) 205 - 4268 Inspections for which no fee is 90.00 / hr
specifically listed (' /n hr min)
CCB Lic.: 72942 I Electrical Lie.: 37546C I t uprv. Lic.: 3447S ELECTRICAL PERM IT FEES Q of
Suprv. Electrician signature, required: C (25% Subtotal. /Y��
\ Plan review (25 /u of pennit fee): /^ 0'
Print name: KENNETH
/9 I 1
TO I Date: �� _/� /� State surcharge (12% of permit fee): t
gn / N . TAL P ERE: �
Authorized signature: G f r
/ �t This permit application expires TO if a permit is not FE ob tained within 180
days after it has been accepted as complete. I 2
Print name: 1 ) b n � „ ,, Date: �d • Number of i nspections allowed per permit. G t7
1: \Buitding\Permits \ELC- PermitA oc 07/01/10 440-46 15T( 1 1 /05/COM/WEB