Permit n CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2013 -00413
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/23/2013
Parcel: 1S135AB01003
Jurisdiction: Tigard
Site address: 10330 SW GREENBURG RD
Project: Red Lobster Subdivision: METZGER, TOWN OF Lot: 9
Project Description: Temporary power for major remodel of existing restaurant
Contractor: BEND ELECTRIC INC Owner: LINCOLN CENTER LLC
63349 NELS ANDERSON RD UNIT A BY SHORENSTEIN PROPERTIES LLC
BEND, OR 97701 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 541- 382 -3589 PHONE:
FAX: 541 - 382 -3974
FEES
Quantity Description Date Amount
Specifics: 1 ea Temp Services or Feeders - 07/23/2013 $59.36
200 amps or less
1 ea 12% State Surcharge - 07/23/2013 $7.12
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $66.48
Required Items and Reports (Conditions)
This permit ' b to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be d• • - in accordance wit _ .proved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspen• d for more the 180
d' s. ATTENTION: Oregon la . • :res you to follow the rules adopted by the Oregon Utility Notification Center. Thos r- s set forth in OAR
52-001-0010 th • ugh OAR 952-0' 952-Clui 0090. ou may obtain a copy of the rules or direct questions to OUNC by calling 503.23 .1987 6 1.8' .mil 344.
Issued 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:
/ • •• RACTOR INSTALLA • N ONLY
SIGNATURE OF SUPR. ELEC' Date: 7 A3 — �3
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.
Electrical Permit A lication �T FOR OFFICI USE ONLY
of Tigard E1 ED Date /B : 7 m om / E ce I Apl7 Q
/ Permit No.:
13125 SW Hall Blvd., Tigard,OR 97223 Plan Review r
`� C - .- Phone: 503.718.2439 Fax: 503.5980 L 3 , , , .-)1 , -. Date/By: Other Permit: �p� QD / jJ �'
.1 G A k a Inspection Line: 503.639.4175 Date Ready/By: Suns: ® See Page 2 for
Internet: www.tigard- or.gov
CITY T ' G ARn Notified/Method: Supplemental Information
. .
TYPE. r G DIVISION PLAN REVIEW
• El 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 El 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 150 KVA or
' - JOB SITE 'INFORMATION AND 'LOCATION ❑Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "1 -3 ",
Job no.: I Job site address: �//�� p IOOHP or more. occupancy.
r �� � t � / ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: ,/ Off- j ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: ❑ Service or feeder 600 amps or more.
. 'FEE - SCHEDULE ,
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
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 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi- family 75.00 2
% e' _ / I _ residential (with above sq. ft.)
` � Renewable Energy ❑ See Page 2
sk.,., Services or feeders installation, alteration, and/or relocation
❑: PROPERTY OWNER",, I ' ❑ TENANT •. 200 amps or less 100.70 2
' ° l_LoS 201 amps to 400 amps 1 33.56 2
Name: y ^ /' 401 amps to 600 amps 200.34 2
Address: /( � 336 S� / �,�6 601 amps to 1,000 amps 301.04 2
`�[ Over 1,000 amps or volts 552.26 2
City/State /ZIP: Temporary services or feeders inst nation, alteration, and/or
Phone: ( ) Fax: ( ) relocation
200 amps or less t 59.36 69, - fo l
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
Owner signature: Date: Branch circuits- new, alteration, or extension, per panel
' ❑ APPLICANT . • ' I • CONTACT PERSON A. Fee for branch circuits with • above service or feeder fee,
7.42 2
Business name: each branch circuit
B. Fee for branch circuits without
Contact name: service or feeder fee, first 56.18 2
branch circuit
Address: Each add'I branch circuit 7.42 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular 67.84 2
dwelling, service and/or feeder j
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
E - mail: Pump or irrigation circle 67.84 2
• , 'CONTRACTOR ' " , . ' . ' Sign or outline lighting 67.84 2
Business name: Signal circuit(s) or limited energy See
�� 1 Y panel, alteration, or extension. Page 2 2 ..„4„.„, Address: 6 -33 49 v l ` U>JI r Each additional inspection over allowable in any of the above
/ !, J mot - 72741 / Additional inspection hr min) 66.25/ hr
1 �/
City/State /ZIP:
Investigation (1 hr min) ) 66.25/ hr
Phone: ((('/ ) 3» I Fax: ( 5 - 7-J/ ) 3s-,2 _ C9/ Industrial plant (1 hr min) 78.18/ hr
Wit, y Inspections for which no fee is 90.00/ hr
CCB Lie.: Electrical Lie.: 9.- ■ ' _ Supt . Lie.: 9r specifically listed (%2 hr min)
P / g ��/ / �/s= ELECTRICAL PERMIT FEES
Suprv. E ectrician signature, r eq sired: Subtotal:
Print name // all( Date: 7 _ _ 73
_ Plan review (25 % of permit fee):
— State surcharge (12% of permit fee): 7. (1 -
Authorized signature: 4_
� dal- v TOTAL PERMIT FEE: 6/40, q
Print name: 6/y( -- Date: 7 — —� This permit application expires if n a cc pte is not obtained within 180
days after it has been accepted as complete.
• Number of inspections allowed per permit.
1:\ Building\ Permits \ELC_PermitApp_ELR_ERE.doe Rev 05/21/2013 440-4615T(l 1/05 /COM/WEB
Electrical Permit Application — City of Tigard
Page 2 — Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: l: ; . 'FEE ■ SCHEDULE
Fee for all residential systems combined ... $75.00 Description I Qty. I Pee I Total I •
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2 i f::
5.01 to 15 kva 133.56 2 �'
❑ Audio and Stereo Systems*
15.01 to 25 kva 200.34 2
❑ Burglar Alarm Wind generation systems in excess of 25 kva:
25.01 to 50 kva 301.04 2
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva (fee in accordance with 552.26 2
❑ Heating, Ventilation and Air Conditioning OAR 918- 309 -0040)
System* Solar generation systems in excess of 25 kva:
Each additional kva over25 7.42 3
❑ Vacuum Systems* >100 kva — no additional charge 0.0 3
❑ Each additional inspection over allowable in any of the above:
Other: Each additional inspection is
charged at an hourly (I hr min) 66.25/ hr
Inspections for which no fee is 90.00/ hr
_ specifically listed (Y hr min)
COMMERCIAL WORK'ONLY: j ELECTRICAL PERMIT "FEES
Fee for each commercial system $75.00 Subtotal:
(SEE OAR 918- 309 -0000) Plan review, if required (25% of permit fee):,,,,, .1 _ , S;¢
State surcharge (12% of permit fee):.
Check Type of Work Involved: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
❑ Audio and Stereo Systems days after it has been accepted as complete.
• Number of inspections allowed per permit.
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems •
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I: \ Building\ Permits \ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10330 SW GREENBURG RD, TIGARD, OR,
97223
Commercial - Electrical
199 Electrical final
2013-12-10 (null)
ELC2013-00413
PASS - No C of O
Violation Summary:
Inspector Contractor