Permit CITY OF TIGARD ELECTRICAL PERMIT
III - COMMUNITY DEVELOPMENT Permit#: ELC2013-00414
T I G ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/12/2013
Parcel: 1S 135AB01003
Jurisdiction: Tigard
Site address: 10330 SW GREENBURG RD
Project: Red Lobster Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Electrical work 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
1 ea Services or Feeders-Over 08/12/2013 $552.26
Specifics: 1000 amps or volts
174 crt Branch Circuits w/Purchase 08/12/2013 $1,291.08
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea Plan Review Electricial 08/12/2013 $460.84
Type of Const: 1 ea 12%State Surcharge- 08/12/2013 $221.20
Electrical
Occupancy Grp:
Total $2,525.38
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 :. • •-• , with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is spen ed for more the 180
days. • ENTION: Orego law re• 'es you to follow the rules adopted by the Oregon Utility Notification Cent r. r-•.e e re s forth in OAR
95 101-0010 through OAR 952-00 %690. Y . may obtain a copy of the rules or direct questions to OUNC by calling 503. 32.19 • t. 33 4 .
Issued By: i.t..0 `I Permittee Signature: G`
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:
• / CONj CT•R INSTALLATIO NLY
SIGNATURE OF SUPR.ELEC' S • Date: g' a-. 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 Application
��T///���
City of Tigard �D • Date/By: 7 3 f«aa/3-00 yly
1LLdd Received /3 I Permit
° 13125 SW Hall Blvd.,Tigard,OR Plan Review
0 /R Other Permit: /6
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: �/743 �/3�� a
1.I Ci ` �I� Inspection Line: 5013.639.4175 but 2 3 2013 Date Ready/By: ' Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: ,, /7 3 57 7� Supplemental Information
TYPE OF nw1 wl" �e4 I>(-'' 4-PLAN REVIEW
I'New construction ❑Addition/�b}� �hi Please check all that apply(submit 1 sets of plans w/items 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
❑ I-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","1-2","I-3",
Job site address: 100HP or more. occupancy.
Job no.:
I 033o 4 0 Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: '7r'r� ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: • ?„„ciLts...,4_,_ ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qtr. 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
Tax map/parcel no.: Ea.add'I 500 sq.R.or portion 33.92 I
Limited energy,residential 75.00 2
�r
DESCRIPTION OF WORK / 0 �j/� (with above sq.ft.)
�62,.c T ✓v0/t ieP�G.„,0WA lee„,5 044/
Limited energy,it above multi-family 75.00 2
residential(with abo're sq.ft.)
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER I ❑ TENANT 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
Address: 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts + 552.26 5v,A,5v, 2
City/State/ZIP: Temporary services or feeders installation,alteration,and/or
Phone:( ) I Fax:( ) relocation
200 amps or less 1 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
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, 175
7.42 I l l 08 2
Business name: each branch circuit I
B.Fee for branch circuits without
Contact name: service or feeder fee,first
branch circuit 56.18 2
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
I dwelling,service and/or feeder _
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: b :-L.. ` , Signal circuit(s)or limited-energy See �
_ panel,alteration,or extension. Page 2 I L
Address: (�334/9 if j e.e......r Each additional inspection over allowable in any of the above
�) � Additional inspection(1 hr min) 66.25/hr
City/State/ZIP: CNe_ 1/ 0,--- e.??DI Investigation(1 hr min) 66.25/hr
Phone:(57/() 381 73 I Fax:(9// ) • /_39?c ustrial plant(1 hr min) 78.18/hr
t Inspections for which no fee is 90.00/hr
CCB Lic.:/�/ Electrical Lic.: -- • , Sup . ic.:' , specifically listed(%:hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature required
Subtotal: it 0 d
f . 3'1
Print name i l/ 6tAly Date: ? 3 1 3 _
Plan review(25%of permit fee): 4/4N), VI
State surcharge(12%of permit fee): ,2i I,d0
Authorized signature: of/ TOTAL PERMIT FEE: 5 25 3g
Print name: / Date: This permit application expires if a permit is not obtained within 180
oZ3—1..i days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\Building\Permits\ELC_PemtitApp_ELR ERE.doc Rev 05/21/2013 4504615T(I I/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
•
Limited Energy Permit Fees: • Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Fee for all residential systems combined ... $75.00 • Description I Qh• I Fee I Total
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
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
OAR 918-309-0040) 552.26 2
❑ Heating, Ventilation and Air Conditioning
System* Solar generation systems in excess of 25 kva:
Each additional kva over 25 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(1 hr min) 66.25/hr
Inspections for which no fee is 90.00/hr
specifically listed(%hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system $75.00 Subtotal:
(SEE OAR 918-309-0000) Plan review,if required(25%of permit fee):
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
•
El Fire Mann.Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
El 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
-
1:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 05/2112013
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10330 SW GREENBURG RD, TIGARD, OR, 2013 -11 -25 00:00:00
97223
Record Type: Record ID:
Commercial - Electrical ELC2013 - 00414
Inspection Type: Result:
199 Electrical final PASS - No C of 0
Comments:
Violation Summary:
Inspector Contractor