Permit CITY OF TIGARD ELECTRICAL PERMIT
• COMMUNITY DEVELOPMENT Permit#: ELC2014-00241
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/13/2014
T l c"'��h g Parcel: 1 S135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 210
Project: Advanced Wealth Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Electrical for water heater:(2)branch circuits.
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
2 crt Branch Circuits wo/Purchase 05/13/2014 $63.60
Specifics: Service or Feeder
1 ea 12%State Surcharge- 05/13/2014 $7.63
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 -- .•o•ted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of i --or• = t questions to OUNC by calling 503.232.1987 or 1.800.332 2344.
Of
Issued Permittee Signature: _ `i
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.
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard 4 Received
111��� Permit No.:
Date/By: 7. (3 %Y / i--; 26/4—edo91.1,/
NI I • 13125 SW Hall Blvd.,Tigard,OR 97223 " Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Other Permit:
01� Date/By: �r��dl�j�Lam(
TI GARD Inspection Line: 503.639.4175 �7 Date Ready/By: Juris ® See Page 2 for
Internet: www.tigard-or.gov (7 s Notified/Method: T v Supplemental information
. ,. }} ,, f a' . i�] .�� ': t - k3 ! 4 r V v p i, c ti
❑New construction [A Addition/alteration/replacement
Please check all that apply(submit I sets of plans w/items checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
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 El Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
❑Emergency system. larger separately derived system.
t„.OR%1 TION AND LOCATION' ❑Addition of new motor load of ❑"A","E","1-2","1-3",
100HP or more. occupancy.
Job no.: 9__,'pJ Job site address: %G,aac $tu ,,r Farr v,1,_4.� P
/� l 0 or more residential units. ❑Recreational vehicle parks
City/State/ZIP: ]/C 7 2 2 3 ❑Health-care facilities. ❑Supply voltage for more than
�l l? t;,,,,,,/ ( ❑Hazardous locations. 600 volts nominal. 1
UitC ld ./a t.no.: Project name: ❑Service or feeder 600 amps or more.
g 2/C� J 9C l�l,n c PC�Gv Wit,/�L ,:., .;f.,'
Cross street/directions to job site: Description Qty. Fee. Total •
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: I 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
(with above sq.ft.) 75.00 2
Limited energy,multi-family
75.00 2
t_t,s/r j,^ i Ce f .ii/ --P/— /�LleeT! _� residential(with above sq.ft)
Renewable Energy ❑ SeePage2", .
Services or feeders installation,alteration,and/or relocation
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 2
City/State/ZIP: Temporary services or feeders installation,alteration,and/or
Phone:( ) l Fax:( ) relocation
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
Owner signature: Date: Branch circuits—new,alteration,or extension, .er panel
i xe q _.,al �i ii 19 y,;j. ‘, A.Fee for branch circuits with
+r z- pJ above service or feeder fee,
Business name:
each branch circuit 7.42 2
B.Fee for branch circuits without
Contact name: service or feeder fee,first / 56.18 5Cp /� 2
branch circuit
Address: Each add'I branch circuit / 7.42 .' yz' 2
City/State/ZIP: Miscellaneous(service or feeder not included)
t7 Each manufactured or modular
67.84 2
dwelling,service and/or feeder
Phone:( ) I Fax: ( )
Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
J, - 4,:, u ...v4' "d'1^i. _. Sign or outline lighting 67.84 2•
Business name: / i •Ir / "gra C,- j' Signal circuit(s)or limited-energy See
` panel,alteration,or extension. Page 2 2
Address: i7 -� Z (� Each additional inspection over allowable in any of the above
c_� 7�� ! 7 Additional inspection(I hr min) 66.25/hr
City/State/ZIP: 1 ,k F'72 / Investigation(I hr min) 66.25/hr
Phone:O -- �'3/ Fax:( ) l b7.y Zcl Industrial plant(1 hr min) 78.18/hr
`/ Inspections for which no fee is 90.00/hr
CCB Lic.:'7�X47 Electrical Lic.3/f 2 e_Suprv.Lic.: !�-7� 5 s.ecificall listed 'h hr min
( `. , 4,0i.:t tL t t,'i rI ii i. t ri'ci1
Suprv.Electrician signature,required: Subtotal: /,, 3 1L'
Print name:
),..) ti--() i> -c--6., Date: Plan review(25%of permit fee):
State surcharge(12%of permit fee): t) 4/3
Authorized signature: TOTAL PERMIT FEE: 47/ 3
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
1:\Buildingl Permits1ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(11/05/COM/WEB
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10220 SW GREENBURG RD 210, TIGARD, OR,
97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2014-00241
Jeff Grove
Violation Summary:
Inspector Contractor