Permit ' :,`
CITY OF TIGARD ELECTRICAL PERMIT
;':,- COMMUNITY DEVELOPMENT Permit #: ELC2010 -00033
T I GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 01/21/2010
Parcel: 1S135AB00900
Jurisdiction: Tigard
Site address: 10200. SW GREENBURG RD 400
Subdivision: LINCOLN CENTER /FIVE LINCOLN Lot: 0
Project: North Pacific Group
Project Description: (5) branch circuits for UPS room.
Owner: FEES
LINCOLN CENTER LLC Quantity Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL 5 crt Branch Circuits 01/21/2010 $85.86
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 01/21/2010 $10.30
Electrical
Contractor:
STONER ELECTRIC
1904 SE OCHOCO
MILWAUKIE, OR 97222
PHONE: 503 - 462 -6500
FAX: 503 - 659 -4968
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $96.16
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. ATTENTI . law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -001 rough OAR 9 -0 0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued B • • �. . .0 4 i 14 "- 4 L Permittee Signature: 41111111111 ��' ��I✓li C./ ..
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' ` � _ I M Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
Jan, ?0, 2010 1:19PV No. 1054 P. 1
'Ili o kJ Rr J
Electrical Permit AnoliCation. i u. # 7 i" e� y l�t)Ir 1)I 1't1(� 1 1 .t)a\i I l 1; 4 1,.. '
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4 '• Received
,, - C of Tigard JAN 2 0 201 gate/:: ! O /o Mr PermitNo.: Eke. ao4o - acer3 4
13125 SW 1Xe11$1vd., Tigard, OR 07223 ]Plan Tlpviem
■ ' Phone: 503.639.4171 Pax; 503.598.1960 . or TIGAR IP '16B Other hlermit:
T I I ) h Inspection T Line: • 503.639.4175 ' CITY b +: Ready/By: ® See Page 2 rot
Internet: www.ligarti-or.gov BUILDING DIVIS ti. RrdlMe
reihod:
MI SLpptementeiInfonuatlon
'TM OP WORK PLAN REVIEW
❑ New constnlction ddition/nitoratioa/roplaccmcnt Plmse choek MI that apply (submit a seta of pilau whtems checked below ):
❑ Service orfceder400 amps ormore ['Building over threestonea
o Demolition ❑ Other where the available fault current ❑laCsrinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 =plat 15proltsor ['Pleating buildings.
less to ground or exceeds 14,000 ❑ Caemercial -trc agricultural
❑ I- and 2- family dwelling rgCommerciaUndustrial ❑ Accessory building amps for an other installation& buildings.
❑ Multi- family ❑ Masterbuildcr ❑ Other: ❑Fire pump. ❑InataUation
JOB SITE INFORMATION AND LOCATION ❑)7metgency la r$erseperetely derivedsystem.
• ❑Addition of rxw motor load or ID "'&", "l -`, 1
Job no.: bze.oc Job site address: /0 21lb i .,_1 �.,t/grr ]oollP orrnac: occupancy.
�� ❑ SixarmoreresideNialunits. ❑Recreational vehicle parks,
Ci[y /$t's[e/ZIPa ( Qe 9 7 z ❑HeeIth-earcfatilitiea ❑Srppbvoltagpfumoredmn
❑He�rdoiislocaiona 600volmruaonaL
44J dg. /apt.no.:0 I Project nit eke/C4,J 17 (8,L, r e, $, ❑ Seerica a feeder 600 amp: Orm(5re.
FEE SCHEDULE
Cross street/directions to job sile: 02 P4 j Le A ,�ptba 1 Qry. 1 roe 1 rotas 1 •
New residential single- or multi family dwelling unit.
T Includes attach garages
Subdivision: Lot no.: 1,000 sq. ft or less 168.54 4 _
Tax map/parcel no.: Ea. add'l' sq, ft; or portion 33.92 1
Limited energy, residential 67.84 2
DESCRIPTION OF WORK (withebovcaq:ft)
Limited onergy, multi - family
Lc 1/4e ■r e_ (J,' /4.., 07., (with above sq. R) 67.84 2
Services or feeders lnttallallon,alterallon, and /or relocation
200 amps or less _ 100.70 2
❑ PROPERTY OWNER I • 0 TENANT 201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
601 amps, to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City, /Stare/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) I Fox; ( ) 200 amps Or lest 5936 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, mnt, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.34 2
Branch ciraiita new alteration Or extension . er . anel
Owner signature! Date: A,Pee for branch circuits with
APPLICANT I ❑ CONTACT PERSON above service or feeder fee,
7.42 2
each branch circuit
Business name: B. Fee for branch circuits
Contact Hama:
without service or feeder fee, 1 56.18 /e 2
_ ` foal branch circuit
Address: Each add'Ibranch circuit ,l/- 1 7.42 29,4, 6 2
— - Miscellaneous (service or feeder not Included)
City /State/ZIP: Each manufactured or modular
—
dwelling, service and/or feeder 67.84 2
Phone: ( ) I Fax: : ( ) Reconnect only 67.84 2
E , Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Ausinoss natno: Signal circuit(a) or limited-
STONER ELECTRIC, INC. energy panel. AIteration,
Address: 1904 SE OCHOCO extension., Describe: Page 2 2
City /State/ZIP: MILWAUKIE, OREGON 97222 Each additional Inspection over allowable In an of the above
Per inspection 66.25
Phone: (503 462 -6500 Fax; (503) 659 -4968 Investigation per hour (1 hr min) 66:25
CCD Lie.: 44$23 I Electrical Lie.: 26 -122c Suprv. Lie.: 34965 Lidusirial lard per hour 78.18
_RLF,CPRICAL PERMIT PEES
Suprv. Electrician signature, required: i Subtotal: 8 , 6
Printnamc: MICHAEL FALCONER Date: / I2.D1,1r Plan review (2346ofpormilfao): $
- State aurchargc permit fco): /o, 3 0
Authorized signature: TOTAL PERMIT FEE: 94,1 4,
Print Hama: __________J Date: This permit appllcatbn expires Ifs permit is not obtained within 180
days after it has been accepted as complete.
' Number ofinspec tionr allowed per permit,
r:uaurm,le0'emit.\EI -PrrrollAra.doc 1041■09 440 46157CI r O5/COMiWEn