Permit •
CITY OF TIGARD ELECTRICAL PERMIT
ill I: COMMUNITY DEVELOPMENT Permit #: ELC2010 -00351
13125 S H all Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/09/2010
T 1 G ARD' Parcel: 1S 135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 300
Subdivision: LINCOLN CENTER /FIVE LINCOLN Lot: 0
Project: LPL Financial
Project Description: (3) branch circuits and (1) signal circuit for fire alarm for TI
Owner: FEES
LINCOLN CENTER LLC Quantity Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL 3 crt Branch Circuits 07/09/2010 $71.02
wo /Purchase Service or
PHONE: Feeder
1 ea Signal circuit or Limited 07/09/2010 $75.00
Energy Panel
Contractor: 1 ea 12% State Surcharge - 07/09/2010 $17.52
CHRISTENSON ELECTRIC INC Electrical
111 SW COLUMBIA ST, STE 480
PORTLAND, OR 97201
PHONE: 503 - 419 -3300
FAX: 503 -419 -3695
Type of Use: COM
Class of Work: ALT 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 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 rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 952- 001.0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. �/
Issued By: �� Permittee Signature: /A `9 , �� 21 � rd "
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNERS SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 603.639.4175 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.
v -.);
JUL-08-2010 THU 01:23 PM cHR 1 qp,Rcy E.q4rjrC INC FM NO. 95034193695 P. 01
Electrical p elIitbw .A licati z 90
City of Tigard Received
fia ., Pet_ .......__._._._ 9 it No.:h2 C /0 .....de
III .--- " 13125 SW liall Blvd., Tigard, 9722,3 ‘; : r
Phone: 503.639.4171 Fax; 59L196 r , h; c }; (,, •■ Date/By; Other Pennit6 1,0 /a - 161/57
—
'1 I (.i A RI) Inspection Line: 503.639.4175 --- .7.: a L. r" . "..,/ ,_ _ ,
Dato Reudy/By. IuriLl: 0 See Page 2 fur
Internet: otww.tigard Notified/Method: Supplemental Infarmntion
'":''' .l , ','l' , '. "•!' • ..• • '' . ''• ': . - i' ":. r1 YIM:c?f - ;.NVc04C , . ' . : - .'.. '.. '' ' : • ..: . .'.',. ii.,•,:..t .!' ..:::'.:!.;:VY.Oitt*S..04#8*
El New construction N Addition/alteration/replacement Please check all that apply (submit 1 sets of pines wfitems checked below):
0 Service or feeder 400 amps or more CI Building over three stories.
0 Demolition 0 Other:
where the available fault current 0 Marinas and boatyards.
, • . ,., . •. , - ._ ., ...... .. , „ . .
*. . :„. . :,::. 1? ,„:•• .• : . , : . , ; - .7; ,c4 !:1'. , i • .: . •.,. ,•': ' . :. '.'.:. :•:,',.,,•':,.. exceeds 10.000 amps ut 150 volts or El Floating building3 .
lass to ground, or exceeds 14,000 13 Commercial-uxu agricultural
0 1 - and 2-family dwelling Co XCmmercial/industrial 0 Accessory building . . amps for all other installauems, buildings.
0 Multi-family 0 Master builder 0 Other: IC Fire pump, 0 Installation of 75 KvA or
larger separately derived syster
• .. : ' ' . : : . '; ' '': J00:;.:$91iL:' 09 ANp ...LackrioN ' : • . .... 'z ,..9 Addition o r new motor lend of [3 "A". "E", "1-2". "
Job no.: Job site address: 10 3 SV,1 &fee ri
El ST units, occupancy,
0 Recreational vehicle parks.
City/State/ZIP: --\ ClHealth-carc facilities. Supply voltnse for
1 0 more thnn 1W 0 Hazardous locutions. 600 volts nominal,
Suite/bldg./apt. no.: 2 01J 1 Project narne:LeL ,T .1:1Service or feeder 600 amps or snare,
• • . ,: .. , 11 . • • , . . .
, r Y :,',... ::'[. ■:'.. . ' : .... ... TEir SetitlAtTV..'.' .
Cross street/directions to job site . E..-,Lio 4 1,..a,1\Q .. _. SI) ?).._ (4E143046 . Dosutiption Qt. 1 Pee. Total •
— Ncw residential single- or multi-family dwelling unit.
Includes attached garage.
- -
Subdivision: I Lot no.: _1,000 sq, fL or less 1 168.54 1 4
Ea. add' I 500 sq. ft. or portion 33.92 I
Tax map/parcel no.:
- -
Limited energy, residential
. .
67,84
• ' ' • : .. ' ' ..''10,00:12074:IN or WOK . : . ''.!' ' •,/:•'':'.! (with above sq. it.)
Limited energy, multi-famtly
67,84
1 A_T CA V .1.1 lb i ‘C,A\‘ DIC U.' . residential (with above sq. II.)
—
_._ Services or feeders installation, Altera ion. and/o relocation
\- S . I.CA . Na- CA e. ut. A -vr.., A caw\ rtili; 200 tamps or less 100.70 2
. • . Ira? PROPO' iV ' ol*Ni* .: .:-.::'. • : ' : . :. ' tE ,,,,, s , t. , : : .., .,,,.,:-.„: 201 amps to 400 amps 13336 2
401 amps to 600 amps 20034 2
Name:
601 amps tO 1,000 amps 301.04 2
Addrcss:
Over 1,000 amps or volts 1 552.26 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP:
relocation _
Phone: ( ) Pax: ( ) 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 1 own which is not - .
401 amps 10 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according 10 ORS 447, 449, 670, and 701.
Branch eircults- new, alteration or extension, per panel
Owner sioature: Date: A. Re for branch circuits with
, •
• •',D. APPLIC : , ; • . ••• ' . ' • I:I 'CONTACT PlilliSON : above service or feeder tea,
•42 2
,..
each branch circuit _
131.1S iness name: B, Fee for branch circuits without
-------- service or feeder fce, first 1
56,18
( 6 1
Contact rime:
branch circuit 90 ..
— —
Encll ticri branch circuit ....7 1 7,42 - 7 i l 'il—[ 2
Address;
Miscellaneous service (11 nut inducted _
Each manufactured r modular
City/State/ZIP:
dwelling. service and/or &oder 67,84 . 2
Phone: ( ) Fax'' ( ) . Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E•mail:
Sign or outline lighting 67.84 KIM 2
COINT14TOK
, , : • C .
. " • , ' Signal circuit(s)orliMited-energy
• el, alteration, or extension. Pa e 2 1/M 2
Business nam-:
lEachadditionalvablc in any of the above
Address: \V ' '`) ,6\ LkyyAbw. ( 9c?).e...) Additional inspection (1 hr min) 66 25/ hr
1.‘ ..
Investigation (I lir min) 66.25/ hr
Cit State/ZIP: •- ttinGY Dr 'V D-
. L industrial plant (1 hr min) 78,18/ hr
one: 05- imuitaa , . )/-40- -2 -4 4 o q. -, ; Inspections for which no feels
90.00/ hr ' I
specifically listrd ( hr min)
CC13 tic. er
Lic.: AaN . tical Lic. • ir S • v. Lic.: /1 - / _ . ; '. • .: .....:: '. ....;.ELECTRICAL • PERMIT. PUS./ i t 4..f.
Ay I ...;. .. 7 D
Suprv. Electrician signature, required: fit/ p_ Subtotal: _
li 1,, .4.. ee): i • • -. '
(--) , z‘ ei- — Plan review (25% of permit f
Print name: kr i •V" ,?-511 ^ kN : -■,__ Date: 1 e State surcharge (12% of pennit fee):
TOTAL PERMIT FEE: '
Authorized signature:
______. Tltio permit application expirt. ir n permit is nut obtai in le II MI —
days after it lint been JeCeptcd s c
Print name: I Date:
. Number of inspectiunn alinwod per perm i t. 65 59
1:\nuildin mme
.Appen, 'i .14n. 4.1 M I /0 /COItIAVI:: ii
--- c - r■ 12:5A--) 7—p5(
JUL -08 -2010 THU 01:24 PM CHRISTENSON ELECTRIC, INC FAX NO. 95034193695 P. 02
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL' V�OR$'.4NLY:
Fee for all residential systems combined .. $67.84
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ )Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other.
COMMERCIAL WORK ONLY:.. ..
Fee for each commercial $67.84
system
(SEE OAR 918 - 309 0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems . . . - l
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Inst Ration
Fire Alarm Installation
IIVAC
❑
Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems! - I
*No Iicenses are required. Licenses are required
for all other installations
1: 1Ruildiutaurmils \GLC•Permir 14,111/N