Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00447
'TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/05/2011
Parcel: 1 S 135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD
Project: Three Lincoln Subdivision: LINCOLN THREE Lot: 0
Project Description: Install outlet for alarm system.
Contractor: FRONTIER ELECTRIC OF WASHINGTON INC Owner: LINCOLN CENTER LLC
7217 NE 99TH STREET BY SHORENSTEIN PROPERTIES LLC
VANCOUVER, WA 98662 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 360 - 892 -4342 PHONE:
FAX: 360 - 892 -1559
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 08/05/2011 $56.18
Specifics: Service or Feeder •
1 ea 12% State Surcharge - 08/05/2011 $6.74
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
Required Items and Reports (Conditions)
This permit is ' . • - • to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done i• accordance with approved • ans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. A' ENTION: Oregon I.w - quir >- •u to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001 1010 through OAR 952-V " -0090. ' ay obtain a copy of the rules or direct questions to OUNC by calling or 1.800.332.2344.
Issued r■ _ ' • 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:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' `�1��i �. 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.
AUG -05 - 2011 05:09 ' ItI J E C TRI P.04
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City of Tigard Received
Date/By: PermitNo.: &C,?a// t 97
q L3 U G� 5 2011 Plan Review 0_5A.017 ' a 13125 SW Hall Blvd., Tigard, OR 972 A . Phone: 503. 718.2439 Fax: 503.59 6 Date/Bv: Other Permit:
TIC, A I: n Inspection Line: 501639.4175 UI I Y OF TIGARD Date Ready/By: lads' 10 See Page 2 for
Internet: www.tigard - or.gov BUILDING DIVISION Notified/method: Supplemental Information
Y y -_ :.... -_ -. y � . ) - ....[; ..:Y ¢t -•. x- axa:rs.- 1 cc.n�r..vs:...w' -- - _
.�: "' `�• "�- : .�:'= `.Tr1'P�,.O���z'9 �'�,.s ;�;:�_?'�. ::1 - ' � : k: t,: T'�`� =n-: Ei.._.,:.,. - `PLAN .RE'{rlE'I'V -
❑ 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 ❑ Other: where the available fault current ❑ Marinas and boatyards.
`lt r �. _ z *VW' aas A ' :te . )"� exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
9 r' ` "� � °1'71k 4:.::,,,,t 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 ❑ Master builder ❑ Other: El Fire pump. ID Installation of 75 KVA or
.: 4 . : w ;.. '_' +.;, >.i,y� ,- _ -- - _ �- , «,., ,, .. - . 4 ;. i , / ❑ Emergency system. larger separately derived system.
p ia_ �r i' ? • ... t t ¢: ftrgAti "r iv #' � '• .
' �- < ^!'.`-- ......._ �- :•- :'.:.,. -.. c r k' ❑ Addition of new motor load of ❑ "A" "E" '9 -2" "t -3
Job no.: Job site address: 10220 SW GREENBURG RD 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: TIGARD, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations, 600 volts nominal.
Suite/bldg- /apt. no.: Project name: SHORENSTEIN TIGARD 3 LINC ❑ Service or feeder 600 amps or more.
a+,": ,r .:'.FL'E SCHEDULE
Cross street/directions to job site: ' .fir
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'l 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: -
=rr :x r F � . z` x 4 }} Limited energy, residential 75.00 3
' =• :,. ^:= ep+_ , .:. ?:. : 4 . ,. Y '., `' r ' • ti-110: >, with above s ft.
Limited energy, multi - family 75.00 2
INSTALL OUTLET FOR ALARM SYSTEM residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 100.70 2
3 Y'1 - -.F+; t .s, ',< -::. . i, -,,.te. y .,._. •sa•nn: c -r:: -:i - -?
�T7 r ' s s '' - ' ° 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 /State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 I
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
' above ve a ice
ID' ',i :A 1s 3' ; -; :. • -.x • . t; .' a�n , o service or feeder fee, 7.4 each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, first l 56.18 56.18 ,.,
Contact name: branch circuit
Each add'l branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular 67.84 2
dwelling, service and /or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
- Pump or irrigation circle 67.84 2
E - mail:
,.• �; -_ ; -t : e Y :.•: - ; _•..•_:; _. . Sign or outline lighting 67.84 2
• •' � v. � ' - -',. *�E.: - r - �.�, ... �•_, • ... �t ?� • � .. �-•_ ,a•.� i f��. ' . ' r. S c or limited-energy
Business name: FRONTIER ELECTRIC panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 7217 NE 99 STREET Additional inspection (1 hr min) 66.25/ hr
City/State /ZIP: VANCOUVER, WA, 98662 Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18 / hr
Phone: (360) 892 - 4342 Fax: (360) 892 - 1559 Inspections for which no fee is 90.00/ hr
specifically listed (Y hr min)
CCB Lie -: 64005 Electrical Lic.: 37 - 436C Suprv, i .: 367S .;r *: i! '.=;• ; 1 E EttlitICAL :PERMIT FEES
----"----. Subtotal: 56.18
Suprv. Electrician signature, req red: Plan review (25% of permit fee):
Print name: LARRY GIBSON ate: 08/04/2011 State surcharge (12% of permit fee): 6.74
TOTAL PERMIT FEE: 62.92
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: LARRY GIBSON Date: 08/04/2011
" Number of inspections allowed per permit.
I:\ Building \Permits\ELC- PemutApp.doc 07101 /10 440 -4615T(1i /05 /COM/WEB