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Permit Al CITY OF TIGARD ELECTRICAL PERMIT 111 , ?` COMMUNITY DEVELOPMENT Permit #: ELC2011 -00448 • TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/05/2011 < Parcel: 1S135AB04500 Jurisdiction: Tigard Site address: 10250 SW GREENBURG RD Project: Four Lincoln Subdivision: LINCOLN BUILDING 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 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. ATTENT : Oreg. • law -. ires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -001 rou•h OAR 9 • -r 51 -00* r. You may obtain a copy of the rules or direct questions to OUNC by calling 593.332.1987 or 1.800.332.2 4. Issued - _I _ A.. / __ 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' 4 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 FR34 ER rELCTR 1 P.05 Electrical Permit Application FOR 01 , (11:1:.: 1 SE ONIA- AUG052 Received Pennit No.: City of Tigard DateB : © ► I.G�O// OGYg4lg n 13125 SW Hall Blvd., Tigard, OR 97223T -�I�' A' �® Plan Review / Other Phone: 503.718.2439 Fax: 503.598 -60 - �� DateB : r O �« Q , t TIGARD Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By: Ions: :. See Page 2 for • Internet: www.tigard-or.gov Notified/Method: Supplemental Information v�ar:: i� ?yy' t. a u, y . s i. i W ..:;:.. ?:..=.t.,�r.a, 1 _ v _ .t '' B„i' '..„ rang •.- '-.:;•: FLA)Y k.^r':. ^'•!;.�r.y!'�'s"e f ' «.. ,.. - �l :y'.r'r`y.''�r.�... :„ .�- ...tAnr t. 9'n:%•.___r _, ... .., . -„ :��,.:�,; �:;4: E. fi:.::: >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. 0 Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. • -''''' ' � < .. . '. ; { : r 1 - x • ': " P s 3sr ' = men-- / lx ` c exceeds 10,000 amps a[ 150 volts or ❑Floating buildings. V iz - „.; :: = -• .:s; .. t • '+ ► 4.' •- 7I€ `dls tTXi 7 I':” ; r � .. s •: r'' :1' less to ground, or exceeds 14,000 ❑ Commercial -use atpiculmral ❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or y I'� t er k -1* 0, "' :` ,`- ❑ Emergency f ne em. larger separately derived system. t^ .'w m " `.Z:,. s'=` +l 5 -. p ' �'.! d 0 :: rA ��`:- ❑ Addition of new motor load of ❑.. .. 2 ..., 1 3 " Job no.: I Job site address: 10250 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. El Suite/bldg. /apt. no.: I Project name: SHORENSTEIN TIGARD 4 LINC ❑ Service or feeder 600 amps or more. 1rWt,• ;'.: :: :FEE SCHEDULE CIoss street/directions to job site: Description I Qty. I Fee. 1 Total I . 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 75.00 2 :x5`; r�,�:_ g � :......,, 1rr u��y" . ztw.�c _,_ s # r:: (with above sq. ft.) ` ..t�:.:r,, t: fir -"` ,:• :; . :r4 :: 's" - dnai-`.. •. �_ :•. -. .: r' ,uf r :3rr�6 •.� i 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 x.,t�����pp .; ,m p;d °- ,rL= 147,+,it w :gs.mw:ru•: v:-i :�nl >-• .,yv.._., t. . r = S . x e I :'ettv ; L e 201 amps to 400 amps 13356 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 n relocation Phone: ( ) I Fax: ( ) 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 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 :fir - yrt; ' f _�i 'ts above service or feeder fee. 7.42 2 tJs -•; ..n , .. :4. ' .. _- :t ` ; ,,,,,_-- i ,,,. -:: ' ,, s. ^ s., -- , . •r': ? each branch circuit Business name: B. Fee for branch circuits without service or feeder fee, first 1 56.18 56.18 2 Contact name: branch circuit Each add'I branch circuit 7.42 2 Address: Miscellaneous (service or feeder not included) City/State/ZIP: Each manufactured or modular 67 84 2 tY dwelling, service and/or feeder Phone: ( ) I Fax: : ( ) Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E - mail: - Sign or outline lighting 67.84 2 }. yr : #�:i "s ,a 3:::.�......_.�.. ;��-. ' , :. .�.'t.,z `% _. , .: , , 4, 5: .x.l @1��•Y: - ` '' :; : " `r �. sF, F Signal () �, = - -- ,�.. °:. *;,.4tYz. Si al circuits or limited -ener gy 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 br 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 I Fax: (360) 892 - 1559 Inspections for which no fee is 90.00/ hr specifically listed ('Ys hr mist CCB Lie.: 64005 Electrical Lie.: 37 -436C Suprv. Lie. S '-: F .; ,0.0] C'j it +AL='ERIHIT :FEES Suprv. Electrician signature, require (25% Subtotal: 56.18 Plan revie (25 /o of permit fee): Print name: LARRY GIBSON Date. 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 Print name: LARRY GIBSON Date: 08/04/2011 days Lion a has been accepted as complete. " Number of perpetmit. I:\ Building \Permits\ELC- PermitApp.doc 07/01/10 440 4615T(L1105 /COM/WES