Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00449
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/05/2011
Parcel: 1 S135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD
Project: Five Lincoln Subdivision: LINCOLN CENTER /FIVE LINCOLN 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. ATTENTIO w requ' you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 t rough OAR 952- 1 -0 0. may obtain a copy of the rules or direct questions to OUNC by calling 50 2.1987 or 1.800.332.2344.
Issued By: 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' f---As-----1 Date:
L _
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.
,111 ll'
AUG-05 05:10 10
FRIA EllEilli P . 06
Electrical Permit Application roR.01 tssE oNLy
City of Tigard AUG 0 5 2011 RpeacteeiBived: '
I I m 13125 SW Hall Blvd., Tigard, OR 9;q4 OF TIGARD , ,i igrAMMT1 Permit No.: ELC "Oa.* 66 V
Review
2 Plan Phone: 503.718.2439 Fax: 503.598/N60 DateJB : Other Permit: 9150,70//' t:2
Inspection Line: 503.639.4175 kris: See
Date Ready/By: ra Page 2 for
TIGARD BUILDING DIVISION
• Internet: www.tigard NotifiecVMethock Supplemental information
- !‘ ,.. '4 , 440, - ,,* t qlfletteaTIF"Oile*nAfc' t ,...4Wi r tArt i gpS Tarfkl.7.74.T.Ma.l. kik iiEvikw:
0 New construction El Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w/items checked below):
0 Service or feeder 400 amps or more ID Building over three stories.
0 Demolition 0 Other: where the available fault current D Marinas and boatyards.
l'af ,-/ — - 44 5 'WV . - lislIeFeeViAtAtirM4=-, „,.:.'...tr: V'PLIA1' exceeds 10,000 amps at 150 volts or D Floating buildings.
t:- . — - .4rtiA!I " ]. .., _ WetR90 - • -
less to ground, or exceeds 14,000 0 Commercial-use agncultural
0 I- and 2-family dwelling 181 Commercial/industrial 0 Accessory building amps for all other installations. buildings.
El Multi 0 Master builder 0 Other: CI Fire pump. CI Installation of 75 KVA or
ri - „z . , „ ,„:„,,,,.,...,:,-, Addition of new motor load of . kr.mcve,1,=-_., 0 EmorgencY sVttem larger separately derived system.
- 41eY-'.' , :r•.:t1ms•te - r , 0 .1,,,,,,,,,,', . .. ,. i.,-.:,.... . ..••'^t.'... 4... . Wi ID i:I
Job no.: I Job site address: 10200 SW GREENBURG RD 100HP or more. occupancy.
ID Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: TIGARD, OR 97223 0 Health-care facilities. 1:1 Supply voltage for more than
CI Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: I Project name: SHORENSTEIN TIGARD 5 LINC 0 Service or feeder 600 amps or more.
;VertiX7fa
Cross street/directions to job site: Description I Qt. l Fee. I Total I ft
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. addl 500 sq. ft. or portion 33.92 1
Tax map/parcel no.:
Limited energy, residential
: n 4 1:4. 1 1W4'.*."01 . 'Wgwikorologita*pa#TAVOMPAtt (with above sq. ft.) 75.00 2
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
1.:MatiakAtit,WW,F27,MitiVOS; RN * 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name:
601 amps to 1,000 amps 301.04 _ 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP:
relocation
Phone: ( ) I 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
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
Vatc,ri:420:400450319tartMaAV4P:iir‘%q4C!..A:' ';:11:, 6 , above service or feeder fee.
742 2
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 branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular
City/State/ZIP: 67.84 2
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
Signal circuit(s) or limited-energy 67.84
F3M:t ''''.",51N,V*Z.40.411,741Wil .
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
Investigation (1 hr min) 66.25/ hr
City/State/ZIP: VANCOUVER, WA, 98662
Industrial plant (1 hr min) 78.18/ hr
Phone: (360) 892-4342 I Fax: (360) 892 Inspections for which no fee is
90.00/ hr
specifically listed (V: hr mm)
CCB Lie.: 64005 Electrical Lic.: 37 Suprv. Licy . . "AT PERMIT PEES
---- — - --- Subtotal: 56.18
Suprv. Electrician signature, requirec,
IIIIMIE: le_ .. . Plan review (25% of permit fee):
Print name: LARRY GIBSON VIIIIIOIIIIIIP 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 ISO
days after it has been accepted
Print name: LARRY GIBSON Date: 08/04/2011 '' Number of as complete. inspections allowed per Dentin.
t:\BuiIding\PermitsELC-PermiiApp.doc 07/01/10 440-4615T(11/05/COM/WEB