Permit CITY OF TIGARD ELECTRICAL PERMIT
„ COMMUNITY DEVELOPMENT DATPERMIT E #: ISSUED: 8/8/2008 ELC2008 -00458
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S 135AB -01002
SITE ADDRESS: 10220 SW GREENBURG RD 601 ZONING: R -12
SUBDIVISION: LINCOLN CENTER/THREE LINCOLN LOT : 009 JURISDICTION: TIG
PROJECT: MATRIX
Project Description: Modifying (8) branch circuits.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 7 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA /SPEC OCC:
Owner: Contractor:
SHORENSTEIN REALTY SERVICES BROADWAY ELECTRIC - COCHRAN INC
ONE SW COLUMBIA ST #300 626 SE MAIN ST
PORTLAND, OR 97258 PORTLAND, OR 97214
Phone: 503 -412 -4800 Contact #: PRI 503 - 234 -6564
FAX 503- 238 -2098
FEES
Description Date Amount Reg #: ELE 37 -546C
[ELPRMT] ELC Permit 8/8/2008 $93.40 LIC 72942
[TAX] 12% State Surchar 8/8/2008 $11.21 SUP 3447S
Total $104.61 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 thro _!h OAAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: ` / /�! i „ / = Permittee Signature: • /�`" �IeG�G,'�
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'N: 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.
FROM COCHRAN —BROADWAY (THU>AUG 7 2008 14: 54 /ST. 14: 53 /No. 7500000250 P 2
'd 'I,
'Electrical Permit Application t9 t on oFFlcr' use oN ,, '
71 Ci ty of Tigard R"
• 13125 SW Hall Blvd., Ti ar d, OR 9722 Da te/By ` : O 6? , f f� Per at No.: "6/..cat jc "C� �SO
g Pl Rev iew
Phone: 503.639.4171 Fax: 503.598.19 0 �„ '� Date/By: g Other Permit:
T 1 G'Alt l) Inspection Line: 503.639.4175 pUG 1 Date Ready/By: 1u y See Page 2 for
w
• • Internet: ww.tigard- or tt'' r K rs�) Notified/Method. rl
f( p Supplemental Information
'. K
TYPE OF WOR.tfi D `vj$1o� : PLAN REVIEW...' .. •
❑ New construction Addition/alteration(� � t Please check all that apply (submit 2 sets of plans w /items checked below):
DU ► ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards
CATEGORY OF CONSTRUCTION . ' _ exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
• 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- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ installation of 75 KVA m
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job 110.; / / Job site address. _ IOOHP or more. occupancy
�/ � j04 . �0,/ S /4 /f .. . I/ >4 ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: / ❑ Health -care facilities. ❑ Supply voltage for more than
/�/r/�� �� / / --7 zz3 ❑ Hazardous locations. 600 volts nominal.
Sui te/bldg. /apt. no.: t 67 d / (Project name 7 `%.� /.4.' ❑ Service or feeder 600 amps or more.
FEE SCHEDULE ..
Cross street /directions to job site: - Description I Qty. I Fen I Total 1 • -
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 ` 4
Ea. add'I 500 sq. ft. or portion 33.40 l
Fax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION, OF WORK (with above sq. it.)
��� ,� r ���� , J j � s `
Limited energy, multi-family be sqft 75.00 2
/` H residential (with above sq. R•)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER:,=' .. • . . TENANT . , . _ _ 201 amps to 400 amps 106.85 2
Name: / tx 401 amps to 600 amps 1 60.60 2
i 601 amps to 1,000 amps 240.60 2
Address jr.?2 , 4�� / _C'G�/". 2 g�� .,-, Over 1,000 amps or volts 454.65 2
City /State /ZIP %6 / �� 97 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (c ) J >__T _e- I Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 . 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
' ❑. APPLICANT ? I : ❑ CONTACT' .. above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name:
without branch scrvi or feeder fee, I 46.85 C�° 2
first branch circuit
Address: Each add'] branch circuit 7 6.65' -c
Miscellaneous (service or feeder not included)
City /State /ZIP: • Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2 _
CONTRACTOR - . ' _ - Sign or outline lighting 53.40 2
r ( Signal circuit(s) or limited -
Business name:
Goc.,,I�M -' A `X,, z d ��Gi- {ecf ; �nergy panel, alteration, or
It Z
Address: l 2 h Nc ,,ti -5-f- 4 extension. Describe: Page 2 2
City /State /ZIP: 1 � 0C- g 7 If 4 Each additional inspection over allowable in any of the above
,/ Per inspection 62.50
Phone: (S 5) L 3L( - L c,?‘; - Fax: (S o3) � 3 - ��C jj Investigation per hour (I hr min) 62.50
CCB Lie.: 7, L.L Electrical Lie.:3�1 -5 � I (oG Suprv. Lie.: tL�� Industrial plant per hour 73.75
. ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal:
( Plan review (25% of permit fee):
Print name: \<._ . - sV\. �
1 Date; 1I J
k� State surcharge (12% of permit fee): //. L./
Authorized signature: TOTAL PERMIT FEE: /a 7, 67
't
Prin[ name: Date: his permit application expires if a permit is not obtained within 180
days after it has been accepted as compkte.
" Number of inspections allowed per permit.
1\ Building \PermitstELC- PermitApp.doc OS/23/06 440- 461ST(I I /OS /COM/WEB
.••• •
CITY OF TIGARD
•
BUILDING DIVISION — #: ELC2008.00458
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/8/2008
Phone: (503) 639-4171 /
Inspection Requests (24 Hrs.): (503) 639-4175 JP IL.
INSPECTION WORKSHEET FOR DATE: 9/19/2008 TIME: 7:00AM PAGE: 16
SITE ADDRESS: 10220 SW GREENOURG RD 601 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/THREE LINCOLN LOT #: 009 TYPE OF USE:
PROJECT NAME: MATRIX
DESCRIPTION: Modifying (8) branch circuits.
OWNER: SHORENSTEIN REALTY SERVICES, PHONE #: 503-412-4600
CONTRACTOR: BROADWAY ELECTRIC-COCHRAN INC PHONE #: 503-234-65M
Inspection Request Scheduled For: Date: 9/19/2008 Pour Time:
Code # Inspection Description onfifen Contact # Message
199 Electrical final 075689-01 503-349-3636
Corrections/Comments/Instructions: e_94.1
H•k6 Lys/6 bo
t/ ocit"
‘r\oo\C-- v(r,
( 3B1 tv (*
NLVAA ‘ 70 1 Tut
\KqPASS fl PARTIAL APPROVAL H CA CEL 0 NO ACCESS
FAIL 7 CALL FOR INSPECTION 17 ADDITIONAL FEES ASSESSED
Inspector: G-Th, Date: q, Phone #: (503) 718- 1-441)
, _ _
_ ... .,
CITY OF TIGARD
BUILDING DIVISION s, • PERMIT #: ELC2008•00468
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/8/2008
Phone: (503) 639-4171 Aft00
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 8/11/2008 TIME: 7:01Arvi PAGE: 6
SITE ADDRESS: 1 0220 SW GREFNBURG RD 601 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/THREE LINCOLN LOT #: 009 TYPE OF USE:
PROJECT NAME: MATRIX
DESCRIPTION: Modifying (8) branch circuits.
OWNER: SHORENSTEIN REALTY SERVICES, PHONE #: 503-412-4800
CONTRACTOR: BROADWAY ELECTRIC-COCHRAN INC • B, 0.., , PHONE #: 503_234.6564
Inspection Request Scheduled For: Date: 8/11/2008 Pour Time:
•
Code # Inspection Description ( Confirm f< Contact # Message
125 Wall cover 074024-01 -s \ 503-349-3636 Y
,/' 1< NI HILL
Corrections/Comments/Instructions: /
7
•
•
PASS 0 PARTIAL APPROVAL D CANCEL fl NO ACCESS
El FAIL fl CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: -." i \I-j 1--"- Date:* M,
Phone #: (503) 718-
-. — .
CITY ������0�������� �
��mn n ��n nm�m��nm�� ^� -,
BUILDING DIVISION PERMIT #: ELC2008-00460
| 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 818/3008
Phone: (503) 639-4171
Inspection Requests (24Hmj:(503)S3Q'4175 ~���' «���
INSPECTION WORKSHEET FOR DATE: 8128/2005 TIME: 7:00Ak8 PAGE: 43
SITE ADDRESS: 10220 SWGREENBUR<3R[)601 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTERM>RBELINCOLN LOT #: 009 TYPE OF USE:
PROJECT NAME: MATRIX
DESCRIPTION: Modifying (8) branch circuits.
OWNER: t'.3MORENSTEIN REALTY SERVICES, PHONE #: 503-412-4800
CONTRACTOR: BROADWAY ELECTR{C-C{)CHRANINC PHONE #: 603234-6664
Inspection Request Scheduled For: Date: 0/38/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
130 Ceiling cover \O747G4-O2 503,708'3222 N
Corrections/Comments/Instructions: ```~`__ ~/
A PASS || PARTIAL APPROVAL 0 CANCEL NO ACCESS
| | FAIL ri CALL FOR INSPECTION ri ADDITIONAL FEES ASSESSED
Inspector: G—'~ �t�u6 Lae Date: ��2��°°� Phone (503) 1.44 � '
^
~ - . _` ^ .