Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2009 -00362
HOARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/22/2009
Parcel: 1S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 450
Subdivision: Lot: 0
Project: Credit Union Home Loan Center
Project Description: 6 branch circuits
Owner: FEES
LINCOLN CENTER LLC Quantity Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL 6 crt Branch Circuits 07/21/2009 $80.10
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 07/21/2009 $9.61
Electrical
Contractor:
WILLAMETTE ELECTRIC INC
PO BOX 230547
TIGARD, OR 97281
PHONE: 503 - 624 -3631
FAX: 503 - 624 -2938
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $89.71
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 OA 95 - -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.33
Issued By: Permittee Signature: �J
OWNER INSTALLATION ONLY J
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' 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.
07 /2 0/2 009 MON 15 : 23 FAX 50 36242938 Willamette Electric j002/O02
.. . . ''.
• Electrical Permit ApplicatioiRECER/r r .,:::::.:.::.... .::.. FOR OFFICE VSE ONLY :...: ... .: ..- '.. •::.., ' '. •
. - ' City of Tigard Received IcS , Permit No.: • L i, _ _o 03(
Dawn :
14 • - 13125 SW Halt Blvd., Tigard, OR 97223 JUL 2 0 2009
Plan Review
'• • • • Phone: 503.639.4171 Fax: 503.598.1960 Date/B : Other Permit:
I . I ,; 1. 0 Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Juris: ref See Page 2 for
Internet: www.tigard Notified/Mcthod: Supplemental Information
1 :1 I i On °
NifikiWAtiMIAM10#0,170i . YegiKsttai700.N#44, ,- - , N 2 r , Ak f tWOWItaa
D New construction • gAddition/alteration/replaccment Please check all that apply (submit 2 sets of plans Witems checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
1 .ASSIggiageaagain. W;ke'reto*OkiNfatelier.,-.WEVOWNWI exceeds 10,000 amps at 150 volts or 0 Floating buildings.
''' less to ground, or exceeds 14,000 [3 Commercial-use agricultural
0 I- and 2-family dwelling D Commercial/industrial 0 Accessory building amps for all other installations. buildings,
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. El Installation of 75 KVA or
• . , CI Emergency system. load of larger separately derived system.
3 4 : 1 1 NA10 7. 4 ' 0 , 74310144.70 •.' : ;..**Ci., a Addition of new motor 0
Job no.: ? 3 1-2 Job site address: ',.■ " ,, , ," ' i :.) / i0OHP or more. occupancy.
' ,.-, I,- r e:': r / '!!"' /''A ' [3 Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: 1 4 ./ . , . ,
. s!'' r . , s 'i . 0 Health-care facilities, 0 Supply voltage for more than
— 0 Hazardous locations. 600 volts nominal.
/§UiteYbIdglapt. no.: ,,'''';.-:;, I Project name: ,-; i ...,, , , ,?.:,,':;' ,...,,, ., , , .:, ,,,, 0 Service or feeder 600 amps or more.
V
Cross street/directions to job site:
' Deseriptioo I Qi; Fee. I ' Total I
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: 1 Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. adcP1500 sq. ft. or portion 33.40 1
Tax map/parcel no.:
, Limited energy, residential
WV6 (with above sq. 11.) 75.00 2
F ii''eti",,,,,..„,,,,:i..-;..,. 't,i4.,--i,:•-•-,.i.t4,4,i,iit.,:6)*5art.,,',1:-*4',:,`,
Limited energy, Multi-family
,.....,,,.. 75.00 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less ' 80.30 2
ana0404# 201a.ps10400 amps 106.85
2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address:
Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) 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 10 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps 10 599 amps 133,75 2
Branch circuits — new, alteration, or extension, per panel
Owner signature:_ Date:
A. Fee for branch circuits with
MINR:0050110ANTO,UMM:;',:" above service or feeder fee, ""' each branch circuit
6.65 2
Business name:
B. Fee for branch circuits
tviihout service or feeder fee ' KJ, V_; :..
Contact name: ' / 46.85 ,/ (,...- ,-. 2
first branch circuit
,,„
Address: Each add'I branch circuit 4:., 6.65 .-- :3 01 2
Miscellaneous (service or feeder included)
City/State/ZIP: Each manufactured or modular
90.90 2
dwelling, service and/or feeder
Phone: ( ) I Fax: : ( )
Reconnect only
66.85 2
E-mail: Pump or irrigation circle 53.40 2
si or outline lightin 53.40 2
Signal circult(s) or
Business name: name: Willamette Electric, Inc.
energy panel, alteration, or
Address: PO Box 230547 extension. Describe: Page 2 2
City/State/ZIP: Tigard, Oregon 97281 Each additional inspection over allowable in any of the above
Per inspection 62.50 1
Phone: (503) 624-3631 Fax: (503) 624-2938
. Investigation per hour (1 hr min) 62.50
CCB Lic.: 75059 Electrical Lic.: 34 Suprv. Lic.: 4226-S Industrial plant per hour 73.75
•.:';'' ItIkt,CtIV,07
Suprv. Electrician signature, required: ------"-- Subtotal: y •, ,.: --
Print name: David Fife Date: . e7 Plan review (25°/c, of permit fee):
State surcharge (12% of permit fee): ----- ‘-t----
,-,
Authorized signature:
TOTAL PERMIT FEE: 7 ----
This permit application expires if a permit Is not obtained within ISO
Print name: Date:
days after It has been accepted as complete.
* Number of inspections allowed per permit.
1:113oildingTermiis 1. ELC-hennitApp.iloc 05/23/06 440.46i 5T( I I/OS/COM/WEB