10200 SW GREENBURG ROAD STE 340-1 r
10200 SW GREENBURG ROAD #340
CITY OF TIGARD FLE,"TRICAL. PERMIT
DEVELOPMENT SERVICES PERMIT #: ELC98-0726
13125 SW Hall Blvd., Tigard,0R 97223(503)639.4171 DATE ISSUED: 12/11/98
PARCEL: I S 135AB-00900
SITE ADDRESS. . . : 10200 SW GREENBURG RD #340
SUBDIVISION. . . . :FIVE LINCOLN ZONING:C-P
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . . JURISDICTION: TIG
F1ro•j ect De scr i pt ion: Add two (2) branch circuits.
-- -RESIDENTIAL 11N I T---- ---TEMP SRVC/FEEDERS----- -----MISCELLANEOUS- -
1000
-----MISCELLANEOUS- _1000 SF OR LESS. . . . : 0 0 --• 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : V!
.ACH ADD' L 500SF. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0
M.AN . HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL ( 10) . . . : 0
.---•--BRANCH CIRCUITS_...-..-._.._. ----ADD' L INSPECTIONS—
0
NSPECTIONS--
0 -• 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0
201 - 400 amp. . . . . . : m 1st W/O SRVC OR FDR. : 1 PER HOUR. . . . . . . . . . . : 0
401 - 600 amp. . . . . . : 0 EA ADD' L. BRNCH CIRC: 1 IN PLANT. . . . . . . . . . . : 0
601 •-- 1000 amp. . . . . : Pi -- -_----------- --PLAN REVIEW SECTION----------------
1000+
ECTION----------------
1000+ amp/volt. . . . . : 0 )=4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR ) = 225 AMPS. . : CLASS AREA/SPEC OCC. :
Owner: -----_--_---------------_______._._____.__._._._ _____.____-- FEES _-__.-_---___--_-
NORRIS, BEGGS & SIMPSON type amount by date recpt
10300 SW GREENSURG RDPRMT $ 40. 00 GEO 12/11/98 98031. 1470
�'xp� �
SUITE 200 n SPCT 2. 00 GEO 12/11/98 980311470
T T.GARD OR 97223
Phone #: b/1
'7 ut,
Contractor: -----------------------------
CHRISTENSON ELECTRIC INC $ 42. 00 TOTAL
11. 1 SW COLUMBIA
SIE 480 ------- REOU I RED I NSPECT I ON's -- -
PORTLAND OR 97201 E?ect' l Service
Phone #: "241-4812 Elect' l Final —
Reg #. . : 000458
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 188
d;ys of issuance, or if work is suspended for more than 188 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 OAR 952-881-1907. You may obtain a copy
of these rules or direct questions to OUNC by calling (583)246-1981. ,
9 /
Permittee Si nat'_ire : IssllPd By : _.
-,.----•-----------_._----_._.-----UWNF_.R INSTALLAI ION ONLY____.__--_----------
The installation is being made on property I own which is not intendsad for
sal?, lease, or rent.
OWNER' S SIGNATURE: —�_ _ DATE: _
---._–_–__CONTRACTOR INSTALLATION ONLY-
SIGNATURE
NL_YSIGNATURE OF SUPR. ELEC' N: !U'� Ci°%� _ DATE:
LICENSE NO:
++++++++•++++++++++++++++++++++++++++++++f++++++++++4•+4+++++++++++f-+++++++++-'-++•+
Call 639-4175 by 7:00 p. m. for an inspection needed the next business day
4...+++++++++4.4.+++++++++++i•++++++++++++++4++++++++++++++++++++++++++++++++++++4+++
CITY OF TIGARD Electrical Permit Application Plan Check#
13125 SW HALL BLVD. Recd By
TIGARD OR 97223 Date Recd--
Date to P.E.
Phone (503)639-4171, x304 Print or Type Date to DST`
Inspection (503)639-4175 Permit#_ _
Fax (503) 684-7297 Incomplete or illegible will not be accepted Called--
I
alled _.I R R,S,=7,., , , "Y AC`.` N a`
1. Job Address: 4. omplete Fee Schedule Below:
Name of Development LINCOLN V Number of Inspections per permit allowed -
Name(or name of business) FIDELI17 NATIONAL Service included: Items Cost Sum
Address 10200 SW GREENBUR.; _Z.) SUITE 340 4a. Residential-per unit
City/State/Zip TIGARD_OR � t000 sq, or lass $110,00 _ 4
_ Each additional 500 sq.ft.or
CommerciaC " Residential�� portion thereof $25.00
Limited Energy $25.U0
Each Manuf'd Home or Modular
2a. Contractor installation only; Foss cRO913Y Dwelling Service or Feeder $68.00 2
(Attach copy of all current licenses) 4b.Services or Feeders
Electrical Contractor C_HRISTF_NSON ELFCTRIC, INC, installation,alteration,or relocation
Address lll SW COLUKBIA, SUSUITE 480200 amps or less - $60.00 2201 amps to 400 amps $eo.00 2
City POR 'L,ANll State OR,_lZip_97201-5886 401 amps to 600 amps $120.00 _ 2
Phone No, 503-241-4812 601 amps to 1000 amps $180.00 2
Job No. 67-nfl,I ' Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. Exp.Date.__ Reconnect only $50,00 2
OR State CCB Reg No. 458 _ Exp.Date 51 99 4c,Temporary Services or Feeders
COT Business Tax or Metro No. 985246 Exp.Date 12 31 98 Installation,alteration,or relocation
200 amps or less $5000
Signature of Supr. EI3c'n`� \� 201 amps to 400 amps _ $75.00
401 amps to 600 amps $100.00
J� cfi 2468S 10/1/99 Over 600 amps to 1000 volts,
License No._ Exp.Date sw"b"above.
Phone No. 50-�3-24T--M2
-' -- 4d.Branch Circuits
" Now,alteration or extension per panel
2b. For owner installations: "" PIP, a)The fee for branch circuits with
purchase of service or
Print Owner's Name _ feeder fee.
Address J�` +V Each branch circuit $5.00 __ 2
b)The fee for branch circuits
City State_ _ Zip_ without purchase of
Phone No. _ _ service or feeder tee•
F first branch circuit 1 $3500
The installation is being made on property I own which i..i not Each additional branch circuit_� $5.00
interded for sale,lease or rent. 4e.Miscellaneous
(Service or feeder not included)
Owner's Signature �! Each pump or irrigation circle $40.00
Each sign or outline lighting ___ $40.00
3. Plan Review sectio►t (if rc,qu red):
+ Signal circuit(s)or a limited energy
panel,alteration or extension $40.00
Please check appropriate Item and enter fee in sec:?on 5B. Minor Labels(10) $10000
4 or more residential units in one structure 4f.Each additlor it Inspection over
Service and feeder 225 amps or more the allowable In any of the above
System over 600 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00 _
as described in N.E.C.Chapter 5 in Plant _Y $5500
*Submit 2 sets of plans with application where any of the above apply. 5. Fees:
Not required for temporary construction services. 5a.Entet total of above fees $ - 40-. -
5%
_5%Surcharge(.05 X total fees)
NQlICL subtotal $ - -r-----
5b.Enter 254%of line 5e for
PERMITS BECOME VOID IF WORK OF CONSTRUCTION AUTHORIZED 16 Plan Review if reguired(Sec 3) $ -NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $ - �--IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. Q Trust Account#,
Total balance Due $ 42.
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