10300 SW GREENBURG ROAD STE 380 w
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10300 SW C reenburg ted 0380
CI ri Y U F T I G A R D _- ELECI RICAL PERMIT
PERMIT#: ELC2002-00516
A DEVELOPMENT SERVICES DATE ISSUED: 10/4/02
13125 SW Hall Blvd., Tigard. OR 97.^23 (503) 639-4171 PARCEL: 1S135AB-01003
SITE ADDRESS: 10300 SW GREENBURG RD 380
SUBDIVISION: LINCOLN ONE/REL) LOBSTER/CASA L ZONING: C-P
BLOCK: LOT : JURISDICTION: TIG
Project Description: Electrical tenant improvement, (2)branch circuits. Job 307.
RESIDENTIAL UNIT_ _ TEMP_SRVC/FEEDERS -----MISCELLANEOUS
10009F OR LESS: 0 200 amp: PUMPARRIGATION:
EACH ADD'L 500SF: 201 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HMI SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER_—_ BRANCH CIRCUITS -- AD_D'L INSPECTIONS_
0 200 amp: W/SERVICE OR FEEDER: — PER INSPECTION: —
201 - 400 amp: 1st WIO SRVC OR FDR: 1 PER HOUR:
401 - 600 amu. EA ADD'L BRNCH CIRC: 1 IN PLANT:
601 - 1000 amp: _ PLAN REVIEW_ SECTION _
1000+ amplvolt: >=4 RES UNITS: > 600 V_0LT NOMIN_AL:
Reconnect only: SVC/FDR >=225 AMPS: C'.ASS AREAISPEC OCC:_
Owner: Contractor:
EOP LINCOLN, LLC WILLAMETTE ELECTRIC INC
10260 SW GREENBURG RD PO BOX 230547
SUITE 100 TIGARD, OR 97281
PORTLAND, OR 97223
Phone: Phone: 624-2938 FAX
Reg #: &-3631 34-283C
FEES _ _^ Required Inspections _
Description Date _ Amount — Rough-in �~
I ELPRMT] ELC Permit 1014/02 $53.50 Elect'I Final
I ELPRMT]ELC Permit 10/4/02 $0.00
rrAX) 89/0 State Tax 1014/02 $4.28
(additional fees not listed here)
~� Total $57.78
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 accordanrm 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 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at(503)24"699 or
1-800-332-2344.
Issued 6y: �1 t,�.c�J _ Permit Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I ownwhich is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: —_ _ DATE:
CONTRACTOR II-N•SSTALLATION ONLY _
SIGNATURE OF SUPR. ELEC'N: .Jdc ;��r/tiT (1J-f'/D-• DATE:
LICENSE NO: _--
Call 639-4175 by 7:00pm for an inspection the next business day
Electrical Permit Application
Dale received: ,/j y O;- Permit n�LeAaV�y�
City of 'Tigard �y Project/appl.no.: Expire date:
f-oft,of Tigard Address: 13125 SW Hall a� T/ ` Date issued: By: Receipt no.:
Phone: (503) 639-4171
Fax: (503) 598-1960 ,�F r� ��UZ Case file no.: Payment type:
Land use approval:
e
CJ t &2 family dwelling or accessory ❑Commercial/indu,;trial ❑Multi-family !�" enant improvement
U New con,
U Addition/alteration/replacement U Other: I]Partial
JOB SITE INFORMATION
Joh address: fcJ SOc, S'L- G / Bldg.no.: ( Suite no.: 3&-v Tax map/tax lot/account no.:
Lot: I Block: Subdivisi n:
1'roject name: i i_ I'._ Description and location of work on premises:
Es(imated dale of conlJ k-1wn/1n--I1,,ii,III
CONTRAC[OWAPPLICATION
Job no: j7C a ee ata.
Business name: I( t r - Description Qty. (ea) Tote) no.ttisp
Address: �, New residential-single or multi-family per
7 9 i; 4 dwelll%wdt.Includes attached garage.
City: I State: 61, ZIP: ITh- / ServicelncludetL•
Phone: G . I Fax: 7�t E-mail: 1000 sq.ft.or less 4
Each additional 500 sq.ft.or portion thereof
CCB nu.: - Elec,bus.lic.no: 7 -25 ? C Limited energy,residential 2
City/melmlic.no.:_ -/-r.� Limited energy,non-residential 2
9- L4 U Each manufactured home or modular dwelling
Signa ure ol-sit ervisii electrician(re uiredl Date Service and/or feeder 2
Sup elect.namc(print) f r _r License no: (yd S S Services or feeders-installation,
alteration or relocation:
PROPERTY e 200 strips or less 2
Nance(print': 201 amps to 400 Limps 2
Mailing address: — 401 amps to 600 amps 2
601 amps to 10)0 ams 2
City: Slate: ZIP: ^� Over 1000 amps orvolls_ 2
Phone: Fax: I E-mail: Reconnect only 1
Owner installation:The installation is being made on property I own Iempor t-serviceaorfeeders-
which is not intended for sale,lease,rent,or exchange according to Inslallallon,alteration,orrelocation:
ORS 447,455,479,670,701. 200 amps or less 2
2111 amps to 400 amps 2
Owner's si rtialtlre' 11d1r 401 to 6lx)anis _ 2
y Bunch circuits-new,alteration.
Name: or extension per panel: — I
__ __. A. Fee for branch circuits with purchase of
Addn-ss: _ _ service or feeder fee,each branch circuit
Cil — Stale: ZIP: B. Fee for branch circuits without purchase
City: --— of service or feeder fee,first branch circuit '/1 S 2
Plmre Fax: L-nntil:
Each addirionnl branch circuit `d122
Mise.(Service or feeder not Included):
Il Service over 225 anips-coni nercial U Hcalih-care facility Each pump or irrigation circle 2
O Service over 320 amps-retina of 1&2 U Hazardous location Each signor outline lighting 2
family dwellings U Building over 10,000 square feet lour or Signal circuit(s)or a limited energy panel,
U System over61x1 volts nominal nein residential units in one structure ahern•.ion,or extension* 2
U Building over three stories U Feeders,4(x)amps or more 'Mscripuon _
U occupant load over 99 perso-, U Manufactured structures or RV park Each additional Inspedlon over the allowable In any of the above:
U Egress/lightingplan U Other Perinspection
Submit_sets of plans with any of the abuse, Investigstivnfcc
The above are not applicable to temporary construction service. other
--- Permit fee.....................$
No all juridictiau sccryN credit cards,please call Jurisdiction few uwwe inhmnui,ni Notice:'this permit application
U Visa U MasterCard expires if•a permit is not obtained Plan review(at -- %) $
Credit card number _LJ within IRO days after it has been State surcharge(8%) ....$ -�7
Expire, accepted as complete. TOTAL . $ IF U. 2k
Nunc of cardholder as shown on credit card
_ _ S
-- Cardholdcrsiipsture Amouni 440461tlf/nY170MI
ELECTRICAL PERMIT FEES: LII MED ENERGY PERMIT SEES:
Complete Fee Schedule Below:
TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
Restricted Energy Fee.. $75.00
_ Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service: Included: Items Cost Total Check Type of Work Involved:
r Residential-per unit
1000 sq.ft or less $145 15 4 Audio and Stereo Systems'
Each additional 500 sq.ft.or
portion thereof $33.40 _ 1 Burglar Alarm
Limited Energy $75.00
Each Manut'd Home or Modular
Dwelling Service or Feeder $90.90 7 n Garage Door Opener"
Services or Feeders Heating,Ventilation and Air Conditioning System'
Installalior,alteration,or relocation
200 amps or less $80.30 2 ❑ ,
201 amps to 400 amps __ $106.65 2 Vacuum Systems
401 amps to 600 amps $160.60 2
601 amps to 1000 amps _ $240.60 2 Other
Ovel 1000 amps or volts $454.65 2
Reconnect only $66.85 2
Temporary Services or Feeders TYPE. OF WORK INVOLVED -COMMERCIAL ONLY
Installation,alteration,or relocation Fee for each system............................. ....... .... . .... ....... $75.00
200 amps or less $66.85 2 (SErI.OAR 918-260-260)
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75_ 2 Check Type of Work Involved:
Over 600 amps to 1000 volts,
see"b"above. E] Audio and Stereo Systems
Branch Circuits
New,alteration or extension per panel Boiler Controls
IJ n)The fee for branch circuits
with purchase of service or, Clock Systems
feeder fee.
Each branch circuit $665 2 ❑ Data Telecommunication Installation
b)The fee Lir branch circuits
without purchase of service Fire Alarm Installation
or feeder fee.
First branch circuit $46.85 _
Each additional branch circuit $6.65 _— HVAC
Miscellaneous Instrumentation
(Service or feeder not Included
Each pump or irrigation circle $53.40 O
Each sign or outline lighting $53.40 Intercom and Paging Systems
Signal circult(s)or a limited energy
panel,alteratlon or extension $75.00__ -- Landscape Irrigation Control'
Minor Labels(10) $125.00 _
Medlcai
Each ,dditional Insp,3ctlon over ❑
the allowable In any of the above r—I
Per inspection $62.50 _ LJ Nurse Calls
Per hour $62.50
In Plant $73.75 4 El Outdoor Landscape Lighting'
Fees: n Protective Signaling
Enter total of above fees $ Other
a%State Surcharge $ _ Number of Systems
25%Plan Review Fee
See"Plan Review section on $ No licenses nre required Licenses are required for all other installations
front of application — —----
_.__ I
Total Balance Due $ Fees:
--- Enter total of above fees $Ej _
Trust Account p 8%State Surchn ge $
Tota!Balance Due $
All New Conlmersial Buildings require 2 sets of plans.
0dsts\fotms\elc-fees.doc 08/30/01
CITY OF TIGARD 24-Hour
BUILDING inspection Line: (503)639-4175
INSPECTION DIVISION Bush.-%ss Lin (503)639-4171 MST
BUP
Received __ Date Requested__ U /41 ---- AM—_-__— PM_ SUP
Location . ZQ .3 0 Q -!,L-z, Suite s520 /` 4 MEC — ------
Contact Person .__ — _._ Ph ) _ PLM
Contractor__ —_ _ _ Ph(_ ) 3 SWR
BUILDING Tenant/Owner .� ELC a_
Footing
Foundation Access: ELC
Fig Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post& Beam
Shear Anchors -- ---
Ext Sheath/Shear
Int Sheath/Shear --
Framing ---- -- -- ---- -
Insulation
Drywall Nailing
Firewall
Fire Sprinkler - -- --------- ------ ---
Fire Alarm -
Susp'd Ceiling -----_--- -- - --__- _ _ --------
Roof
Other: _ --- -- ---- --- - ----- - ----
Final
PASS Pp' FAIL
_ -- ----- - --- - - -- - ---
PLUMBING
_
Post& Beam ----
Under Slab
Rough-In
Water Service
Sanitary Sewer -
Rain Crains - -
Catch Basin/Manhole
Storm Drain --- --- --- - --�
Shower Pan
Other: --- -- - -
Final ------------
PAS:: PART FAIL "�� -- "----- -- -
MECHANIC_AL
Post SBeam - - ---_a.--- -�_
Rough-In -
Gas Line
Smoke Dampers --•-- _
Final
PASS PART FAIL - ----- -
ELECTRICAL
Service -- ---� -�-
Rough-In
UG/Slab -`
Low Voltage
Fir&Alarm -
[ i1� ❑ Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd.
-kft PART FAIL
SITE _ _ - [] Please call for reinspection RE. _ _.. E] Unable to inspect-no access
Fire Supply Line
ADA --
Approach/Sidewalk Data 0 a _ Inapoder__. _ ' _Ext
Other:
Finai -- DO NOT REMOVE this Inspection record from the fob site.
PASS PART FAIL