Permit (37) CITY OF TIGARD ELECTRICAL PERMIT
Permit it: ELC2017-00451
: COMMUNITY DEVELOPMENT
Date Issued: 06/15/2017
I[-GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 415
Project: Spec Space Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Electridal for TI:(3)branch circuits for new light fixtures and receptacles.
Contractor: WILLAMETTE ELECTRIC INC Owner: LINCOLN CENTER LLC
PO BOX 230547 BY SHORENSTEIN PROPERTIES LLC
TIGARD, OR 97281 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 503-624-3631 PHONE:
FAX: 503-624-2938
FEES
Quantity Description Date Amount
3 crt Branch Circuits wo/Purchase 06/15/2017 $71.02
Specifics: Service or Feeder
1 ea 12%State Surcharge- 06/15/2017 $8.52
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $79.54
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 OAR 952-001-0090. You a obtain a co-• • e ru eT direct questions to OUNC by calling 503.232.1987 or 1.800,33 .2344.
Issued By: _ Permittee Signature: � ,-
,i
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' Date:
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.
Electrical Permit Application FOR OFFICE USE ONLY
Received /
City of Tigard DateB : (o /7 la Permit#. EL.�-moi 7..a fsi
III 't 13125 SW Hall Blvd.,Tigard,OR 97223s Plan Review
L.
Related Permit#:0(4/924,1/7- p,, 3
Phone: 503.718.2439 Fax: 503.598.10r:010 Date/By:
Inspection Line: 503.639.4175 1 Ready Date/By: Suns:�� ® See Page 2 for
TIGARD ��`� Notified/Method: •/�^'V Supplemental Information
Internet: www.tigard-or.gov �!
,,.
❑New construction Add1t10n/alteratlOn/r. Please check all that apply(submit 2 sets of plans w/itemsthree
checked):
® A0. ��� ❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: t,�h where the available fault current ❑Mannas and boatyards.
t�•�;: =r ®: � 6c.,-„-',,,K;7;7
,- K;7 t) exceeds 10,000amps at150 volts or 0 Floating buildings.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
El1-and 2-family dwelling ®Commercial/industrial 0 Accessory building amps for all other installations. buildings.
0 Multi family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA orz 0 Emergency system. larger separately derived
4OB� .!; „d Z .� :GAO F' s system.
❑Addition of new motor load of Y
Job#: y‘6 Job site address: /0 s/r) G..J_ems,,,,4 /_ looHP or more. ❑"A","E","1-2","1-3",
�; /
El Six or more residential units. occupancy.
City/State/ZIP: / /'/,-6.y//! h ,Y,', 3 ❑Health-care facilities. 0 Recreational vehicle parks.
❑Hazardous locations. ❑Supply voltage for more than
Suite/bldg./apt.#: y/5 Project name: je,;,w 600 volts nominal.
❑Service or feeder 600 amps or more
Cross street/directions to job site:
F%. ...c 9Aij
Description I Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'1500 sq.ft.or portion 33.92 1
Limited energy,residential
�. T ,, .`! V.-$1,0 �, gY, 75.00 2
Lf �- ��, (with above,q.m lti
/,,r Limited energy,multi-family 75.00 2
/ / 3qk residential(with above sq.ft.)
.4
l/' tP C p �/ (��/ Renewable Energy 0 See Page 2
A ,,,`` Cf tg R'Pr'; ¢ �El#1�� : .a Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Address: 401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
v _Branch circuits-new,alteration,or extension,per panel
-.e.2-11,7,-,477,44,44-e, C PERSOI ¥, Fee_for branch circuits with
Business name: eh/ l k I b., A. c"re- b-le v,.'r.- G ,,C, t, above service or feeder fee, 7.42 2
-f-3:
each branch circuit
a ti / r t B.Fee for branch circuits without /
Contact name: �/ �3 J" yy
service or feeder fee,first / 56.18 5Ll p 2
Address: branch circuit ,
Each add'l branch circuit /2___ /7.42 %Jr
City/State/ZIP: 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: Reconnect only 67.84 2
ca gmCO*RACTOe�•;�'', �� y , ,l rs'fk or irrigation circle 67.84 2
/�
Business name: j 6Z . e,}'1� L- G 4�/`,% r , c Sign or outline lighting 67.84 2
p L Signal circuit(s)or limited-energy El See Page 2 2
Address: / L %3 1 ja 2 3 6 / ) panel,alteration,or extension.
Each additional inspection over allowable in any of the above
City/State/ZIP: 71z , 'c) fig,0 R % )2-ei Additional inspection(1 hr min) 66.25/hr
Phone:(.,r43) 1 y- 3 d,e) Fax:(.fuJ 6 2 1! - Z 9 2e Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email: Inspections for which no fee is 90 00/hr
Suprv.Lic.: specifically listed(Vs hr min)
CCB Lic.: 7 J'4 S 9 Electrical Lic.:j 4J-22Z)C p 'l L L��. E E(I IRT l.00/hr . , '
Suprv..Electrician signature,required, Subtotal: // "2"
Print name: n /- Date:6 -41.-- -/ ❑Plan Review Required(25%of permit fee):(/i.v' j `° l�C State surcharge(12%of permit fee):/ /;'f r-V-
Authorized signature:
TOTAL PERMIT FEE: ^� +"
el,
This permit application expires if a permit is not e' ained within 18
Print name: Date: days after it has been accepted as complete.
*
Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10220 SW GREENBURG RD 415, TIGARD, OR,
97223
Record Type: Record ID:
Commercial - Electrical ELC2017-00451
Inspection Type: Inspector:
199 Electrical final Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor