Permit CITY OF TIGARD ELECTRICAL PERMIT
�� @ :` COMMUNITY DEVELOPMENT Permit #: ELC2010 -00097
T I CARD. 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/03/2010
Parcel: 1 S135AB04500
Jurisdiction: Tigard
Site address: 10250 SW GREENBURG RD 112
Subdivision: LINCOLN BUILDING n Lot: 0
Project: 1(-1( ruTdric.fe1 N'o I:.P11-)'
Project Description: Add /alter (3) branch circuits.
Owner: FEES
LINCOLN CENTER LLC Quantity Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL 3 crt Branch Circuits 03/03/2010 $71.02
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 03/03/2010 $8.52
Electrical
Contractor:
CAPITOL ELECTRIC CO INC
11401 NE MARX STREET
PORTLAND, OR 97220
PHONE: 503 - 255 -9488
FAX: 503- 257 -7121
Type of Use: COM
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 thro !ti 0 R 952 - 001`0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: ` 4' n( Alitg c. Adi j flA N f Permittee Signature:
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' )C J' p Date: ->k'P
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.
1111 1 4:56 5032577121 CAPITOL ELECTRIC PAGE 02
Electrical Permit A Dnhicatia I E ----f--4---.',-1---:;.' ' ; :;;14 4, --, :� } ' 4
a Rbccivcd 'J ��
lit v Permit no.:
,. Ci of Tigard Di tc/B
City y. R7 o10 Qo X47
: . — r M tl 13125 SW Hall Blvd,, Tigard, OR 97223 F EB 2 6 2010 Plhn Review
X 5 00 - 'i ,t'' Phone: 503,639.4171 Pax: 503.598.196 D Other Permit:
Th G'A R:....-
U TnSpecti Line: 503.(539.4175 OF Date Ready/By: earls; LI See rage 2 Pic >k Inelernot: www.tigard- or.gov CITY OF TIGARD N'IiliCd /MClhod: T 1 l /' C . Su plcT ^nine Infimmtfon
- • • • BUILDING DIVISION 1 _ �j
TYPE OF WORK 1 PLAN REVIEW
I Now construction 1.!.1 Addition /alteration /replacement Please check all that apply (submit 2 sets or pions w /Rams checked below):
Li Demolition Li Other: LJ] Service or feeder 400 amos or more ❑ Building over throe stories
CATEGORY OF CONSTRUCTION where the avallable raua current ❑ Marinas and boatyards
LJ 1- and 2- family dwelling 1L Commercial /industrial II Accessory building exceeds 10.000 amps 31 150 voles or Floating buildings
❑ Multi - family ❑ Mastcr Builder ❑ Other loss to ground. or exceeds 14,000 Commercial -use agricultural
10H SITE INFORMATION AND LOCATION amps for all Other installations. ❑ butdings
Jab no.: 100070 I Job site address: 10250 SW Greenburg Rd n Fire Pump 7 Instanation of 75 KVA or
J rV Emergency system larger separately derived system.
City/State/ZIP: Portland, OR, I�/ 1_11 Addition of new motor load of
ity /State / ❑ A'. °E ^, t•2 "1.3
A ni/ E PfFy I 100HP or more L7 occupancy
Suite/bldg./apt, n0,; IJldg 4. Ste 112 I Pmjccl name Nvetee.g d O Slx or mare residential units ❑ Recreational vohide parks.
ll ❑ licalth -care facilities LI Suppl volta for more than
Cross Strect/Direciions In job site: Ii Hazardous location;: n 6011 volts nominal,
T ❑ Scrvicc or feeder 600 amps or morc
Subdivision: I Lot no,: FEE SCHEDULE
De4crlptton I Qty. 1 Fee, I Tort
Tax map /parcel no.: New residential - single or multi - family dwelling unit.
DESCRIPTION OF WORK Inleindes attached garage.
Install Base feed for furniture 1000 sq. ft. or Icss S 168.54 4
N. Add'I 500 sq. ft or portion 5 33.92 1
LJ PROPERTY OWNER I T 4 I TENANT Lihtiled energy residential
Name: (with above sq. ft.) 5 67.84 2
Limited energy, multi-nuttily
Address: residential (with above sq. 4.) 5 67,84 2
Service or feeders Installation, alteration, and /or relocation
City /Stole /ZIP: 20p snips or less s 100.70 _ 2
2011 amps to 4011 amps $ 133.56 2
Phone: 4011 amps to 600 amps 5 200,34 2
Fax:
6011 amps to 1000 amps S 301.04 2
Owner Installation: This installation is being made on property that 1 own which is nut ONler 1000 amps or volts 5 552.26 2
intended for sale. lease. rent or exchange, according to ORS 447, 449. 670, and 701 Temporary services or feeders Installation, alteration, and /or
Owner signature: Date: relocation
200 amps or less 5 59.36 1
Li APPLICANT 1 Li CONTACT PERSON 20! amps to 400 amps 5 125,08 2
Business Name: 401 amps to 599 amps 5 168.54 2
I3ritnch circuits - new, alteration, or extension, per pane(
Contact name: A. Fcc for branch circuits with
1
service or feeder fee, each
Address: branch circuit S 7,42 2
B. Fcc for branch circuits
City/State/ZIP: without service or feeder rec.
first branch circuit 1 $ So. 1 56.18 2
Phone: Fox: F.afh additional branch circuit: 2 .5 7.42 14,8 2
Mittectiancous (service or feeder not Included
E-mail: Each manufactured or modular '
CONTRACTOR dwelling, service and or feeder 5 67.84 2
Business Namc: CAPITOL ELECTRIC CO., INC. Reconnect Only 5 67.84 2
Nair) Or irrigation circle 5 67.84 2
Contact nnmc: Sigel Or outline lighting 5 67.94 2
Signal circuii(s) or limited -
Address: 11401 NE MARX ST. cncI panel, alterations, or
cxtinsinn. I)cgcribe: Page 2 2
City /State /ZIP: PORTLAND, OR 97220 -1041
-
Each additional inspection over allowahle In any of the above
Phone: 503 - 255.9488 Fax: 503.257 -7121 Per inspection 5 86.25
Investigation per hour (I hr min) 5 66.25
CCB Lic.: 48748 'Electrical Lic.: 26.496C ISuprv. Lic.: 1112.S lnddstrial plant per hour 5 7p I p
Fuprv. Electrician signature, required; ELE PERMIT PEES•
Subtotal $ 71.02
Print Name: DAR LL MCNEEL Date: 02/26/10 Plnnl review (25% of permit fee)
Authorized signature: 444444440 044 Stale surcharie ( 12% of permit fcc) $ 8.52
TOTAL PERMIT FEE $ 79
Print Name: DARR LL MCNEEL Thha permitnpplIcnllan experts Ire permit le nn[nhtolned within 189
dn)a Oaa It Il hmt nreepted n, complete.
• Nut nbcror inspcctinnx per pcnnit ailewecl.
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