Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2010 -00130
T' GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/19/2010
Parcel: 1S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 900
Subdivision: LINCOLN TOWER Lot: 0
Project: NW Mortgage Expansion
Project Description: Add /alter (4) branch circuits for TI.
Owner: FEES
LINCOLN CENTER LLC Quantity Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL 4 crt Branch Circuits 03/19/2010 $78.44
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 03/19/2010 $9.41
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 $87.85
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 952-001-0100. 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: • v \el. L ( ♦A / \Q 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:
c‘•.1 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.
Electrical Permit Application ,FOR'OFFICEUSEONLYI
RECEIVED Received f�
Y4 a' g RECEIVED A� Permit no.: V - CO i•
-,(--) °� ,�_ . -�'� City of Tigard Date /By: v I ��
a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
W , ` ^7, g F Phone: 503.639.4171 Fax: 503.598.1960 MAR 1 9 2010 Date /By: Other Permit:
ti?aktr, Ins pection Line: 503.639.4175 Date Ready /By: J 's: �� ❑ See Page for
*0x+l4P^ ww
Internet: w.tigard- or.gov
CITY OF
TIGARD Notified/Method: 7 Supplemental Information
BUIi A lc DRVISION
TYPE OF WORK • l
PLAN REVIEW
❑ New construction I "J Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Demolition ❑ Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories
CATEGORY OF CONSTRUCTION where the available fault current LI Marinas and boatyards
❑ 1- and 2- family dwelling U Commercial /industrial ❑ Accessory building exceeds 10,000 amps at 150 volts or Floating buildings
❑ Multi family ❑ Master Builder ❑ Other less to ground, or exceeds 14,000 Commercial -use agricultural
JOB SITE INFORMATION AND LOCATION amps for all other installations. ❑ buildings
Job no.: 100395 Job site address: 10260 SW Greenberg El Fire Pump ❑ Installation of 75 KVA or
❑ Emergency system larger separately derived system.
City /State /ZIP: Tigard, OR El Addition of new motor load of ❑ "A ", "E ", "1 - 2 ", "1 - 3 ",
1 001 IP or more
cc n, cy —
quit,1hld21:Ipt. no.: 900 Project name: NW Mortgage El Six or more residential units III Recreational vehicle parks.
❑ Health -care facilities ❑ Supply voltage for more than
Cross Street /Directions to job site: ❑ Hazardous locations ❑ 600 volts nominal.
❑ Service or feeder 600 amps or more
Subdivision: Lot no.: FEE SCHEDULE
Description I Qty. ' Fee. I Total '
Tax map /parcel no.: New residential - single or multi - family dwelling unit.
DESCRIPTION OF WORK Includes attached garage.
New and relocated switches, outlet and lighting for tenant improvement 1000 sq. ft. or Tess $ 168.54 4
Ea. Add'I 500 sq. ft or portion 5 33.92 I
' ❑ PROPERTY OWNER I ❑ TENANT •' Limited energy residential
(with above sq. ft.) $ 67.84 2
Name:
Limited energy, multi - family
Address: residential (with above sq. ft.) _ 5 67.84 2
Service or feeders installation, alteration, and /or relocation
City /State /ZIP: 200 amps or less $ 100.70 2
201 amps to 400 amps $ 133.56 2
Phone: Fax: 401 amps to 600 amps $ 200.34 2
601 amps to 1000 amps $ 301.04 2
Owner installation: This installation is being made on property that I own which is not Over 1000 amps or volts $ 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 $ 59.36 1
11 APPLICANT 1 ❑ CONTACT PERSON 201 amps to 400 amps $ 125.08 2
Business Name: 401 amps to 599 amps 5 168.54 2
Branch circuits - new, alteration, or extension, per panel
A. Fee for branch circuits with
Contact name:
service or feeder fee, each
branch circuit $ 7.42 2
Address:
B. Fee for branch circuits
without service or feeder fee,
City /State /ZIP: first branch circuit 1 5 56.18 56.18 2
Each additional branch circuit: 3 5 7.42 22.26 2
Phone: Fax:
Miscellaneous (service or feeder not included)
E-mail: Each manufactured or modular
. CONTRACTOR dwelling, service and or feeder $ 67.84 2
Business Name: CAPITOL ELECTRIC CO., INC. Reconnect only 5 67.84 2
Pump or irrigation circle $ 67.84 2
Sign or outline lighting 5 67.84 2
Contact name:
Signal circuit(s) or limited -
Address: 11401 NE MARX ST. energy panel, alterations, or
extension. Describe: Page 2 2
City /State /ZIP: PORTLAND, OR 97220 -1041
Each additional inspection over allowable in any of the above
Phone: 503 - 255 -9488 Fax: 503 - 257 -7121 Per inspection 5 66.25
Investigation per hour (1 hr min) $ 66.25
CCB Lic.: 48748 'Electrical Lic.: 26 -496C ISuprv. Lic.: 3132 - Industrial plant per hour $ 78.18
„ �� ELECTRICAL PERMIT FEES*
Suprv. Electrician signature, require a wj/L/ Subtotal $ 78.44
Print Name: DARRELL MC � , Date / : 03/17/10 Plan review (25% of permit fee)
Authorized signature l '/ / State surcharge ( 12% of permit fee) $ 9.41
I CC//LL TOTAL PERMIT FEE $ 87.85
Print Name: DARRELL MCNEEL This permit application expires it'll permit is not obtained within 1 80
days after it has been accepted as complete.
" Number of inspections per permit al lowed.