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Permit :., CITY OF TIGARD ELECTRICAL PERMIT I ,_.;, a :°; COMMUNITY DEVELOPMENT Permit #: ELC2009 -00630 T I GARj? 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/24/2009 Parcel: 1S135AB04500 Jurisdiction: Tigard Site address: 10250 SW GREENBURG RD 300 Subdivision: Lot: 0 Project: Forest City Project Description: Add /alter (21) branch circuits, and (2) 200 amp or less services. Owner: FEES LINCOLN CENTER LLC Quantity Description Date Amount BY SHORENSTEIN PROPERTIES LLC, 555 CALIFORNIA ST 49TH FL 2 ea Services or Feeders - 200 11/24/2009 $201.40 amps or less PHONE: 21 crt Branch Circuits w /Purchase 11/24/2009 $155.82 Service or Feeder 1 ea 12% State Surcharge - 11/24/2009 $42.87 Contractor: Electrical 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 $400.09 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 ac000py of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. t Issued By: ( f I 1.(t 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' ^ � 0 0 J\p p 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. li RECEIVEft ate FOR OFFICE USE ONLY / • Ele !trical Permit Application Permit no.: Ci of Tigard Date/By: 4.119 • A • IN 13125 SW Hall B lvd., Tigard, OR 97223 Plan Review g ' ••• Phone: 503.639.4171 Fax: 503.598.1960 NOV 24 2009 Date /By: Other Permit: ��- PZOSi `��� TI GARD Inspection Line: 503.639 Date Ready /By: Juris: ii See Page 2 for Internet: www.tigard- or.gov CITY OF TIGARD Notified /Method: 11 (2) Supplemental Information BUILDING DIVISION TYPE OF WORK PLAN REVIEW ❑ New construction U 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 ❑ Marinas and boatyards ❑ 1 and 2 family dwelling IJ Commercial /industrial U 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.: 291150 Job site address: 10250 SW Greenburg rd El Fire Pump El Installation of 75 KVA or ❑ Emergency system larger separately derived system. City /State /ZIP: Tigard, OR ❑ Addition of new motor load of ❑ "A ", "E ", "1 - ", "1 -3 ", 100HP or more. ❑ occupancy tiuir hld .;almt. no.: 300 Project name: Forest City El Six or more residential units ❑ 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. I Fee. I Total I H 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 less $ 168.54 4 Ea. Add'I 500 sq. ft or portion 5 33.92 I U PROPERTY OWNER I U TENANT Limited energy residential Name: (with above sq. ft.) $ 67.84 2 Limited energy, multi - family Address: residential (with above sq. ft.) $ 67.84 2 . Service or feeders installation, alteration, and /or relocation City /State'ZIP: 200 amps or less 2 $ 100.70 201.40 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 1 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 5 59.36 1 Li APPLICANT 1 U CONTACT PERSON 201 amps to 400 amps $ 125.08 2 401 amps to 599 amps $ 168.54 2 Business Name: Branch circuits - new, alteration, or extension, per panel A. Fee for branch circuits with Contact name: service or feeder fee, each branch circuit 21 $ 7.42 155.82 2 Address: B. Fee for branch circuits City /State /ZIP: without service or feeder fee, first branch circuit $ 56.1" 2 Phone: Fax: Each additional branch circuit: $ 7.42 I 2 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 $ 67.84 2 Pump or irrigation circle $ 67.84 2 Contact name: Sign or outline lighting 5 67.84 2 Signal circuit(s) or limited - Address: 11401 NE MARX ST. energy panel, alterations, or extension. Describe: Page 2 2 City /State /ZIP: PORTLAND, OR 9722 0 -1 041 Each additional inspection over allowable in any of the above 'Phone: 503 - 255 -9488 Fax: 503 -257 -7121 Per inspection $ 66.25 Investigation per hour (I hr min) 5 66.25 CCB Lic.: 48748 (Electrical Lic.: 26 -496C ISuprv. Lic.: 3132 -S Industrial plant per hour _ $ 78.18 6 4"1 ipic ELECTRICAL PERMIT FEES* Suprv. Electrician signature, required: Subtotal $ 357.22 Print Name: DARRF�L MCNE Date: 11/17/09 Plan review (25 % of permit fee) State surcharge ( 12% of permit fee) $ 42.87 Authorized signature: �i, .c ,�1� { TOTAL PERMIT FEE $ 400.09 Print Name: DARRELL MCNEEL This permit application expires if a permit is not obtained Within 180 days after it has been accepted as complete. * Number of inspections per permit allowed.