Permit CITY OF TIGARD ELECTRICAL PERMIT
IN
` COMMUNITY DEVELOPMENT Permit #: ELC2010 -00366
TI GARP/ 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/20/2010
Parcel: 1 S 135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 280
Subdivision: LINCOLN ONE Lot: 0
Project: FX Global
Project Description: (1) branch circuit for dedicated server outlet
Owner: FEES
LINCOLN CENTER LLC Quantity Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL 1 crt Branch Circuits 07/20/2010 $56.18
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 07/20/2010 $6.74
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 $62.92
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 OA 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: / �Z� ? 4'1L C_- Permittee Signature: Ar Z/ / C' 79-7-7 p!"`'
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 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.
L — # /a Ie i , ,
6
Electrical Permit Application -� n � c> -- , , ['US!' c► i, r . s i
4 � Received
City of Tigard 61S`N Date/By: . 7 Zd /d , `unit no : LCO20 / 0 —'00.36 a , Plan Rcvio�
" 13 125 SW Hall Blvd., Tigard, 0)i 97223 Q�j � Other Permit:
•
Phone: 503.639,4171 Fax: 503.596.1960 1° 1 G r i . Date /sty;
Tnspcctien Line' 503.6139.4175 N. e7 /ate Ready /13y: furls;
Supplemental I fur Pape 2for
. =. . ? Internet: www•tigard- or.gov \ \ \ )\ �+
�1G C icd(Melhod: Supplemental Infer nark.
TYPE OF WORK . _ tJ PLAN RENEW
•
New Construction •' I Addition/alteration/replacement Q�` Please check all that apply (submit 2 sCLe of plane wlitems checked below):
Ill Demolition ❑ Other: V ❑ Service or feeder 400 tamps or more ❑ Building over three stories
CATEGORY OF CONSTRUCTION � where the available fault current 7I Marinas and boatyards
L 11- and 2-family dwelling ' I Commercial/industrial • — Li , Accessory building exceeds 10,000 amps at 150 volts or Floating buildings
❑ Multi ❑ Master Builder U Other less to ground, or exceeds 14,000 Commercial agricultural
.1013 SITE INFORMATION AND LOCATION amp: ter an other installatiorin, I_I building?
Job no.: 100935 I .lob site oddreRR: 10300 SW Greeoburg Rd ❑ Emergency system U Fire Pump L - In51a11at an 0175 KVA or
larger separately derived system.
t ❑ Addition of new motor load of U "A ", •'E ", "1 -2 ", "1 -3 ",
City/State/ZIP: Tigard Oregon T C /r p 6 e �
1 . 9 - 100HPormoro E occupancy
Suite/bldg./apt. no.: NO eject Hume: L I Six or morn residential units (J Recreational vohiete parks.
i_I Health -cart facilities ❑ Supply voltage for more than
Cross Street/Direction. . Rite: ❑ Hazardous locations ❑ 600 volts nominal.
❑ Service or fccdcr 500 amps or more
FEE SCI'1PDULE
Subdivision; Lot: no.: Description I Q. 1 r I Tnta1 J •'
Tax map /parch) no,: New residential •.single or multi - family dwelling unit.
DESCRIPTION OF WORK includes attached atomise.
1
Add (1) dedicated server outlet 1000 sq. ft. or Tess $ 168,54 4
F•t. Add'l 500 sq. ft or portion 5 33.92 1
J I PROPERTY OWNER 1 LJ TENANT Limited cncrgy residonlial
(with above aq. 0.) 5 75.00 2
Nome: Limited cncrgy. multi-family
Address: residential (with above sq. 0.) $ 75.00 2
Service or feeders Installation, alteration, and /nr rclocntion
City /Stale /7_f P; 200 amps or less S 1 00.70 2
201 amps to 400 amps S 133,50 2
401 amps to 600 amps 5 200,34 2
Phone: roe: 601 amps to 1000 amps 5 301.04 2
—
Owner installation: This installation is being mode nn pmperty that 1 own which is not Over 1000 amps or volts 5 552.26 2
intended for salt, lease, tent or exchange, according to ORS 447, 449. 670, and 701 Temporary services or feeders installation, alteration, and/or
Owner signature: Dale: relocation
200 am .s or loss Mil $ 5930 I
U APPLICANT 1 11 CONTACT PERSON 201 am • s to 400 am . s _I 2
401 am s to 599 am s =IIMZEI 2
f3usrn 5s Name: Branch clrcnita - new, alteration, or extension. per panel
A. Fee for branch circuits wills
Con!net name: service or fccdcr fon, each
branch circuit 5 7.42 2
Address!
B. Fcc f"orbranch circuits
without service or feeder fee.
City /State/ZIP: first branch circuit 1 $ 56.18 56,18 2
Phone: Fax; Each additional branch circuit: 5 7,42 2
Miscellaneous (Rervlce or fccdcr out included)
E -mail: Each mnnuf0Ctured or modular
CONTRACTOR dwelling. service and or feeder $ 67.84 2
Business Name: CAPITOL ELECTRIC CO., INC. Reconnect oily $ 07,94 2
Pump or irrigation circle 5 07./14 2
Contact name; Sign or outline lighting 5 47.94 2
Signal circuit(s) or limited -
Address: 11401 NE MARX ST. cncrgy panel. alterations, or
extension, Describe: Fire Alarm 5 75.00 2
_ Pngc 2
City/Statc /7.fP: PORTLAND, OR 97220 -1041 Each additional Inspection over allowable in any of the above
ions: 503 - 255 -9488 Fax: 3.257 -7121 Per inspection $ 66,23
V
P r.
Investigation per hour (i hr min) 5 6G.2S
CCB Lic.: 48748 I Elcctrical Lic.: 26 -4 1 Suprv. Lie.: 3132- Industrial plant perilous $ 79.19
E1 P•CTRTCAL PERMIT FEES"
$ugly. Electrician signal _ mqt re i' r Subtotal $ 58.18
Print Name: RRELL MC' L - Dalo; 07115/10 Plan review (25% aperitif fee)
Authorized signature: State surcharge ( 1 2% of permit fee) 8 6.74
/Pgi w + � 7 1446. 1 `��J/ TOTAL PERMIT FEE $ 82,92 V
Print Name: LL Thla permit application expires if a permit h not obtained willtlr Ise
days niter 0 has been tuck-opted as maintain.
• ',hurdler of inspections per permit alimner!.