Permit IN • CITY OF TIGARD ELECTRICAL PERMIT
•
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00034
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/14/2011
Parcel: 1 S 135AB04500
Jurisdiction: Tigard
Site address: 10250 SW GREENBURG RD 125
Project: Carroll & Riggs Subdivision: LINCOLN BUILDING Lot: 0
Project Description: Electrical TI
Contractor: CAPITOL ELECTRIC CO INC Owner: LINCOLN CENTER LLC
11401 NE MARX STREET BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97220 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503 - 255 -9488 PHONE:
FAX: 503 - 257 -7121
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 01/13/2011 $100.70
Specifics: amps or less
6 crt Branch Circuits w /Purchase 01/13/2011 $44.52
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 01/13/2011 $17.43
Electrical
Type of Const:
Occupancy Grp:
Total $162.65
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 • ordance wit' — 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. • ENTION: Oregon la'v requires you to follow the rules adopted by the Oregon Utilit • ificatii n Center. Those rules 'are set forth in OAR
952 -00 -0010 through OAR 952-0: -Or:0 ' ,u may obtain a c• .y of the rules or direct questions to OU by jr":" or 1.800. 32.2344.
Iss ed By: �� L i 14 A ■ ' Permittee Signatuca /VAT' (V�
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 INSTILLATION ONLY
SIGNATURE OF SUPR. ELEC' � A; ,� ' 1 ., s , Date:
i
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.
01/13/2011 10:33 5032577121 CAPITOL ELECTRIC PAGE 02/02
"Electrical Permit ApplicRtion E ;;� F�(1li C,reH�I[.:1:. I.;SM: ONLY }teccivcd "' IV Permit no.:
City of Tigard Date/L /. /rf // 0„ ) P EL Coda/ /OGb
1:3125 SW Hail Blvd„ Tigard, OR 97223 JAN 13 2011 Plan Review
' r Phone: 503.1539.4171 Pax: 503.593.1964 Dale /13y, Other Permit:
TiGAR0 Inspection Line: 50'3.(:39.4175 Datc /B furls:
Internet: www.tigard-or.gov CiTY OF TI RD y y i_ ace nn to z.hr
B UILDING DIM 0 / MC[hod: Supplemantnl lntb motion
TYPE OP WORK PLAN REVIEW
1. -,..I New construction n • ddition /;dteralien /rtyplaeement Please check ell that apply (submit 2 sets of plans w /items checked below):
I_..I Demolition ❑ Other: ❑ Service or feeder 400 amps or more ❑ Building over three storm:
CATEOORY Oi'.CONSTRITCTION where the available taut current ❑ Marinn0 and boalytrd5
LI 1- and 2- family dwelling H Commercial /industrial I I Accessory 'marling exceeds 10,000 amps at 150 volts or Floating building.^,
L.1 Multi- famil Ti Master Builder ❑Other less to ground, or exceeds 14,000 Commercial -use agricultural
JOB SITE INFORMATION AND L LOCATION amps for all other Installations. ❑ buildings
tub no.; 110158 Job she address: 10250 SW Groenburg Rd 111 Fire Pump ❑ Installation of 75 KVA or
❑ Emotooncy System larger separately dorivod system.
City/Stale/7..1P: Tigard Oregon ❑ Addition of new motor load of ❑ "A ". "E', "1 - ", "1 - ",
100FIP or mom, Ti occupancy
Shits /hIrlR.;ant. nn.: 125 Project name; Carroll & Riggs ❑ Six or mom residential units n Recreallonai vehicle parks,
F3 Heahh -taro facilities 7 Supply voltage fnr more than
Cross Street/Directions to job site: ❑ Hazardous locations
❑ 600 spits nominal,
❑ Service or feeder 600 amps or more
Subdivision: 1,01 no FEE SCHEDULE
Descrlptlan I Qty, I Fee. I Total I
Tax ntap/parecl no.: New residential - single or multi - .family dwelling unit.
.__ DESCRIPTION OF WORK Includes attached garage.
Tenant improvement 1000 sq. ft. or less $ 188.54 4
Ea, Add'1 500 sq. ft or portion 5 33,92 1
PROPERTY OWNER 1 Li TENANT Limited energy residential
Name:
(with above sq. f1.) $ 75,00 2
Limited energy, multi - family
Address: residential (with above sq. ft.) 5 75.00 2 -
Service or feeders installation, alteratlnn, and /er relocation
City /grate /ZIP; 200 amps or less _ . . ' t 5 100,70 100.70 2
201 amps to 400 amps _ $ 133.56 2
Phone: lax:
40I 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 f own which is not Over 1.000 amps or volts 5 552.26 V 2
intended for sale, lease, rent or exchange, according to ORS 447, 449, 670. and 701 Temporary serviees or feeders Installation, alteration, and /rot
Owner signature: _ Date: reloeetlon
200 amps or less $ 59.36 I _
(i APPLICANT . - I LJ CONTACT PERSON 201 amps to 400 amps $ 125.05 2
401 am s to 599 amps $ 1 65.54 2
Busine.55 Name; >? ...
Branch circuits - new, alteration, nr extension, per panel
Contact name; A. Fee for branch circuits with
service or feeder fee, each
Address: branch circuit 5 7,42 2
B. Fcc for branch circuits
City /State /71P: • without service or feeder fcc,
first branch circuit 5 56,19 2
Phone: Fax: Each additional branch circuit: 6 S 7.42 44.52 _ 2
Miscellaneous (service or feeder not Included)
E -mail: Each manufactured or modular
CONTRACTOR - dwelling, service and or feeder S 07.54 2
Business Name: CAPITOL ELECTRIC CO., INC. Reconnect onl 5 67.94 2
Pump or irrigation circle 5 67,84 2
Si n or outline li htin 3 67.64 2
Contact name:
.6 R 6
Signal circuit(s) or limited -
Address: 11401 NE MARX ST.
energy panel, alterations, or
extension. Describe: Fire Alarm 5 75,00 2
City/State/ZIP: PORTLAND, OR g7220 -1041 Page z
Each additional Inspection over allowable in any of the above
Minna 503.255 -9488 Fax: 503 - 257 - 7121 Per inspection R fi6.25
_ Investigation per hour (1 hr min) $ 66.25
CCI3 Lie,: 48748 IElee ie.; 26-496C ISuprv. Lie.: 3132-S Industrial plant per hour s 75.1$
Suprv. lilectriclar signature. req d ,ae.„76 ! r
: "`r 13 ELECTRICAL PERMIT FEES"
Subtotal $ 145.22
Print Name: DARRELL MCNEEL Date: 01/13/11 Plan review (25% ofpermit fcc)
Authorized signature: Z :) Slate surcharge ( 12% of pen» it fcc) $ 17.43
• 4 ..: ,TOTAL PERMIT FEE $ 162.65
Print Name; DARRELL MCN L • Than permit nppticnilnn expires If n permit I, not obtained within tan
tiny. odor n ban hone accepted n! complete.
a Number or inspections per permit allowed.