Permit ,, CITY OF TIGARD ELECTRICAL PERMIT
1 4 . COMMUNITY DEVELOPMENT Permit #: ELC2011 -00337
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/21/2011
Parcel: 1 S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 400
Project: Kforce Subdivision: ASHBROOK FARM Lot: PTS 1, 2
Project Description: (4) branch circuits for 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
4 crt Branch Circuits wo /Purchase 06/21/2011 $78.44
Specifics: Service or Feeder
1 ea 12% State Surcharge - 06/21/2011 $9.41
Type of Use: COM Electrical
Class of Work: ADU
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 acc• • - • - 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. AT ITION: Oreg•. la. equir -s you to follow the rules adopted by the Oregon Utility Notifi Center. Those rules are set forth in OAR
952 -001 .010 through OAR 91- 001 -r0• i. Y•u may obtain a copy of the rules or direct questions to OUNC by calli 03.232.1987 or 1.800.332.2 44.
Issu d By: ■ ■•=16...4' 7 Permittee Signatu • c 2
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' • f, �`_/ . Date:
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.
05/20/2011 08:15 5032577121 CAPITOL ELECTRIC PAGE 02/02
FOR OEF1t.:E USE ONIA •
J1ectrkCal Pel(ll# A DpHeat /On Received
--• ..- ME r / Permit nn.: Q� /
City of Tigard soli Dale /By: i Ai. / / iw 6
"I 13125 SW glad 3311 /C1, Tigard, OR 97223 2 Plan Rcvi Other Pcrmrt: M , 0
Phone: 503.639,4171 Fax: 503,598.14N ` 1 2011 00.Q/By:-
ins ection Line: 503.634.4175 Date Ready/By: .luris: _, see Prow a roc
FirRI[r) P 8 CITY OFTIG� S Icmonlal ln6mmnlinn
Internet: vt arti•or. ov CITY i' V[lil1J Notified /Method:
• UUII .D G DIVISION
TYPE OF WORK PLAN REVIEW
II New construction LLI Addition/alteration/replacement Please check all that apply (submit 2 sets OF plans wlilems checked below):
❑ Demolition L] Other: ❑ Service or feeder 400 amps or mom ❑ 9Ullding over three stories
� CATEGORY OP CONSTRUCTION _ where the available fault current ❑ Marinas and boatyards
— 7 I. and 2- family dwelling ❑ ° Commercial /industrial LJ Accessory building exceeds 10,000 amps 311S0 volts or ❑ Floating buildings
Li Multi- family ❑ Master Builder Li Other lees to ground, or exrneds 14,000 ❑ Commercial -use agricultural
3013 SITE INFORMATION AND LOCATION amps for all other installations, buildings
r 1 Fire Pump L] Installation of 75 KVA or
Job no.: 110991 I .lob Sift address; 10300 SW Greenburg Rd ❑ Ymer ens system larger separately derived .system.
9
❑ Addition or new motor load of ❑ "A ". "E ", "1.2 ", "1 -3 "•
City /State /ZIP: Tigard Oregon 100I-11 or more. n occupancy
KforCG
❑ Heahh.carc facilities Supply voltage Six or more residential units ❑ Recreational vehicle parks.
Suite/bldg. /apt. no,: 400 Project name; I e for more than
g
Cross Street/Directions to job .cite: El Hazardous locations 600 volts nominal,
El Service or feeder 600 amps or mom
MP-SCHEDULE
Subdivision; Lot no.: nnacrlplitn Qty. Pre, total _
Tax map /parcel nn,: New residential - single or rrrttlti- famlly.dwellin0 unit.
DESCRIPTION OF WORK I Includes al niched garage. „
Tenant im rovcmant work add outlets. 1000 sq, il, or less 5 t68.54 ' 4
Ea. Adll'I 5005. ft or portion S 33.92 1
I PROPERTY OWNER I _, 1 1 TENANT Limited energy residential
(with above g. ft.) $ 75.00 , 2
Name: Limited energy, multifamily
residential (with above sq. 0.) $ 75.00 2 —
Add Service or feeders Installation, alteration, and /or relocation
200 amps or Isms - 5 100,70 2
City/State/ZIP: amps to 400 anip S 133,56 2
401 amps to 600 amps _ S 200,34 2
Phone; Fax: 601 am.s to 1000 am s 5 301 2
Owner installation; This installation is being made on properly that I own which is not Over 1000 amps or volts s 552.26 _ 2
intended fbr sale, leaser rent or exchange, according to ORS 447, 449, 670. and 701 Temporary services or rashers installation. alteration, and /or
Owner signature; Date: relocation
200 amps or less - 5 59.36 I
-
I T P __LE . I E CONTACT PERSON 201 amps to 400 amps .. s 125-05 2
401 am s to 599 am •5 5 x65.54 2
Business Name: Drench circuits • new, alteration. or extension. •cr anti
— .
A, I.!ee for branch circuits with
Contact name: service or feeder fee, each
branch circuit 5 7.42 2
Address: B. Fee for branch circuil5
without: service or feeder roc,
City /Statc/7.IP; (irsi branch circuit I S 55,10 56.13 2
Each additional branch Circuit: 3 5 7.42 22.26 2
Phone: 1rax: Miscellaneous (service or feeder not included)
E -mail: Poch manufactured or modular ,
CONTRACTOR dwelling, service and or feeder 5 67.84 2
Busi ness Name; CAPITOL ELECTRIC CO., INC. Reconnect only 67.84 2
ti j
Pump or irrigation circle 5 67.14 2
Si • n or outline li It1in• $ G7.8'1 2
Contact name:
Signal circuit(s) or limitcd-
Address: 11401 NE MARX ST. energy panel, alterations, or
extension, Describe: . $ 75.00 2
City /State /ZIP: PORTLAND, OR 97220.1041 P 5c 2
Each additional Inspection ever allowable in any of the above
Phone: 503- 255 -9488 Fax; 503 -257 -7121 Pcr inspection _ S 56,25
investigation per hour (1 hr min) 5 66,25
CCi3 Lie.: 48748 'Electrical l.,ic.: 26 -4960 I�Su N. Lic.: 3132.5 industrial plant Cr hour 1 78.10
�i r%�iV Vim ���� ELECTRICAL PERMIT FEES.
Suprv. Elcclrician signature, required' 77 Subtotal total $ 78.44
Print Name; DARRELL- CREEL Da e: 08/20 Plan review (25% of permit fcc)
Authorised signature: - State surcharge ( 12% ofpermit fee) $ 9.41
TOTAL PERMIT FEE $ 87.85
Print Name: DARRELL N EEL nos permlt.tppnerdion exptrrr If n r••rmlt Ii not obtnmrd will„ loo 1_ ,
ttnye niter It Sc. been accepted nn c...Plnla. p -/
"'Number of inspections per permit allowed.
I: 1NUildinCiPs , mba1lt1.C.PennitAno.dne 10/Otm9 Ah0- M1ril$T(I l,nS /COM /W??n