Permit CITY OF TIGARD ELECTRICAL PERMIT
°x 2 . COMMUNITY DEVELOPMENT Permit #: ELC2011 -00419
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/28/2011
Parcel: 1S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 560
Project: Ignis Systems Subdivision: Lot:
Project Description: (1) branch circuit 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
1 crt Branch Circuits wo /Purchase 07/28/2011 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 07/28/2011 $6.74
Type of Use: COM Electrical
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 OAR 9 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: 111ILTY.t' /l_ Permittee Signature: 01 / f' /'A,6 5
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 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.
07/26/2011 11:18 5032577121 CAPITOL ELECTRIC PAGE 02/02
Electrical Permit Armlication Received
City of Tigard
RE Date /By: "7izr /f/ ermit no.L- Gev�d /l ___do 7, 7
4 03125 SW Hell Blvd,, Tigard, OR 97223 Plan Review
:
' : - >?honot 503.639.4171 Fax: 503.598.296o JUL 2 6 2011 �1���4/� ea /6 0
T1Get1ZU InSpe,P.tipnLine: 503.(539.4175 Date /13 y Other Perm id f y /By; Juris: I. I s. Pup: 7 n„•
Internet: ww.tigard -ar -gov
w Notificd/Mcthod: Su nlcmenisi urlbrntrtiln
TYPE OF WORK BIJiL iiNG LJ VISiL)I'J PLAN REVIEW
LJ New construction L'J Addition /alteration /replacement Please check all that apply (submit 2 sets or plant w /items checked below):
❑ Demolition ❑ Other: Li Service or rentler 400 amps or more L.] Building over thrrr. Stories
CATEGORY OF CONSTRUCTION where the available vault current H Merinas and boatyards
I 1 1- and 2- family dwelling I I Commercial /industrial I_ i Accessor buildin exceeds 10.000 amps at 150 unit; or ❑ Floating buildings
n Multi•Mmily ❑ Muster 13611d6T H Other loss to ground, or exceeds 14.000 ❑ Commercial -use agricultural
JOB SITE INFORMATION AND LOCATION amps for all other installations. buildings
Job no.: 111252 1 ,lob site address: 10300 SW Greenburg Rd ❑ Fire Pump ] Instauahen of 75 I VA or
I ❑ Emergency system larger separately dcrivcd system.
City /Statc/71P Tigard Oregon �--i Addition of now motor load of 7.1 "A", "E ", "1-2", "1.3 ",
100HP or more. LI occupancy
t� no.: 500 rojeci name; Isms Systems ❑ Six or more residential units ❑ Recreational vehicle parks.
❑ Health - care facilities ❑ Supply voltage for more Ikon
Cross Street/Directions tc: iJ Hazardous locations 600 volts nominal.
Li Service o_ r feeder 600 amps or more
Subdivision: Lot no,: FEE SCHEDULE
Dm,seriptlon I Qty. I Per. J 'raid I
Tax map /itareel n0.: Y Nest residential - single or multi - faintly dwellings gait DESCRIPTION OF WORK Inchlde8 Attached garage. __
Install battery hack up 1000 sq. A. or less $ 168.54 4
Fa. Adel 500 sq, ti or portion $ 33.92 1
LI - _ PROPii')2TY OWNER I LI TENANT Limited energy residential
Name: (with above sq. iL) $ 75.00 2
Limited energy, mulii.family
Address: residential (with above s a _ $ 75,00 2
Service or feeders installation, alteration, and /or relocation
City/Stale/ZIP: 200 amps or less $ 100,70 2
201 amps to 400 amps $ 133.56 2
Phone: Fax: 401 amps to 600 snips $ 200.34 7.
601 amps to 1000 amps $ 101,04 2
Owner iestrflntlon: This installation is being mode on property that I own which is not Over 1000 amps or volts �W $ 552.2e 2
intended far sale, lease, rent or exchange, according to ORS 447, 449, 670, and 701 Temporary services or feeders Installation, alteration, ants /or
Owner signature: _ Date: relocation
200 amps or less $ S9J6 I
LI APPLICANT [ J CONTACT PERSON 201 amps to 400 amps
I LS 125.06 1 2
Business Name: 401 amps to 599 amps S 168.54 2
1 ;rAgch circuita - new, alteration, or extension, per panel
Contact name: A, Pee for branch circuits with
service Or feeder fee, each
Address; branch circuit 5 7,42 2
B. Fcc for branch circuits
Cil:y /Slate /7.1P; without service nr feeder fee,
first branch circuit. 1 $ 55,18 56.18 2
Phone: Fax: Each additional branch eirruit: 5 7,42 2
Miscellaneous (service or feeder not included)
E-mail: Each manufactured or modular
CONTRACTOR dwelling, service atul or feeder S 6714 2
Business Name; CAPITOL ELECTRIC CO., INC. Reconnect o S 67.84 2
Pump or irrigation circle $ 67.84 2
Contact name: John McNeal Sign or outline lighting $ 07.84 2
Signal circuit(s) or limited.
Address: 11401 NE MARX ST. energy panel, alterations, or
extension, Describe: $ 75.00 2
City /State /ZIP: PORTLAND, OR 97220 -1041 Page 2
Each additional inspection over allowable in nay or le above
P one: 503-295-9488 Fax: 83.257 -7121 Pcr inspection $ 56,25
Investigation per hour (I hr min) $ 66.25
• CCB Lie,; 46748 Electrical Lie,: 26 -496C Su.rv. Lie.: 3132 -S industrial plant per hour $ 78.18
Faqirs', Electrician signature, required; ELECTRICAL PERMIT FISSS
`/Z/,ti,,/ Subtotal $ 56.18
Print. Nome; DARh'E . MCN Date: 07126/17 Plan review (25% of permit fee)
'r(7
Authorized signature; State aurchar ( 12% of permit fee) $ 6 - 74 /
� TOTAL PERMIT FEE $ 62.92 7 / /
Print Name: DARR L MCNEE), This permit nppnennnn crpiwee it o 166 .,66 I gut ,0,666Ni within 1511
dor. otter It hn4 been neceptc4 AN enmPl.to.
• Nutni,tr of intpcctionx per permit: allowed.
In tdrl4 ;netr'ermitr \ELC- Perm;iApp.d.'c 10/01!115 440 461,5r( a MI5/COM/WO