Permit CITY OF TIGARD ELECTRICAL PERMIT
- -• COMMUNITY DEVELOPMENT Permit #: ELC2011 -00466
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/17/2011
Parcel: 1 S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD
Project: Lincoln Tower Subdivision: METZGER, TOWN OF Lot: 9
Project Description: (1) 200 amp plug for existing panel in room "E" on the second floor.
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 08/17/2011 $100.70
Specifics: amps or less
1 ea 12% State Surcharge - 08/17/2011 $12.08
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $112.78
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 2- 001 -0090. You ma . • - . copy of the ules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
1
Issued By: 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' 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.
08/17/2011 14:04 5032577121 CAPITOL ELECTRIC PAGE 02/02
r INIIIMMIEMBIEMZIMIIMMIN
Electrical Permit Applicati� 4 Erma I n r 6 , , r Received City of Tigard Datc/By, 1 5�( 7/ti Le--,7U1( —cca -(6 G
II * 13125 SWl�ailBhhd„ J
Tigard. 972 G 17 2011 Plan Review QthcrPermit'
'' Phone: 503.639.41171 Fax: 503.598.1960 Date/By;
'l(Tr.1 T. n Inspection Line: 503,530.4175 /'� OF 1,,;f i -t-�• Date Ready /By; Juris: L Sec rage 711.•
Internet: WWW,tigard- or_g0Y idll l TIGARD g „ Iernenlni int'crmalieu
BUILDING r Notifi /Method: rt
Li \/i ifs.;
TYPif OF WORK PLAN REVIEW
New construction Li Addition /alteration /replacement. Please check all that apply (submit 2 sets of plans w/items checked below);
❑ Dcnlolitipn ❑ Other: ❑ Service or feeder 400 amps or more 7 Building over three stories
CATEGORY OF CONSTRUCTION where the available fault current ❑ Marinas and boatyards
L 1- anti 2- family dwelling U Commercial /induatrinl LI Accessory building exceeds 10,000 amps at 150 volts or ❑ Floating buildings
❑ Multi ❑ Master Builder ❑ Other less to ground, or exceeds 14,000 n Commercial•use agricultural
JOB SITE INFORMATION AND LOCATION amps for another Installations, buildings
,roll no.: 111259 .Io11 site address: 10260 SW Greeburg Rd i- I Fire Pump 17 Installation of 75 KVA or
-- Li Emergency system larger separately dnrived system.
Uity /Sintel7,IP Tigard Oregon ❑ Addition of new motor load of
100HP or mere. l.1 occupancy
Suite/bldg. /apt, no,; 2nd fir "E" Rm Project name; Lincoln Towor Sus El sin or more residential units n Recreational vehicle parks,
-. III Health-care facilities Li Supply voltage for more than
Cross Street/Directions to 'ob site: ❑ Hazardous locations 600 volts nominal.
Li Service or feeder 600 amps or more
Subdivision: I Lot no,: FEE SCHEDULE
1 Description I Qty. I kec. 1 Total 1
Tax ma /roroelno.: New residential - single ormuid- fnmlly dwelling Init.
DESCRIPTION OF WORK Includes attached garage.
install new 200a bus , plug to feed exiosling 200n. panels 1000 aq. ft. or less $ 168.54 1 4
Ea. Add'1 500 sq, fl or portion $ 23.92 t
LI PROPERTY OWNER LJ TENANT Limited energy residential
(with above sq. 0,) $ 75.00
Name:
Limited energy, multi-family
Address; residential (with above sq. fl..) $ 75.00 2
Service or feeders installation, alteration, and /or relocation
City /State /ZIP; 200 amps or less 1 S 100,70 100.70 2
201 amps to 400 amps .. S 131.5(, _ 2
Phone: Pax; 401 amps to 600 amps S 200.74 2
601 amps to 1000 amps S 301.04 2
Owner installation; This installation is being made on property that i 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 scrvleeS or feeders installation, alteration, and /nr
Owner signature; (lat relocation _
200 amps or less $ 59.35 I
APPLICANT CONTACT PERSON 201 amps to 400 amps $ 120.08 2
Business Name: 401 amps to 599 amps $ 168.54 2
Branch cirOmts - new, alteration, or extension, per panel
Contact name: A. Fee ibr branch circuits with
service or feeder fee, each
branch circuit S 7.42 2
Address; B. Fee for branch circalls
City /State /71P; without service ur feeder fee,
_ first branch circuit $ 56.18 Z
Phone; Fax: Each additional branch circuit: $ 7.42 2
Miscellaneous (service nr feeder not Included)
E -mail; Each mans lectured or modular
CONTRACTOR dwelling, service and or feeder 5 67.84 2
iitrsinesa Nanic: CAPITOL ELECTRIC CO., INC_ Reconnect only S 67.54 2
Pump or irrigation circle $ 67,84 2
( - 'enlocl name: SIgn or outline lighting $ 67.84 2
Signal circuit(s) or limited.
Address; 11401 NE MARX ST. energy panel, alterations, Or
extension, Describe, 5 75.00 2
City /State /ZIP; PORTLAND, OR 97220 -1041 Page 2
Hach additional Inspection over allowable In any of the above
Plume; 503 - 255 Fix: 503-257-7121 Per inspection % GG,25
Investigation per hour (I hr min) $ 66.25
GCB Lie,; 48748 P.Icctrjeat Lie.: 26-496C [Sop/. Lie.: 3132 "5 Industrial plant erhour $ 78,18 l
Suprv. Electrician si} nalalre, requite ELECTRICAL PERMIT FEES"
j ,5 ei Subtotal $ 100.70
Print Name: DARRELL MCNEEL Date: 0 11711 Plan review (25% of permit fee)
Authorizes,' Signature' State surcharge( 12% ofpermit fen) $ 12.08
i !//41. : f TOTAL PERMIT FEE $ 112.78
Prins: Nome: DARRELL MCNE TIM permit appncatlnn cap lren Ii n p "anti kii am obtained within ISO
den., Orr ii bee been accepted en complete.
"' Number of hlapcetiona per permit allowed.
h ,, \RUihtinp \I'em,ils\EI.C-Perrnd a rm.tlw 1 001 1/09 440.45151(1 l /ms /COM /WiiR