Permit rl CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 -00189
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/03/2012
Parcel: 1S135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD
Project: 3 Lincoln Subdivision: METZGER, TOWN OF Lot: 9
Project Description: (2) branch circuits for new light fixtures in elevator lobbies of 3rd and 4th floors.
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
2 crt Branch Circuits wo /Purchase 04/03/2012 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 04/03/2012 $7.63
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 -0 . Yo may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. /
Issued By: Permittee Signature: (5A /97 .. /('4
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.
Cali 603.639.4176 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.
04/02/2012 14:59 5032577121 CAPITOL ELECTRIC PAGE 02/02
l-OIZ (N - l•. USIC ONLY
Electrical .permit A, licatia� Received
° D ate/By''' 3 �2 gi it nn.. //,2 '/ / CP
City of Tigard
13125 SW Hall Blvd„ Plan Rev Tigard, OR 97223 Other Permit:
- Phone: 503.639.4171 Fax: 503.598.196A PR 3 2012 Date/fly: •
Tnspection Line' 503,/ 39.417S Date Ready /By: Sec Nat 2 air
T I G A F. 1) Internet: www.tl d -or, ov
13� 8 Notified/Method: , ;IA:m nialmthmmtioa
_ • , ........ • CIT O FTEC!,��nD 1�1
TYPE OP WORK BU+tDING O;ViS)O V PLAN REVIEW —
IJ New construction Addition/alteration/replacement Please cheek all that apply (submit 2 Sele of plena wfdems checked below):
Li
0 Demolition Other. ❑ Service or feeder 400 amps or more ❑ Building over three stories
CATEGORY OF CONSTRUCTION where the available fault current n Marinas and boatyards
I_ _ l- and 2.Otmily dwelling LI Commercial /industrial ❑ Accessory building exceeds 10.000 amps at 150 voila or ❑ Floaung buildings
Multi- famil, U Master Builder ❑ Other less to ground, or exceeds 14.000 ❑ Commercial -use agricultural
1011 SITF. INFORMATION AND LOCATION amps for all other Installations. buildings
❑ Fire Pump ❑ Installation of 75 KVA or
job rte.: 120510 Jub site address: 10220 SW Greenberg Rd ❑ Emergency system larger separately derived system.
❑ Addition of new motor load or ❑ •A•. E. -1.2', -3 ",
City/State/ZIP: Tigard OR 100HP or more. ❑ occupancy
l ❑ Six or morn residential units ri Recreational vehicle parks.
Suiterbldgdapl, Oct.: Lobbes 3 6c 4'Project name: 3 Lincoln Lobby Lights 71 Hcelth -tart facilities ❑Supply voltage for more than
Cross Strect/Direclions to job site: 7 Hazardous locations 600 volts nominal,
—
El Service nr feeder 600 am -s or more
FEE SCHEDULE
—
Subdivision: I Lot no.: Description I Qty. L Fee. I Total I "
Tax ma /r�arccl nu,: New resldeotlnl - single or maltl- f•nttly dwelling unit.
DESCRIPTION OF WORK Includes attached garage, _
Install new fixture in 3rd and 4th flour elevator lobbies 1000 s ft o r less S 160,54 4
Ea, Add'l $00 sy. ft OT n
pO S 33,92 I .
Li PROPERTY OWNER I LI TENANT Limited energy residential
(with above sa $ 75,00 2
Name : — Limited energy, multi-family L residential (with above sq. ft) S 75.00 _ 2
Address: Service or feeders installation, alteration, and/or relocatton
200 amps or less 5 100.70 2
City /State/ZIP; 201 amps to 400 ampS S 133.56 2
401 amps to 600 amp!. 5 200.34 2
Phone: Fax: 601 amps to 1000 amps S 301.04 2
Owner installation: This installation is being made on property that 1 own which is not Over 1000 amps or volts s 552.26 2
intended for sale, lease, rent Or exchange, according to ORS 447, 449, 670, and 701 Temporary acrvlees or feeders Installation, alteration, and /or
Owner signature: Date: relocation -
200 amps or less $ 5936 • I
Li APPLICANT _I U CONTACT PERSON 201 amps to 400 amps S 12508 2
401 amps to 599 amps $ 16e.54 2
Business Name: Broneh circuits - new, alteration, or extension, per p,anel
A, Fee for branch Circuits with
Contact name: Service OT feeder fee, each
branch circuit S 7.42 2
Address: 15. Foe for branch circuits
without service or feeder fee.
City /State/ZIP: first branch Circuit 1 S 56.18 56.18 2
Iiach additional branch circuit: _ 1 5 7.42 7.42 2
Phone: Fax: Miscellaneous (service or fader not Included)
Email:
each manufactured or modular i
CONTRACTOR dwelling. scrviee and or feeder S 67.84 2
Business Name: CAPITOL ELECTRIC CO., INC. Reconnect only 5 67.84 2
Pump or irrigation circle S 67.54 2
Contact name: Gary Staten Signal or outline lighting S 67.54 2
Signal circuits) or limited -
Address: 11401 NE MARX ST. energy panel, alterations, Or
extension. Describe: S 75.00 2
Page 2
City /State/ZIP: PORTLAND, OR 97220 -1041 Each additional Inspection over allOwnhle In tray of the ahnva AZ hone: 503 - 255.9488
Fax . - 257 -7121 Per ins cation S 6625
Investigation to hour (I hr mini 6665
C(`.H Lie.: 48748 ElecU east Li 96C Su • rv. Lie.: 1132 -5 Industrial plant per hour I S 78.16
,e' _ E LECTRICAL PERMIT 1rEES•
Suprv. Electrician signature. required: / Subtotal 5 63.60
Print Name: Darrell :__,i / Date: 04102/12 1 Plan review (25 %ofpermil fee)
State surcharge ( 12% of permit fee) S 7.63 /
Authorised signature � �� TOTAL PERMIT PEE , Si 71.23 t/
Prior Namc: 0 - :11 McNeal This parenitappltcanos nob. Ire permit Isom obtained within raa
days ear 11 b, been neceMnd an entnplete,
• Number of inspilCliOrte per permit allowed.
•
t : i(b,ikling\rc i1s\0.C- renannpp.dec IOrotrn, 4411.4 IST(11ms,MMrwu