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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2012 -00226 TIC A R. j- 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/20/2012 Parcel: 1 S135AB03400 Jurisdiction: Tigard Site address: 10260 SW GREENBURG RD 710 Project: Axiom EPM Subdivision: METZGER, TOWN OF Lot: 9 Project Description: Electrical 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: 503 - 619 -3200 FAX: 503 - 257 -7121 FEES Quantity Description Date Amount 9 crt Branch Circuits wo /Purchase 04/20/2012 $115.54 Specifics: Service or Feeder 1 ea 12% State Surcharge - 04/20/2012 $13.86 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $129.40 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 0 52- 001 -0090. You ma • • _ •• , _ copy of . t or direct questions to OUNC by calling 503.232.1987 or 1.800.332.. 2344. "" 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 503.639.4176 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. 04/19/2012 13:04 5032577121 a yp CAPITOL ELECTRIC PAGE 02/02 qc^ " volt (1F Fit 'P. 11ti1%ON'I,l' Electrical Permit Application C t. Received I}IteR3y: A 1 11 ^ it no.: , 0 (' - ,8 • I. City of Tigard 1 2012 ■' . )3125 SW HAEI13 Tigard, Other Permit: 1vd.,Tl d, OR 97273 A PR Plan Review Phone: 593.639,4171. Pox: 503.398.1960 l)att/By: i /2... 0 , 0 - T 1 . , A R t,, Tnapection Line: 593.639.4115 CITY OF TIGAP D Date Ready /By: see Page 2 for Internet www.tigard- or.gov BUILDING `ILDING D IV I SION Notified/Method: �M x lnfcm"en r TYPE OF WORK ►v 1� PLAN REVIEW L J New construction I v I ' Addition /alteration /replacement Please check gll that appry (submit 2 sots of plane wfteme checkrad below): El Demolition U Other; ❑ Service or feeder 400 amps or More ❑ Buckling over three stories CATEGORY OF CONSTRUCTION where the available fault current ❑ Marinas and boatyards U 1- and 2- family dwelling El Commercial /industrial U Accessory building exceeds 10,000 amps at 150 volts or Ll Floating buildings n Multi - family U Master Builder ❑ Other less to ground, or exceeds 14.000 ❑ Commercial -use agricultural JOB SITE INFORMATION AND LOCATION amps for all other irtMallatlons. buildings - Job no.; 120516 Job site addr�ss: 10260 SW Greenburg Rd ❑ Fins Pump ❑ large installation of el K El Emergency system larger separately denied SYStem. — 0 Addition of now motor load of ❑ "A ", "E ", "1-2 ", "1.3". city/State/VP: Tigard OR 10011P or more. El occupancy ❑ Six or more residential units ❑ Recreational vehicle parks. Suite/bldg, /: nn.: 710 Project name: Axiom Exp 0 Health -care Facilities ❑ Supply voltage for more than Cross StreetiDirectiens to job site: ❑ Hazardous locations 600 volts nominal, ❑ Service or feeder 600 amps or more _ FEE SCHEDULES Subdivision: Lot no.: De eriplion I QS'- I Pee. I Total " Tax map /parcel no.: New residential - single or multi-famlly dwelling unIL DESCRIPTION OF WORK Includes attached arn> _ Tenant improvement. Relocate troffers and add outlets 1000 sq. ft. or less $ 168.54 4 Ea. Add!' 500 sq. ft or portion 5 33.92 1 U PROPERTY OWNER I U TENANT _ Limited energy residential Sakti above sq. Q.) 5 75.00 2 Name: Limited energy. multi •family residential (with above sq. ft.) _ S 75.00 2 Address: service or feeders Inataltatloa, alteration, and /or relocation 200 amps or less S 100.70 2 City/State/ZIP: 201 amps to 400 amps S 133.56 2 401 amps to 600 amps S 200.34 2 Phone: Fax; 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 S 552.26 2 intended for sale, lease. rent or exchange, according to ORS 447, 449. 670. and 701 Temporary services or feeders Installation, alteration, and/or Owner signature: - _ , Date: •relocation 200 amps or less f S 59.36 I U APPLICANT U CONTACT PERSON � amps l0 5!19 amps j I S 168.54 1 Busineta Name: Branch circuits -'new, alteration, or extension, per panel A, .Fee for branch circuits with Contact name: service or reader Ile, each branch circuit 5 7.42 2 Address: B. Pee for branch circuits without service orr feeder fee, City/State/ZIP: first branch circuit 1 5 56.18 56.18 2 Phone; p er; ^ Each additional branch circuit: 8 5 7.42 ` 59.36 2 ; Miscellaneous (service or feeder not Included) E -mail: Each manufactured or modular CONTRACTOR dwelling. service and or feeder S 67,84 2 Business Natnc: CAPITOL ELECTRIC CO., INC. Reconnect only S 67,84 2 Pump or i ration circle S 67,84 2 . Cnntaci name: Gary Steiott Sign nr outline lighting S 67.84 2 ' Signal eircuit(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 Each additional Inspection over allowable in any of the above Phone; 503.255 -9488 Pax; 503- 257 -7121 Per inspection 5 66.25 Investigation per hour (1 hr min) S 66.25 CCl3 Lie.; 48748 IElectricnl4;ic.: 26.496C LSuprv. Lie.: 3132 -S )nditgtrial plant per hour S • 78.13 L . Suprv. Electrician signature, required. t3LBCT RICAL PERMIT FEES* 115.54 . . !/ ./...._ / Subtotal $ Print Name: Darrell McNeel - Date: 04/19112 Plan review (259( of permit fee) Authorized signature: 6 _ _ / TOTAL ntc surc ( 12% of permit fee) $ 19.40 ©�(��� TOTAL PERMIT PER i. 129.40 Print Name: Darrel sal rho pononappneatioo aspires Its permit t. net oMalood ..unm i RA - - - dpi% niter it lira A M eret,pted au complete. . . ' • Number or Inspections per permit. allowed. ' - ' -. ' I:'0uihlin' , "wtr:- Pem,nnoo.doc I0.mI gig - 440.46t51111/05/COMMrBO. • •