Permit q CITY OF TIGARD ELECTRICAL PERMIT
s . COMMUNITY DEVELOPMENT Permit #: ELC2012 -00712
T EGAR 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/17/2012
Parcel: 1S 135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 417
Project: Cypress L -3 Subdivision: METZGER, TOWN OF Lot: 9
Project Description: (28) branch circuits and (2) 200 amps or less 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
2 ea Services or Feeders - 200 12/17/2012 $201.40
Specifics:, amps or less
28 crt Branch Circuits wo /Purchase 12/17/2012 $256.52
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 12/17/2012 $54.95
Electrical
Type of Const:
Occupancy Grp:
Total $512.87
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 OA' 9 / - 001 -00 • r, You may ob :in a copy oft a rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: . 4 — / uf Permittee Signature: PPN ` �1
a 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.
12/14/2012 10:16 5032577121 CAPITOL ELECTRIC PAGE 02/02
Electrical Permit Application RECEIVED i Tll.' ill „( 1: 1 SI; (E' l ,
City of Tigard Date/By: /d1! 7 (9 Permit no.:eL )O/01., - IJIJ 7 f d--
13125 SW Hall Blvd., Tigard, OR 97223 DEC 1 7 1' an Review
• I I' Phone; 503.639.4171 Fax: 503.598.1960 2012 Date/By Other Permit
T It ; A I:1r Inspection Line: 503.639.4175 Dntc Ready /By: .iuris.— r ❑ See Pa1rc 2 far
Internet: www.tigard -rr,gov CITY OF TIGARD NOtificd MCthnd; 1 (` Supplemental Information
BUILDING Dn 'ISIn !V
❑ New Construction 0 Addition /altcrationlreplacemer t Please check all that apply (submit 2 seta of plans wflems Chocked below)'
0 Demolition ❑ Other: ❑ Service or feeder 400 amps or more ❑ Buikting over three Stories
where the available fault current ❑ Marinas and boatyards
. 1,11 I- and 2- family dwelling C Commercial /industri ❑ Accessory building exceeds 10.000 ernes at 150 volts or ❑ Floating buildings
❑ Multi -femil 0 Master Builder ❑ Other round, o exceeds 14,000
• 4 ,,, .,. ii,r„_ ,�,,, loss to „—� �1 0 ❑ Commercial-use agricultural
r ... . ,, , wq ;. ” 7i s:. c�p�,,y l lr'5 ,y 1L1_' 1,.1.:! ;1.„ . , ..+..5` K ' ":151,i,i amps for all other Installations. buildings
Job Co.: 130046 Job site address• 10220 SW Greenberg Rd ❑ Fire Pump ❑ Installation of 75 1CVA or
0 Emergency system larger separately derived system.
Ciry /Statc/1TP Tigard OR ❑ Addtt;on Of new motor load of C "A'. "E",'1 -2", "1 -3 ",
10OMP Or more ❑ occupancy
Suitc/hldg. /Set no 417 Project name. Cypress L -3 ❑ six Or more residential units ❑ Recreational vehicle parks.
0 Health -cart facilities ❑ Supply voltage for more than
Cross Street/Directions to jab site: ❑ Hazardous locations 600 volts mmTlinal
❑ Service or feeder 600 am.: or more
Subdivision: Lot nn.; 7Z -1'a
fleseripdon Oty. Pee. Teal "
Tax ma / arccl no.. New residential - single or multi - family dwelling unit.
Includes attached garage,
Tenant improvement 1000 sq. Il. or less $ 188.54 4
Ea. Adc11 500 sq. ft or portion 5 33.92 1
limited energy residential
Name' (with about sq. ft,) S 75 00 2
Limited energy, multi - family
Address: residential(withabovesq $ 750, 2
Service or feeders installation, alteration, and /or relocation
City/State/ZIP: 200 amps or less 2 S 100.70 201.40 2
201 amps to 400 amps R 133.56 2
Phone Fax 401 amps l0 600 amps 5 2110,34 2
601 amps to 1000 amps 5 301.04 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, tease, rent or exchange, according to ORS 447, 449, 670, and 701 'temporary services or feeders installation, alteration, and /or
Owncr signature. Date: relocation
,.,,
200 amps or less
' '55 59.36 I
` :.+ i�.9, . +a:,,n+F`+ .,.. "r , .4y- at 01 amps to 400 amps
125 2
� Bu e ncss Name:
11+1 r- �^T s lr�--se wry d:, a . � • �'" 2 � 1 amps to 599 amps S 169.54 I 2
Branch circuits - new, alteration, or extension, per panel
Contact name' A. Fee for branch circuits with
service or feeder the, each
Address' branch circuit 5 7.12 2
13 Fee for branch circuits
City/State/ZIP without service or feeder fee,
first branch circuit G 56.18 2
Phone Fax Each additional brunch circuit 28 5 7.42 207.76 2
Miscellaneous (service or feeder not Included)
E-mail:
Each manufactured or modular
"'++' .• �
•.i-•w u
t . ,, •a:SL .e 44..,:r47 „li •••x�•:r dwelling, service and or feeder S 67,14 2
Business Name: CAPITOL ELECTRIC CO., INC. Reconnect onl
5 67.84 2
Pump or irrigation circle S 67.84 2
Contact name: Gary Stolort Sign or outline lighting S 67,s4 2
Signal eIcui *s) nr limited -
Address: 11401 NE MARX ST. energy panel, alterations, or
extension. Describe: 5 75.00 2
Ciry /State2TP PORTLAND, OR 97220 -1041 Page 2
Each additional inspection over allowable in any of the above
Phone: 503 - 255 -9486 tax: 503 - 257 -7121 Per inspection S 66.25
[Supra Lic Su
Investigation dust per hour 1 hr nun) ,2S `.:: - . , . :
CCB Lic. 26-496C
48748 �llectrical Lic P ( ) S 6G
I p 3132-S Industrial lent r hour 5 78,173
Suprv. Electrician signature, required: � ✓r�� l� ' '� ”" 5 • . ' . ":��'.' Yli 7+ ' «..: • w :
:.:. W r' • , ; , a+ i,.....•
� r Subtotal $ 408.18
Print Name: Darrell *a*, Dare; 12/14/12 Plan review (25% of permit fee)
it fee) 5 49.10
State surchnrge ( 12%
Authorized signature' J / off crm
/ —)pi --41.4. �NVk TOTAL PERMIT FEE $ 458.28
Print Name. Derrell McNeal Vitt pernueapiknrloe expired ir ll WTI? M not obttarrd *Rhin IRO
dxyr kn.r it amt been accepted ex templed,
• Number of impetuous per permit spewed
m ikGna \PennitzltlLC.Pcm,iiApp,,Ms 1n/o1RM 440- 46i5T(11 /05 /COMAVED
.4"-/d-C1
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10220 SW GREENBURG RD 417, TIGARD, OR,
97223
Commercial - Electrical
199 Electrical final
02/21/2013
ELC2012-00712
PASS - No C of O
Violation Summary:
Inspector Contractor