Permit .
�t CITY OF TIGARD ELECTRICAL PERMIT
a COMMUNITY DEVELOPMENT Permit #: ELC2013 -00057
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/23/2013
Parcel: 1S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 465
Project: Dora! Headquarters Subdivision: METZGER, TOWN OF Lot: 9
Project Description: (5) branch circuits 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
5 crt Branch Circuits wo /Purchase 01/23/2013 $85.86
Specifics: Service or Feeder
1 ea 12% State Surcharge - 01/23/2013 $10.30
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $96.16
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 acco 'th 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. ATTE ON: Oregon la requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001 -0 0 through OAR 9 -001- I ; I. You may obtain a copy of the rules or direct questions to OUNC b .-11' . . .1987 or 1.800 32.2344.
Issued By: ■ � 6/I' 4 _4j Permittee Signe u =. " — /
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' — .Ott 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.
01/23/2013 r 15:01 5032577121 CAPITOL ELECTRIC PAGE 02/02
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Electri(cal_Permit Application
RECEIVED MI. 01: I: 1. l si: trvl.1
e�e,v of Tigard Aate/By: /� �f _
City � j ! l � Permit no.: She e - 05 7
I NI ■ (3125 SW Hall Blvd., T18ard, OR x7223 JAN 2 3 2013 ;R 1CW Other Permit: 0 7
�:. Phone: S03.639.4171 Fos 503.598.•1960
. r 1 c; n 1; I -, Inspecri0n Line; 503.639.4175 Date Ready /By: )uris; ❑ see two 2 for
Internet: www,Hgard- or. %' OF�G Notlficd/Mcthod: Se
. _ •• • .. ... • I ■ I 1 I
!e +_ 1• y.=-4 '>•f' -"l.}. MY"i�:t4,3, _1 7 eG_S L) 4r: �'�tit. '�...,,i"� •E: ��r4r ^-•1.',,.. �'d: 4ki }. _ h.- f�!.._ r_
❑ New construction 0 Addition /alteration/rcplaccmcnt Please check all that apply (submit 3 sets of plans wfitems checked below):
❑ Demolition ❑ Other: ❑ Service or feeder 400 amps or more El 9uilding over three atoriea •
...; y• .['C , Z. •'Z'S o ra +, tiVr 1r 0 4 1; y •; where the available fault current ❑ Marines end boatyards
❑ I- and 2- family dwelling 0 Commercial /industrial 0 Accessory building exceeds 10,000 amps at 150 volts or 0 Floating buildings •
E l Multi -famil _ ❑ Master Builder 0 Other less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
/7 "— n • i " r ' -• ' n t-s ° i� n r r . amps for al other installations, buildings
buildin
��:: -0.�'�.? „�"'���,�.a '
i CSI' f+_ 0-' � '.,.1.1_�+,:.cl1S.,C�'�;�1_y {,� � ”
., P 9
Job no.: 130432 Job site address; 10300 SW Greorlburg Rd ❑ Flre Pump El installation of 75 KVA or
❑ Emergency system larger separately derived system.
City /State /ZIP: Tigard OR ❑ Addition of new motor load of El "A", "E ", •'1.2••, "1-3", ,
100HP or more, El occupancy
Suite/bldg. /apt. no 465 (Project name: Donal Healthcare
❑ six or more residential units 1:1 Recreatlonel vehicle parks.
❑ Hcttltll -care facilities ❑ Supply voltage for more than
Cross Strcct /Dircetilms to job site: El Hazardous locations 600 volts nominal.
❑ Service or feeder 600 amps or more
.. A- *;, .' •: '' u i 's` ,%,i -a: .1' f� v;.3acalIt _ :rti lvi.. '.t t1 . `a .. ..:; .
Subdivision: 11.ot no.; ' ` ; . .,
Description DI. Fee, Total
Tax m: /.arccl no.: New residential - single or multi - family dwelling unit.
.Firs,' + b= z,1 : 1,xe13ia1r•j : -a):My .. F-t'e :, > iy. .i,r includes attached garage.
Tenant Improvement 1000 sq. A. or less 8 168.54 4
Ea. AddMI 500 sq, ft or portion S 33,92 I
- ' •1 r;_ r t .., r ri i h.:? �'•_�ry ■ 1 :l\ !'mte energy �J. y; ��4..•' t"1•ir..).:114J.�1.:�.' _an;'.�'q l ? :a'i� .4�i.� !psi 0 Li
:>g+�•. '-e id residential
Name: (with above sq. ft.) S 75.00 2
Limited energy, multi- family
Address: residential (with above sq. ft.) S 75.00 2
Service or feeders installation, alteration, and /or relocation .
City/State/ZIP: 200 amps or less $ 100,70 2
201 amps to 400 amps 5 133.56 2
Phone: Fax; 401 amps to 600 amps S 200.34 2
601 amps to 1000 amps $ 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 . I S 5 9.36 I 1
,: � �NraiTE: :: = sgiii, lR:n : ■ I i2''�2:: :. &1 2, ;i°�sj ,,,tK 201 amps to 400 amps $ 12 2
IIusihess Name: 401 amps to 599 amps S 168.54 2 '
Branch circuits - new, alteration, or extenfion,,ler Nisei
Contact name: A, Fec.tbr brunch circuits with
service or feeder Fee, each
Address: . ` branch circuit •• S 7.42 2
B, Fcc for branch circuits
without service or feeder fee.
City/State/ZIP: first branch circuit 1 S 56,15 56.18 2
Phone; Fax: Bach additional branch,clrcutk 4 $ 7,42 29.68 2
Miscellaneous (service or feeder not Included)
]small; Each manuthctured or modular
•-%Tice.' „t l a671M, [. W-3 L; -`Mr,;; : ' _ �+ 1 r • r : , dwelling, service and or feeder 5 67.84 2
Business Name: CAPITOL ELECTRIC CO., INC- Reconnect only $ 67,84 2
Pump or irrigation circle S 67.84 2 •
Contact name: Gary Stelert Sign or outline lighting 5 67,84 2
• Signal circuit(s) or, limited-
Address; 11401 NE MARX ST- energy panel, alterations, or
extension, 1)escribc; s 75.00 2
City/State/ZIP: PORTLAND, OR 97220-1041 ]'age 2
Ends additional inspection over allowable in any of the above
Phone: 503 Fax: 603 -267 -7121 Per inspection S 66.25
Investigation per hour (1 hr min) $ o&25
CCB Lic,; 48748 [Electrical Lie.: 26 -4960 • . Lie,: 3132 -S Industrial slant , r hour S 78.18 •
g 1>i'rcd•
Suprv. Electrician signature. rc g,:------.." ' f1� 1":%ia; :a • ,4i 7 �: t".: *4-
Subtotal $ 86.86
Print Name: Dar . atcF Plan review (25% of permit fee)
Authorized signature: State surcharge ( 12% of permit fee) $ 10,30
1 _ TOTAL. PERMiT FEE $ 96.16
Print Name: Da P9 MCNeel This permit npp1lctiion er1Nrt+ urn posit is ring (Mustard within 1o0
days After it One been accepted nn campin•e. /
Number o fin s pacri o na par pmmit nilawetL
1:t euudina \Pentlit\.l,ar'-rmhxpp lnrolrov 440.46151'f11/OSICOM IWPD
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
10300 SW GREENBURG RD 465, TIGARD, OR,
97223
Commercial - Electrical
199 Electrical final
05/02/2013 00:00
ELC2013-00057
PASS - No C of O
Violation Summary:
Inspector Contractor
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
10300 SW GREENBURG RD 465, TIGARD, OR,
97223
Commercial - Electrical
125 Wall cover
04/23/2013 00:00
ELC2013-00057
PASS
Violation Summary:
Inspector Contractor
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
10300 SW GREENBURG RD 465, TIGARD, OR,
97223
Commercial - Electrical
130 Ceiling cover
04/10/2013 00:00
ELC2013-00057
PASS
Violation Summary:
Inspector Contractor