Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2013 -00158
TIGARD- 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/12/2013
Parcel: 1 S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 400
Project: Kforce Subdivision: METZGER, TOWN OF Lot: 9
Project Description: (3) branch circuits
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
3 crt Branch Circuits wo /Purchase 03/12/2013 $71.02
Specifics:, Service or Feeder
1 ea 12% State Surcharge - 03/12/2013 $8.52
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $79.54
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 01 -0090 You may obtain a copy ?f the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
n/n� � v� 1 4PPL/ CAT
Issued By: �C-! Z./ 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.
03/12/2013 09:02 5032577121 n�� CAPITOL ELECTRIC PAGE 02/02
Electrical Permit Application RFCCE r(lu 01:11t1: t'.s1; oNi.l
' ecetve r
City of Tigard DatCJBy: 3A Cr Permit no.; �,Le c 1 -dD( -
13125 SW Ball Blvd.. Tigard, OR 97723 MAR 1 . . Plan Review
Phone: 503.639.4171 Fare S03.593.1960 Date/By: Other Permit;
T r c; n I: r; IrlspeCti0tt Line: 503.639.41.75 CITY OF TIGARD Date Ready/By: luri • • / a 0 Sao Page 2 rnr
I - : • . www.tigerd"or.gov BUILDING DIVISION Notified /Method: Supolemamalrnlcmmion
❑ New construction CJ Addition/alteration/replacement Please check all that apply (submit a sets or plans Whams checked below):
❑ Demolition ❑ Other. ❑ Service or feeder 400 amps or more ❑ Building over three stories
{r ... r . ' `"i- :... ,_.z_. -� r i... where the available fault arrant ❑ Marines and boatyards
❑ 1 • and 2•family dwelling 0 Commercial /industrial ❑ Accessory building exceeds 10.000 amps at 150 volts or ❑ Floating buildings
❑ Multi "fhm i ❑ Master Builder ❑ Other to ground, or exceeds 14,000 ❑ Commercal -use agricultural
. ., ..,.. ^ .0J? _ ' •`i� 1;tr Si ,.i a , -1!._ `.11Fi, , _ ..: .. _ 1 amps for all other installations. buildings
Job no.: 130449 Job site address: 10300 SW Oruenburg Rd ❑ Fire Pump ❑ Installation of 751(VA or
❑ Emergency system Larger separately derived system.
City/Statc/ZrP; Tigard OR ❑ Addition of new motor bad of ❑ "A ", "E ", "1.7', "1 -3 ",
100HP or more. ❑ occupancy
Suite/bldg. /apt. no.: 400 Project nume: KFORCE BF Relocate ❑ six or more residential units ❑ Recreational vehicle parka.
❑ Health -care fbcilitics ❑ Supply voltage for more than
Cross Street/Directions to 'ob site: ❑ Hazardous locations 600 volts nominal.
❑ Service or feeder 600 am •s or MOM
Subdivision: Lot no.: "s c . 1_. t _.
rleecripdnn Qv/. Fee. T otal "a .
Tax ms .1. arcel no.: New residential - single or Multi—family dwelling unit
.. T ;_ Includes attached garage.
Relocate 2 BF add 1 OP Outlet 1000 sq. ft. or less $ 168.54 4
Ea. Add'I 500 sq. ft or portion S 33.92 1
j� 1 e� a n) ua :.Ii( 3n '0".. — .1•7"y{ y_..l : : +" .TAkc `rte "r.a�itt 1- a-:',,j Limitcd energy residential
u Name: (with above sq. ft.) $ 75.00 2
Limited energy, multi - family
Address; residential (with above sq. R) $ 75,0(1 _ _ 2 ,
Service or feeders installation, alteration, sad /or relocation
City/State/ZIP: 200 amps or less S 100.70 2
201 amps to 400 amps $ 133.56 2
Phone; Fax 401 amps to 600 amps $ 200,34 2
' 60! amps to 1000 amps S 301.04 2
Owner installation: This installation is being made on property that 1 otwt which is not Over 1001) amps or volts S 552.26 2
intended for sale, lease, rent or exchange, according to ORS 447, 449. 670, end 701 Temporary services or feeders instnlintinn, alteration, and/or
Owner signature: Date: relocation
200 amps or less $ 59.36 I
''l 111 :r.. IW,":.... y.. ' . .l"_t:i
L.ti elL*3:;'' :dsv is I I, 201 amps to 400 amps S 125.08 2
Business Name. 401 amps to 599 amps
IS 168.541 I 2
Branch circuits - new, alteraton, or extension, per panel
Contact name; A. Fee for branch circuits with
service or feeder fee. each
Address:
branch circuit $ 7.42 2
B. Fcc for branch circuits
City/StatefZ[P:
without service or feeder fee,
first branch circuit 1 $ 56.18 66.18 2
Phone; Fax, Each additional branch circuit: 2 5 7.42 14.84 2
Miscellaneous (service or feeder not included)
E-mail: Each manufactured or modular
i . ,.r:.,: ,2.r:'::_l ;11rt,: °, =_.Wi.� ,. ,..:__r,e .•_ dwelling, service and or feeder 5 67.84 2
Business Name: CAPITOL ELECTRIC CO., INC. Reconnect only S 67,84 2
Pump or irrigation circle 3 67.84 2
Contact name: Danny Gibbs Sign or outline lighting S 67,84 2
Signal cireuit(s) or limited -
energy panel, alterations, or
Address; 11401 NE MARX ST. extension, Describe; S 75.n0 2
City/StatrJZIP: PORTLAND, OR 97220 -1041 Paget
Each additional inspection over allowable in any of the above
Phone: 503- 265.9486 Fax: 603 -267 -7121 Per inspection $ 66.25
investigation per hour (I hr min) S 66.25
CCB Lie,: 48748 Electrical Lie 26..496C Suprv, Lie.; 3132 -S ■ industrial slant . •r hour S 78,18 --"9591111141111 . Suprv, Electrician signature. required: ._>.:.t.S.1 °' 'r,.! a ` _ ~ ... ., $ .
1 �;,{� Suttint .1 , 71.02
Print Name: DarrellMCNeeel Date; 03/12/13 /_ Plan review (25% of permit fcc)
/ � _ '� State surcharge ( 12% ofpermit fax) $
$ 8.152
TOTAL PERMIT FEE 79.54
Print Name: Darrell McNeel This permit sppeatkn !VIM Ha penult i, not obtained within tea
days after it has been accepted m complete.
• Number ufinspcei per permit altowal.
r: lauilding 'Pcrmits\Et.C•PermitApp.doc I0r01 /09 -40- 1d15T(11r05 1COM/WEB