Permit CITY OF TIGARD ELECTRICAL PERMIT
I 7 g' n COMMUNITY DEVELOPMENT Permit #: ELC2013 -00170
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/18/2013
Parcel: 1 S135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 551
Project: Apex Systems 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 03/18/2013 $71.02
Specifics: Service or Feeder
1 ea 12% State Surcharge - 03/18/2013 $8.52
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $79.54
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through J412J 952- -0090. You may 6 t obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987
U 3..2 or 1.800.332.2344. �J ,a'
Issued By: Lf Permittee Signature: /d APPc_i 23 4l _
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available Inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
03/15/2013 15:34 5032577121 CAPITOL ELECTRIC PAGE 02/02
EIectrical Permit Application 3ll V �p� d) 'silt ()11:,1'1,: (;sic uNI.„.
• CCCIV.. F
City of Tigard MAR 1 0 2013 Date/By; i O / % Permit no.: , 90/ 3_ tx 170 Le
• 13125 SW Hall Blvd., Tigard. OR 97223 Plan Review Other Permit/3U i
Phone: 503.639.4171 Talc 503.598. FC'I'n
"y ®o le )) Date/13y: I , ! - 00 .o
- r I .:; ,., r: T : , Inspection Line: 303.639.4175 Date Read Ju ' '' / 0 Soo t aco 2 an
Internat. wtvW.lygard-or.gtry I$I1II.IDINGI�IVI�I ®� Notified/Method: i[6O supplememnt
>7. 5;. .T;1a5 7,_3_a.. 5 ' a - ���, f'� - _
.c '. 1:. •n �:�•. r, ._.. }Y.i - .• 1'. . �.,ko, �J"i._.- ,.:e4 o � {._� { r ?..25 ? l� !ra, z;7-:
❑ New construction El Addition/alteration/replacement Please check ell that apply (submit 2 seta of plans writerns checked below):
❑ Demolition 0 Other ❑ Service or feeder 400 amps or more ❑ taming over three stories
aG �r Mri e � 1 + i ,o `! i i -. 7n , � '.: :.a ❑ Marinas and boatyards
. �..,' � t ._. . i ,., r � +'a,� •.1.� .'4 b S ._ �;"� where the available fault current
❑ 1- and 2- family dwelling El Commercial/industrial ❑ Accessory building exceeda 10,00D amps at 150 volts or ❑ Floating buildings
❑ Multi- fltmil ❑ Master Builder ❑
__,,,._ _.,,..� . _, _ Other � lase to ground, OF exceeds 10,000 ❑ Commercial-use agricultural l.n �..f J, x y; _, • amps for at other installations. buildings
Job no.: 130450 Job site address: 10220 SW Greenberg Rd ❑ Fire Pump 0 Installation of 75 KVA or
0 f;mergency system larger separately derived system.
City / State/ZIP: Tigard OR 0 Addition of new motor load of DI "K. "E" "t -2", "14",
looHP or more. ❑ occupancy
❑ Six or more residential units ❑ Recreeilonal vehicle parka
Suite/bldg./apt. nn.; 551 Pmjvct name: Apex Bane Pestle
❑ Health -care facilities ❑ Supply voltage for more than
Cross Street/Directions tojob site: ❑ Hazardous locations 600 volts nominal.
❑ Service or feeder 600 am .8 or more
Subdivision; r ".iFE � ;21 ,kf E 74?" � �
Lot no 7 , ,.k f....a �.. - ,d ✓ _ c i 3`
Description Qty, res. Total Mal
Tax ma / arcel no.: New residential - single or multi - family dwelling unit.
--� I°` � '" ,T " Includes attached garage.
- "'.L�.:..� ;-•� Yr-?'-r ---F 5 ;�a.:.' ' �;�` ...e�n .. t.;�:.,_n.'S14
Install (,) base !bed ckts 1000 so. R or leas 3 168.54 4
i 1rr-. -:fir r�r i ;a, t , r,- �T- _u k ., _ Ea. Add? 500 sq. fl residential $ 33.92 1
.,e --_ >C tin 1� • _,7�. = #, . „7e7 -,..1. � . S�r_JL• , ].icl'a ii r-+. ,,- r Limited energy residential
Name; (with above sq. ft.) $ 75.00 2
Limited energy, multi - family
Address: residential with above Vt.) $ 75,00 2
Service or feeders Installation, alteration, and /or relocation
City / StateJZIP: 200 amps or less F 100.70 2
201 amps to 400 amens $ 133.56 2
Phone: Fox: I 401 amps to 600 amps S 200.34 2
601 amps to 1000 amps S 301.04 2
Owner installation: This Installation is being on property that t own whibh is not Over 1000 amps or volts S 552,26 2
intended for sate. lease, rent Or exchange, according to ORS 447, 449, 670, and 701 Temporary services or feeders Installation, illteratIon, and /or
Owner signature: Date: I relocation
�,,, ��„ _ 200 amps Or ices $ 59.35 I
' !: {_e,� =i� �.3., _ Z .a;,',i : 201 amps to 400 amps _ S 125 MI 2
Business Name: 401 amps to 599 amps 5 168.54 2
Branch circuits new, alteratio ., a J 51
Contact name: A. Fee for branch circuits with
service or ibeder fee, each
Address: branch circuit
13. Fee for branch circuits
City/State/ZIP: without service or feeder Fee,
first branch circuit 1 S 56.18 88.18 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
._ " ;ti::!:- ,' 'i :7;;4 t t :. :.^_l : . n` , s T dwelli service and or feeder
■ $ (7.84- 2
Business Name: CAPITOL ELECTRIC CO., INC. Reconnect only s 67 114 2
Pum • or irri anon circle 5 67.84 2
Contact name: Denny Gibbs Si • nor outline Ii: ting S 67.84 2
Signal circuits) or limited -
Address: 11401 NE MARX ST. energy panel, alterations, or
---_ extension, Describe: 5 75.00 2
City / State/ZIP: PORTLAND, OR 87220. 1041 P . e 2
Each additional inspection over allowable In any of the above
Phone: 503 255.9488 Fax: 603 - 257.7121 Per inspection 5 66.25
_ investigation per hour (I hr min) $ 66,25
CCB Lie.: 48748 !Electrical Lic.: 26-496C Nary! . Lie.: 3132 -S Industrial • lent • r hour 8 78.18
P signature,
uircd' ear :_f c r r �: ' ,:' -. c am- . _'
Su rv, Electrician si ature, req �� ' ,,„ ' .a - te r . �:
Print Name: Darrell McNees ate: 03/15/13 $ 7 .Ox
of per
Authorized signature; ` State surcharge ( 12% permit fee $ 8.52
l f1 -d / v "I TOTAL PERMIT FEE $ 79.64
Print Name: Darrell atICNool - __ Tim permit appllvntioa asplea Ifa permit la not obtained wilhtri tea
days after It has hem Recopied ns eeanptete.
• Number of inmvatioree per permit ellowtd,
mLLlteingT mil tft.C- Pem,ItArp,dec 10101/09 440.461;T(IIHI 5/COMN/WEa