Permit sus CITY OF TIGAR ELECTRICAL PERMIT
' COMMUNITY DEVELOPMENT Permit #: ELC2013 -00184
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/25/2013
ETR g Parcel: 1 S 135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 200
Project: Farmers Security 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 03/25/2013 $71.02
Specifics: Service or Feeder
1 ea 12% State Surcharge - 03/25/2013 $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 95 0 - -0090. You may a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: . 7 A/1 2 / 1d' i Permittee Signature: £2( �P4 _ e14. I OkL
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.
03/25/2013 11:13 5032577121 CAPITOL'ELECTRIC PAGE 02/02
PP • MEWED : ry I�l)K ill 1 It'i. 1 �I oNI N
Electrical Permit Application , c ece,
City of Tigard Datc/By: 3/2,5' $.i Permit no.; LC r�0/ 3 - 00 /84
1 3125 SW Ha11131vd., Tigard, OR 97223 Plan Review
- MA 2 5 2013 Date/By. other Permit:
'- Phone; 503.639.4171 Fax: 503.598.1960
1 - 1 c , • t-, Inspection Lane: 503,639.4175 Date Ready/By: Juri ;7 o Sex Pege 2 Per
Internet: wtwv.ligard -OT. g m . CITY OF TDGGP►(�i� Notifted/Mcthod: � 5upptmenml lnfbrmalien
ii 1' - r�:._"i..2. 3i t<u �.Y '1; 1' 4;1thESi lkx. 1"�� ±kri`k . o ' �'„i V I�710� ,'-k ,.. p re- .,I :. ..S m. , etd ! +?._'r I' , ,S,t nLL :i§L:I y r: a.. ti- J lW,tl;, t.; :r
❑ Ncw construction 0 Addition /alteration /replacement Please cheek all that apply (submit 2 sets of plans wftema cheesed below);
❑ Demolition ❑ Other ❑ Service or feeder 400 amps or more ❑ Building over three atones
' 7." .. ;.1;_t:. ,- "`n1, LiLLI( h . ,i'ir: I,cr,. ,I: i ' .7 4 ^ i =." where the available fault current ❑ Marinas and boatyards
❑ I- and 2-family dwelling 0 Commercial /industrial I■ Accessory building exceeds 10,000 amps at 150 volts or ❑ Floating buildings
❑ Multi Tamil ❑ Master Builder 0 Other less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
, ?w :. ,, 7 . , ;'d ∎75.+ l:,E ,77 ='.`.'i ..: ^..-_ w ' g 0,, ' -`i., amps for all other installations. buildings
0 Fire Pump ❑ Installation of 75 KVA or
Job no.: 130751 Job site address: 10200 SW Greanburg Rd 0 Emergency system larger separately derived system.
❑ Addition of new motor load of ❑ 'A', "E", "1.2", "1 -3',
City /Stato/ZiP: Tigard OR 10oHP or more, ❑ occupancy
, 0 Six or more residential units ❑ Recreational vehicle Oaths.
SUiiC/bldg. /npt. no.: Suite 200 Project name: Farmers security [] Health -care facilities ❑ Supply voltage for more than
Cross Strect/Directions to lob site: _ ❑ Hazardous locations 600 volts nominal.
❑ Service or feeder 600 amps or more
;w
Subdivision: - l Lot no.: Description • • Qtr- Pea T " ,.
Tax in ./.,:reel no.: New residential single or multi- family dwelling unit.
J , ,.�. �i- -" ' � T p •�% it t_ 11 Tt i; • .J . 1: ._."'ag 'G ' ii i' , `.W'7�:, Includes attached garage.
.. . ":. ..,..�_ 7� ,,�.��t?,.1:.1�!'�.11f1.N.l�ia� „?xurtir._,�t����?. - _
install general purpose circuits 1000 .9. ft. or less J 9 168.54 r 4
• i:n. Add1 500 sq. It or portion S 33.92 , 1
".;',,,g111 . Iiti;v' .y E S` At lafw4 ° P i .nii:i _l.$N1 mpitni. s:±. M.,4'. x, , "Limitcd energy residential
• SWith above sq. ft,) 5 75.00 2
Name: Limited energy, multi - Family
--- residential (with above ag. ft.) S 79.00 2
Address: Service or feeders installation, alteration, and/or relocation
2 00 a mps o r less s 100.70 50 2
—
Clty/State/ZiP: 201 amps to 400 tun s >' . S 133,
401 amps to 600 amps S 200,34 2
Phone: Pax: 601 amps to 1000 amps S 301.04 2
Owner Installation: 'this installation is being made on property that 1 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 S 59,36 I
a t�s l l h d ri tires +it i s r n.! l is wAS&F,Er v11;1 .:u 201 tune to 400 amps S 115.08 2
401 amps to 599 amps 5 165,54 2
Business Name; Branch circuits - new, alteration, or extension, per e anel
A, Fee for branch circuits With
Contact name: service or feeder fee, each
branch circuit _ S 742 2
Address; B, Pee for branch circuits
•
without service or feeder fcc,
City /State /ZIP: _ firm/ branch circuit 1 S _ 56.18 58.18 2
Each additional branch circuit; I 2 5 7.42 14,84 2
Phone' Fax: Miscellaneous (service or. feeder not included)
E -mail: Each manufactured or modular
; it „u ,a , • R ?" r,,, .5. _ 1, 'P ri,` +�� ; , :ti .: dwell in s ervice a nd or feeder 8 67.84 2
�. , i r�.r ,.rmlP�es ..., - -fir yw -_1._ J _ «, ._':fr_ti..r.7 _�.. Q, .
Reconnect only S 67.84 2
Business Name: CAPITOL ELECTRIC CO., INC.
Pum or Irri lion circle S 67.84 2
Contact name: eery Stelort Si •,n or outline Ii' htin. S 67.84 2
Signal circuits) or limited-
Address: 11401 NE MARX ST. energy panel, alterations. or
extension. Describe; S 75.00 2
Pogo
City/Statc/ZIP: PORTLAND, OR 97220-1041
Each additional Inspection over allowable In any of the above
Phone: 503- 266 -9488 Fax: 503- 267 -7121 Per inspection 8 66.25
investigation us hour (1 hr min) S 66,25
CCB Lie,; 48748 IElectriCal Lie.: 26 -496C I5uprv, Lic,; 3132 -5 industrial dant icr hour $ 78.18
.r` Egg ;,,' ,'.n , 1 /�iy' z , :
a 1 ,, d' rl _ l .:k ., "gy 'r %,` ;.r_f; r ' . '42.1 ..
Suprv. Electrician signature rcgvircd:,Ll� Subtotal $ 71.02
P Name: Darrell McNeal �1ate: 03125J'13� Plan review (25% of permit fcc)
State surcharge ( 12% of permit fee) $ 8.82
Authorized signature: �.. 1 G _ . �j !I ( / Alm O4� TOTAL PERMIT FEE ` $ 79.64
Print Name: Darrell McRae! This permit application sashes ire premtt Is not obtained «Irate ISO
dm. nn•• a Nu been accepted .. .empete. .
• Number Of nisei: MOM per permit allowed.
T tfu (lding\Permiestc- PnonitApp.doc 10/01/09 440.451 ST(1t/05fCOM/wF.B