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Permit CITY OF TIGARD ELECTRICAL PERMIT ''I 2 COMMUNITY DEVELOPMENT Permit #: ELC2013 -00295 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/29/2013 Parcel: 1 S135AB00900 Jurisdiction: Tigard Site address: 10200 SW GREENBURG RD 110 Project: Fidelity National Title Subdivision: METZGER, TOWN OF Lot: 9 Project Description: (1) branch circuit. 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 1 crt Branch Circuits wo /Purchase 05/29/2013 $56.18 Specifics: Service or Feeder 1 ea 12% State Surcharge - 05/29/2013 $6.74 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 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 -0 . Yo may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. / Issued By: Permittee Signature: i�N /97 r" 9— / 7c7 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. 05/24/2013 13:57 5032577121 CAPITOL ELECTRIC PAGE 02/02 1 (110 ltl 1 I(1 l �I (1\11 Eleetr cal Permit Application . • •'� d0o2 q...5. q...5. ,2.y i3 .r �ermitno.:Ee��oi3 � /r� Date�/ey City of Tigard ��— —� Plan Review Other Permit: 13125 SW Hall Bled., Tigard, OR 97223 Date/By 303.639.4171 Pax: 503.59 2 8 2013 Date Ready /By: ]uris: // 6.......... r❑ pew2r "` t 1 n t ins 503.639.4171 Line: 503,639.4175 M l n lnt �, mRnmmim+ eeet: www.tigard- Of401, Notlficd/Methnd: - • - - . . F TIGARD - __ ... + A ddition /alxrMi n rep ement Please Check at that apply (submit S seta of plane wlnems checked below): ] Demolitios ❑ ] New con ❑ Service or feeder 400 amps or more ❑ Building over three atones n ❑ where the available fault Wrrent ❑ Marinas and boatya s building exceeds 10.000 amps at 150 volts Or ❑ Floating buildings 3 I- and 2-family dwelling (3 Mast Master Builder 0 Accessory g less to ground, or exceeds 14,000 ❑ Commercial -use agricultural 3 7-77 famil ❑ --:',..77. Magtcr Builder ©0 Other amps fo at other Instatlatlona. buildings �,' _ _ R - ---.;17-:-.-.-;,: _ J..:!. ^, 7:77.---"-"" ❑ Fire Pump ❑ Installation of 75 KVA or lob no 131009 ]oh site address: 10200 SW Greenberg Rd ❑ Emergency system forger separately derived system. ❑ Addison of new motor load of ❑ "A` "E" "i -2" "1 -a City /Statc/Z1P: Tigard OR /=-/4+ 6/7 / /1//07/0 77r4x 1001 or more. ❑ occupancy O Six or more residential units ❑ Recxeelienal vehicle parks. SuirC/hldg. /01pt no.: 110 ProjCCt name: Add GP Outlet ❑ Health -care Facilities ❑ Supply voltage for more than ❑ Hazardous locations 600 volts nominal, Cross Street/Directions to job site: _ ❑ Service Hazardous l feeder ati 600 amps or more Subdivision: Lot no.: Description Q Fee. Tore ME . N ew res - a or multi-family dwelling unit Tax ma reel no.: Includes attached garage. 1000 sq. ft. or less S 168.54 4 _stall eneral u ose outlet Ea, Addl 500 ;.ftft or • • rtion S 33.92 i Limited energy residential (with above sq. ft.) S 75,0 Name: Limited energy, multi- family residential with above •. ft. S 75.00 II Address: Service or feeders installation, alteration, and /or relocation 20D amps Or lcsa S 100.70 2 City/Stare/ZIP: - 201 amps to 400�s S 133.56 2 401 amps to 600 amps S 200.34 2 Phone: Fax: 601 am.. to 1000 am. _ S 301,04 IIBI _ $ 552.26 2 Owner installation: This installation is being made on property Mat I own which is not Ov 10 amps or volts irufallatien, alteration, sod/or intended for sale, lease. rent or exchange, Recording to ORS 447, 449, 670, and 701 Temporary Owner signature: Date: -- S 59.36 200 amps or less $ 125.05 II 201 em •s to4D0etn• mailimemoimismismows 401 amps to 599 amps S 165.54 Business Name: - Branch circuit+ - new, alteration, or extension, per net A, Fcc for branch circuits with Contact name: service or feeder foe, each branch drain S 742 2 Address: B. Fee for branch circuits without service or feeder foe. City/State/7.1P: first branch circuit 1 S 56,15 55 -18 2 _ — Each additional branch circuit: 5 7.4E - 2 Phont: Fax; Misrallancotla (service or feeder not included — Each manufactured Or modular (mail; dwelling. service and or feeder - 5 67.54 111 - Reconnect cell — 5 67.84 Business Name: CAPITOL ELECTRIC CO -, INC. Pump or irrigation circle 5 67.64 Si rat or outline lighting S 67.84 Contact name: Gary Stolen Signal circuit( or limited- _ energy panel, alterations, or Address: 11401 NE MARX ST. extension. Describe: S 75,00 Pa e2 City/Stalo/ZIP: PORTLAND, OR 97220 -1041 Each additional hove/Ion over allowable In any of the above •crins. lien S 66.25 OM hone: 503- 265 -9498 Fax: 1 - .257-7121 S 66.25 Me [nvesti 'an per hour (I hr min) M. e Electri ic.: 26 -4960 : hour M _ S 78.03 . CCB Lie: 48748 / Industrial •lent Apr 1 : P� '._c� : "• . .. , - .: Suprv. Electrician signature, require.. ,,,_ Subtotal 8 50,18 a , - y Plan review 25% of . -rmit fee $ Print Name: Darrell Me r. State surcha _ ( 12% of • it fee S Authorized signature: , A TOTAL PERMIT FEE $ 62.92 'rats permit ep1iUceden MOM, Ws Minh Is net obtained within lab Print Name. Darrell Mc der atterh hnsbMn •eeepsed n eoaptell. s Number of inspection per permit allowed. e40 t rr(I I fmSCOM,WEB t: Ulwldi "a�Permiu \P..T.C- pmnitAm•�ano t0,017aC 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 10200 SW GREENBURG RD 110, TIGARD, OR, 97223 Commercial - Electrical 199 Electrical final 06/03/2013 00:00 ELC2013-00295 PASS - No C of O Violation Summary: Inspector Contractor