Permit 111111 p CITY OF TIGARD ELECTRICAL PERMIT
° ' = COMMUNITY DEVELOPMENT Permit#: ELC201300632
T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718 2439 Date Issued: 10/22/2013
Parcel: 1 S 135AB01003
Jurisdiction: TIGARD
Site address: 10300 SW GREENBURG RD 410
Project: Buckendorf Subdivision: METZGER,TOWN OF Lot: 9
Project Description: (2)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
FAX: 503-257-7121
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo/Purchase 10/22/2013 $63 60
Specifics: Service or Feeder
1 ea 12%State Surcharge- 10/22/2013 $7.63
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 ATTENTI• . ■ .• law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 rough OAR 95 r01-0r•!. You may obtain a copy of the rules or direct questions to OUNC by calling 593-23111987 or 1 800 332 44 •
Issued By: �✓ � _ 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' 111.1.11LN. 0_ '0—k _ ( • 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.
10/22/2013 13:25 5032577121 CAPITOL ELECTRIC PAGE 02/02
Electrical Perxnit €EIV ' I'UR(11'l•i''tt:( Sl:.(> P V
ecelve.
City of Tigard Date/By //7/ /3,0.44 Permit no / l3-ev&3' --
■ 13 125 SW Hail Blvd.,Tigard OR 9
A)n Date/By Review
' ' Phone; 543,639.4171 Pam 50 i -(r 2013 DatGBy Other Perm it
•l 1,.,;,\R f, Inspection Line, 503.639.4175 Date Ready/By:
June ❑ See Page 2lbr ltccmet www.tigard-argov
CITY OF TIGARD Notified/Method: Si,plcmcntnl rnrormntlon
M
't'yg ,,�tl�41ika lei` T1i,/lr,Y 4 ui\tk:ri (..- ti.i'M f•I....T�i:4,7c1-1`.:-. 174't,P'r '�u, I5, -f a *ar 4 v 5 ,r ti i
�❑ New construction . �� �aYai`F�:�...>:�:-�. � trlV..�):�-1A:UC�.)�1�YC'"'rJ :ti* ''!�_1'��"5
❑ Addition/alteration/replacement Please check all that apply(submit 2 oats of plane w/itema chocked below).
❑ Demolition ❑ Other:,p i1' her: _ 1Nf L � ,_ ❑ Service or feeder 400 amps or more ❑ Building over three stories .
- � rLa s i e3r ,,;.1i r':21-/;;J,to where the available fault current ❑ Marinas and boatyards
❑ I-and 2-family dwelling 0 Commercial/Industrial ❑ Accessory building exceeds 10,000 amps at 150 volta or
❑ Multi-famfl ❑ Master Builder ❑ ❑ Floating buildings
Other teas to ground,or oxceeds 14,000
1 * ti rL"r 'R "' iiii•a •' .11.47`s gi'a.t +` liked I amps for all other Inataaabone ❑ Commerclal.uee agricultural
io 9'ti �4i'>! ��r: rr"'na w t, y,
buildings
Job no,: 131637 Job site address' 10300 SW Greenburg Rd ❑ Fire Pump ❑ installation of 75 KVA or
—
❑ Emergency system larger separately derived systom
City/State/zrF. Tigard OR ❑ Addition of new motor toad of ❑ A^,"E^,"1.2","1-3",
�
_ 100Hp or more, ❑ occupancy
Suite/bldg./apt/bldg./apt nn„ 410 Project name BuCkendorf ❑ Six or more reaicoMlal units ❑ Recreational vehicle parka.
❑ Health-care facilities ❑ Supply voltage for more than
Cross Street/Directions to job site,
❑ Hazardous locations 600 volts nominal.
�
' ❑ Service or feeder 600 am or more
Subdivision; Lot no,, n• ,a!c T a, i 'i 34S^'"C:7! I r 1T
neaerJ hnn Qty. Foci Total
••Tax ma / arcel no;
y ,st/.* r�, }w� pl y1 a l4tia-' , Yf r X04 0 'Y. New residential.einrle or multl.famfly dwelling unit.
Tenant improvement tGGS ` " li Inc tades attached enrage
1000 sq ft or less 5 1613,54 4
r F1,Add S00 silt or portion S 3
73cu2!rlisr'�a- dl 1 3.92 1
�>,Jl.,.e1.:'I, tll;�,�!�'' T i Limited energy residential
Name' (with above sa 11) $ 75 00 2
Limited energy,multi-fhmily
Address, residential(with above sq.R) ,5 75,00 2
Service or feeders installation,alteration,and/or rciecation i
Clty/Stotc/7.IP 200 amps or less $ 100 70 2
—
201 amps to 400 amps $ 133,56 2
Phone, Fax' 401 amps to 600 amps 5 200,34 2
Owner installation: rhisis installation is being made on property that I own which is not 601 amps to 1000 amps _ S 301 04 2
p '� Over 1000 amps or volts $ 557,26 2
intended for sole,lease,rent or exchange,according to ORS 447,449,670,and 701
Owner signature; Temporary services or feedCra installation,alteration,and/or
relocation— Date; reloca
"• 200 amps Or les 5 59,16 1,‘.:r n 9u.l ya + :1 M I a i !: ,:
a ltx ai w+a 201 amps to 400 amps
5 123 08 2
Il3tis' csc Namc 401 amps to 599 amps S 168 54 2
Branch circuits•new,alteration,or extension,per'pnel
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/State/ZIP'
without service or feeder fee,
first branch circuit 1 5 56 18 56.18 2
Phone Fax: Each additional branch circuit- 1 $ 7,42 7.42 7
Miscellaneous(service or feeder not includt
E-mail _ Each manu
m�.;,�r,�„ f;lCttrred or modular
. 0Xiki,'�, ; ;d.ti wi a'" ';21,11.- ,1v 11V.A-k`-i°i='4-0��, + iaur' dwelling,service and or feeder
$ 67,84 2
Business Name, CAPITOL ELECTRIC CO,,INC, Reconnect only 5 67.84 2
Pu^rip or lrrlgalion circle $ G7 84 2
Contact name Sign nr Outlrnc light — $-67 84 2
Signal circuit(s)or limited-energy See
Address, 11401 NE MARX ST. ate!.alto-Boons,or extension, — Page 2 2
Each additional inspection over allowable In any of the above
-Crry/Slnlcl7_iP, PORTLAND.OR 97220-1041 Additional inspection(1 hr min) 6625/hr ill
Invest; lion 1 hr mm 6625/hr
Phone' 503.255.9488 Fax: 503-257-7121 Industrial plant(1 hr lntni, 78,18/hr
t;CB I,tc 48748 Elects' lc., 20-496C Suprv,Lic- 3132-S anecifka l fisted 1/2 n hr fee is 90.nn1hr
/ a eCllicall Hstcd 112 hr mm
Suprv.Electrician signature,rcgnlred.A1
%� l �..�?.;i?:La�--rti r•�?�'a�'. -.a'. r
%.!.!_ / . rTl r,ter,.,+
Print Nitrite: •- d McNeal Date' 11,,13 Subtotal 63,60
Plan review(25%of perm it fee):
Authorized signature: State surcharge 12%of'en-nit fee 7,63
Print Nome, Darrell Mc -: "� .0 TOTAL PERMIT FEE: $ 71.23
TWA permit application nepire,Ira permit I.nal obtainn4 within tan
day,liner II bon been*raven nr complete.
•Number Of inspecnona per permit ollowcd
inite,na\PnImita\ELC•Pcrm,lhpp doe 10/01/05
440.4515TO trnstCOM/wr n
i '' 04--a C 4) c� Pt x . "CO
co -
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10300 SW GREENBURG RD 410, TIGARD, OR,
97223
Commercial - Electrical
199 Electrical final
2013-11-19 (null)
ELC2013-00632
FAIL
Corrections for the box in the ceiling not made
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10300 SW GREENBURG RD 410, TIGARD, OR,
97223
Commercial - Electrical
199 Electrical final
2013-11-25 (null)
ELC2013-00632
PASS - No C of O
Violation Summary:
Inspector Contractor