Permit Support Document CITY OF TIGARD ELECTRICAL PERMIT
I 7 COMMUNITY DEVELOPMENT .%I 9_1 1 Permit#: ELC2014-00255
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/19/2014
Parcel: 1 S135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 600
Project: Farmers 600 L630 Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Install dedicated outlet as directed. 5/21/14,reprinted permit to correct address from 10200 to 10220 SW
Gre q Rd Suite 600. -
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 05/19/2014 $63.60
Specifics: Service or Feeder
1 ea 12%State Surcharge- 05/19/2014 $7.63
Type of Use: COM Electrical
Class of Work: ADD
Type of Const:
Occupancy Grp:
Total $71.23
Required Items and Reports(Conditions)
This permit i e• t to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done ' accordance with :••roved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. TTENTION: Oregon la r-•.' - y• to follow the rules adopted by the Oregon Utility Notification - er. Those rules are set forth in OAR
952-111-0010 th •ugh OAR 952-0$ 0090. V.• ■ obtain�a/copy of the rules or direct questions to OUNC by = 2.1987 or 17800.332.2344.
Is ued By: ���' `?_-4 ' _ /L , Permittee Signa - '' CY-P
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/ 05/21/2014 13:49 5032551966 CAPITOL ELECTRIC PAGE 01
Eericl Pe CEIVEE
l uu t,l It I. I St.try l
Dale/By:eT c5"R /, 0 'crmit no.: `/4961 / .-00,;)5-s---
-Nl�S�
City of Tigard 2 1 2014 J
■ 13125 9W 1laEl Blvd„Tigard,OR 97223
pin Review
'- Phone, S03.639.4171 Pate 503.$ t Davy,
Other Permit:
r:i~� t? Inspection Line: 503.639.4175 IV(� '� F 16GAHu
Internet: www.tigard-or.gov Date Ready/By: Jude, ❑ See Poe 2 far
11 In�'►R�it �1"1,s1r ' Notiiied/Method; Supplemental lid n.cdan
❑ New construction ❑ Addition/alteration/replacement Please check all that apply(submit 2 este of plans wdtems checked below):
❑ Demolition ❑ Other: ❑ Service or feeder too amps or more ❑ Building over throe stories
where the available fault current ❑ Manners and boatyards
❑ 1-and 2-family dwelling ❑ Commercial/industrial ❑ Accessory building exceeds 10,000 amps at 150 volts or ❑ Floating buildings
O Multi-fnmil ❑ Master Builder 0 Other leas to ground,or exceeds 14,000 ❑ Commercial-use agricultural
„y' RR r J Jr _'; ~[i.., .t «J'i_._ .,.2:ci_' amps for al other Installations, buadings
Job no.' 140887 Job site address: 10220 SW Greenburg Rd ❑ Fire Pump ❑ installation of 75 KvA or
❑ Emergency system larger separately derived system.
City/State/ZIP: Tigard,OR 97223 ❑ Addition of new motor load of ❑ "A^ ^E" "1-2" "1-3"
100HP or more, 0 occupancy
❑ Six or more residential units ❑ Recreational vehicle parks.
Suite/tddR,/apt,no,; 600 Project name: Farmers ❑ Health-care facilitiC5 ❑ Supply voltage for more than
Cross Street/Directions to job she ❑ Ha.ardour locations 600 volts nominal.
❑ Service or feeder 600 am or more
e
Subdivision: Lot arc'
--______ Description Qty. gee. Tatar
_.,.ui K Tr"i •.. New residential-single or multi-family dwelling unit.
r... .. 1; � 7+_..:,_ �::.. ;,. Ji err,, :`' . r , includes attached garage.
CHANCTE ADDRESS ON PERMIT#ELC2014 00255 FROM 10200 SW GREItNDURG TO 1000 sq,ft,or less S 168.54 4
10220 SW(roof FNtit,Rt. STE G00 I Ea /idd'l 500 sq.fl or portion 8 33.92 1
T'•Ti.4,,,IdC..'.7.a Jl _,;!a,_.'. i` ._ '-,+ten ,. i..,. _, 1, _... _.. .W-.:: . ".;".w Limited energy residential
, (with above sq.R.) $ 75.00 2
Limited energy,multi-family
Address:
residential(with above sq.ft.) $ 75,00 2
Service or feeders installation,alteration,and/or relocation
City/Sole/ZIP: 200 amps or less S 100.70 2
201 amps to 400 antes S 133.56 2
Phone Fax 401 amps to 600 amps S 200.34 2
601 amps to 1000 amps 5 301.04 2
Owner installation: This installation is being made on property that I own which is not Over 1000 amps Or 9011s S 552,26 ,- 2
intended for salt.lease,rent or exchange.according to ORS 447,449,670,and 701 Temporary services or feeders instaMtIon,alteration,andlor
Owner signature: i)ate: relocation
200 amps or Icss 5 59.36 I
201 amps to 400 amps $ 125,08 2
Business Name: 401 amps to 599 arn1s S 158.54 2
Branch Circuits-new,alteration,nr extension der'and
Contact name A. Fee for branch circuits with
service or feeder fcc,each
Address branch circuit S 7,42 2
B. Fee for branch circuits
City/State/ZIP.
without service or feeder fcc,
first branch circuit S 56.18 2
Phone: Fax: Each additional branch circuit: $ 7,42 2
Miscellaneous(service or feeder not included)
Email: Each manufactured or modular
r1'71 " dwelling.service and or feeder $ 67,84 2
Business Name: CAPITOL ELECTRIC CO„INC. Reconnect only _ S 67.84 2
Pump or irrigation circle $ 67.84 2
Contact name; Sign or outline lighting S 67.84 2
Signal circuit(s)or limited-energy See
Address: 11401 NE MARX ST. panel,alterations,or extension. Page 2 2
Each additional Inspection over allowable In any of the above
City/State//ZIP: PORTLAND,OR 97220-1041 Additional inspection(I hr min) 66.25/hr
Investigation(1 hr min) 66.251b.t
Phone: 503-255.9488 Fax: 503-257-7121 Industrial plant(I hr min) 7/1,1S/hr
i Inspections for which no fee is 90.00/hr
CCB Lie.: 48748 !Ricci' %C !sup. Lie.- 132-S specifically hated 1/2 lit min
Suprv.Electrician signature,required: ilif T.' ^_ "":,_'N? v . v.".-._:,..i.,'a.."i L.nSa",r..:l7. u'; ;,J' G' ';
Subtotal.. S -
Print Name; Dar IL y, / Date: 05121/ Plan review(25%of permit fie):
Audrorirad signature: �� J�— Slate surchar 12%of nest fee ; $ -
L PERMIT FEE: $ 'Z1.a'1al
Print Name: ,. all MCN9ef
'11th permit npplkat:en erpiraa VA permit Is not ebntlnrd twroat tap
Sc,.art.it bar been accepted ne eamptete.
•Number of inxpectinns per permit allowed.
i,.Rudd;ngTOrmid!ELC-PcrmitApodoc 1/21.,I3 440.4413T111tONCY7vfWBB