Permit * t`r CITY OF - �I�7AF�® ELECTRICAL PERMIT
x %fin V
COMMUNITY DEVELOPMENT Permit #: ELC2010 -00310
GARD, 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 06/24/2010
TI
Parcel: 1 S135A601006
Jurisdiction: Tigard
Site address: 10500 SW GREENBURG RD 100
Subdivision: LINCOLN PLAZA Lot: 0
Project: Beal Bank
Project Description:
Owner: FEES
LINCOLN CENTER LLC Quantity Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL 1 ea Services or Feeders - 200 06/23/2010 $100.70
amps or less
PHONE: 13 crt Branch Circuits w /Purchase 06/23/2010 $96.46
Service or Feeder
1 ea Signal circuit or Limited 06/23/2010 $67.84
Contractor: Energy Panel
CAPITOL ELECTRIC CO INC 1 ea 12% State Surcharge - 06/23/2010 $31.80
11401 NE MARX STREET Electrical
PORTLAND, OR 97220
PHONE: 503 - 255 -9488
FAX: 503- 257 -7121
Type of Use:
Class of Work: Type of Const:
Occupancy Grp:
Total $296.80
Required Items and Reports (Conditions)
This permit is iss - • •ect 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 a• •rdance wit 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. ATT TION: Oregon la : • es you to follow the rules adopted by the Oregon Utility Notific- enter. Those rules , are set forth in OAR
952 - 001 -00 0 through OAR 952 -0' -0100. Y. • ay obtain a copy of the rules or direct questions to OUNC by c- • • 13.246.6699 or 1.800.332.2344.
Issued . :y: / f C / �iv�J (--t PermitteeSi• ature: ! - "
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 an inspection that business day.
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.
06/23/2010 09:19 5032577121 CAPITOL ELECTRIC PAGE 02
Electrical Permit A p liCtd)1411 E C .. V �R�z� >ri �� H�acl'ritir'�1�1��" fttt� 7
c 1" 84*) R eserved �" - c,„., kl 'J!t+'""„e'C'at`1a �„ ? f .
',, ,lyiY+ City of Tigard / Permit no,:
x � ° 13125 SW Hail Blvd„ Tigard, OR 97223 JUN 2 3 2010 °a " '' - ; Ce �a -a�3�0
t°' r I' � q l^ Phone' 503.b394i71 Fax 503,598 PlonReviow - ___
"w 630.417S _ Date/6 Other Permit; / p
,,,- 1 `,.§ 1. >3 Tnspcetion Line; 5(13, I. e f0- p0 /A,
3r31.Or.gov CITY OF 4-7��� Date Rudy /By; Jurig;
BUILDING DIVISION Scnf In r
' rktati Internet: wWW.tig
DIVISION Natifod /McthOd;
8uppicmonln l Iniorm.unn
TYPE QF WORK
Ncw construction 12 Addition/alteration /replacement pt -AN RSVTEp/
Please check all that opply (submit 2 sots of plans wAlnma checked below);
Li Ucmolitionh
CATEGORY OF CONSTRUCTION r: Service or feeder 400 amps or more I_l Building over three stories
, �� where Cho available fault Current
I - and 2- family dwelling L•J Commercial /Industrial ❑Marinas and boatyards
cceasory building exceeds 10,000 amps at 150 volts or Floating buildings
- Mutt;- famil L] Master Builder ❑Otlicr
JDO SITE INFORMATION AND LOCATION - lass to ground, or a 14,000 Gornmercial -use agricultural
amps For all other Instnst allFlaa tions. ❑ buildings
Job no.: 100929 Job site address: 10500 SW Greenburg Rd ❑ Fire Pump
Cl Int'•tarlatlon 0175 KVA or
❑ Emergency aystom larger separately dorived system.
City / &tatcl7.IP; Tigard OR ❑ Addition of new motor load of
��i
— 100HP ormore. El occupancy
❑ Six or more residential unite r—�
LJ Recreational vehicle parks.
Suite /1•idg. /apt, no.: 100 Project name: Beal Dank
Cross Strout/Directions rn j o` site; ❑ Health -care flcilitics L Supply voltage for more than
�—�_ ❑ Hazardous locations I=I 600 volts nominal.
❑ Service or feeder 600 amps or more _
Subdivision: Lol no.: FEE SCHEDULE
fax map /parcel no.: Dmipnnn Qt T «. 1 Tow j_
New residential - single or mufti - family dwelling unit.
DESCRIPTION OF WORK Includes attached garage.
Relocate panel. New outlets/ lights
1000 sq. R, or Ices — g 188,54
L I PROPERTY OWNER Fa. Adel 500 sq, () or onion 4 —
TENANT energy residential
Limited ene g 77.72 I
Name: l
with above s . ft, C 57.84
_ Limited energy, multi - family -
A,ddreset
residential (with about sq. R. J - 5 G7.A 2
Service or feeders installation alteration, and /or relocation
City /State /,ZIP 200 am•s Or less
ma 5 100.70 100.70 2
201am•sro400am•s IMEM 2
Pitons! Fax; 401 amps 10 600 am •a
5 200.34 2
NM
Owner hcstnlladnn; This installation is being made on property that 1 own which is not 601 am s to 1000 am•s
Over 1000 am•s or volts 5 301 NM 2
intended for sale, lease, rent or exchange, necortiing to ORS 447, 449, 670, and 701 5 S 2 G 2
Owner signature; Temporary services or feeders installation, alteration, and/or
Date: relocation
ii APPLJCANT 200 amps or Iess 5 59,56
CONTACT PERSON 201 am to 400 am • s l
Business Name: 401 an�rs to 599 amps F 125,08 2
5 160,14 2
B clrbertlts - ncw, alteration, or extension, per e an
Colrtact name; A. h et ibr bmneh c irc u i t s wit ol
service or fccdcr fcc, each
Address; ____._..branch circuit
13 S 7.42 96.46 2
City /SIate /ZIP, B. Fee for branch circuity
without. service or feeder fee,
first branch circuit R .5618 2
Phone: Fax: Each additional branch circuit:_ 5 7.42 E- mail;
Miscellaneous (service or feeder net Included) ------'-------- 2
Each manufactured or modular
CONTRACTOR dwelling, service and or fonder
Business Name: CAPITOL ELECTRIC CO., INC. $ 57.84 2
Reconnect only 5 57.&4
Pumeor irrigation circle 2
Cornett name; Sign or putlinc li�.htin 3 67s4 2
S 67.84 2
Signal circuit(s) or limited -
Address: 11401 NE MARX ST. energy panel, alterations, or
extension, Describe: Fire Alarm 1 $ 67.84 $ 67.84 2
City /Stalcl7_TP: PORTLAND, OR 97220 -1041
Each addition ins ection over allowable In any of of thc above
Phone: 503. 2554488 Fax: 5 03- 257 -7121 Per i n spection _
5 66,25
CCB Lie.: 48748 Electrical 1.—=2-i:76-1-19,c Suprv. Lic,: 3132 -S
Investigation pia t p r ho
5 _i
hr min) 66,25
Tndu$trialplantperhour 5 7 8 I
Suprv. Electrician signature. requ CT,.HCTTCtCAL PERMIT FEES"
Print Nam. DARK ''� Subtotal
L Date; 06123110 Ter Plan review 2.5% of Clnrit fee $ 285 -00
12
State su
Authorized signature; rcher % of er
pmit e
fe)
Al • �.. ■ A ' TOT PERMIT FEE $ 31.80
Print Name: DARRELL MC _ , $ 28G.60
Tin, 'wont application expire, It n inn-mob not ohtionnl within 180
day, nner k ha, horn ncceptn4 a, complete.
" Number of inspection. eel. permh Allowed,