Permit CITY OF TIGARD ELECTRICAL PERMIT
` c COMMUNITY DEVELOPMENT Permit #: ELC2010 -00425
TIGARD, 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/18/2010
Parcel: 1 S 135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 600
Subdivision: LINCOLN CENTER /FIVE LINCOLN Lot: 0
Project: Axium
Project Description: (59) branch circuits for TI
Owner: FEES
LINCOLN CENTER LLC Quantity Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL 59 crt Branch Circuits 08/18/2010 $486.54
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 08/18/2010 $58.38
Electrical
Contractor:
CAPITOL ELECTRIC CO INC
11401 NE MARX STREET
PORTLAND, OR 97220
PHONE: 503 - 255 -9488
FAX: 503 - 257 -7121
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $544.92
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 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: 0 ,qi f Ce9-7 ion
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.
08/16/2010 08:48 5032577121 CAPITOL ELECTRIC PAGE 02/02
Electrical Permit Application ' '! , ' FC ROF> IC u5I i l.\ •.;,
it Received
City of Tigard l a � r fl natc/By t cr' if /d 'C /D - 00 AS
: k q 13125 SW Hall Blvd„ Tigard, OR 972 4 " ,e t 7 '<; r, .._ 1 ESIIME
. g '+ <a Phone: 503,639.1171 Fax: 503.598.1960 A her Pernt;t� u Veyei 00 !p
171 G A P L+ sp
Inectidn Line: 503.639 AUG 1 1 2010 Date Ready /By: L W. Page 2 mr
Iritcrt)ct; wwW.tigerd- or -gov }a • Notified /Method: si,Ppkmmntal 'Altma In',
TYPI - •.OF WOKI< t~ -j E
r� ),q n nar;nlOSr,t P6ANRI;+VIGW
=New cvn :Fruclio 1 Add it in dal tannin n /rcplaccrtteh lL.IJI"`- ' o °J. v Please check all that apply (submit 2 5etts of plans wiilem.5 checked belowj: T
❑ t)cmnlirion [-] Other: ❑ Service ar feeder 400 amps or more Ll Building over three stones
CATEGORY OF CONSTRUCTION where the available fault current ❑ Marinas and boatyards
1....1 1- and 2- family dwclling j4L1 Commercial /industrial L Accessor buihlit, exceeds 10.000 amps at 150 volts or Floating buildings
❑ Multi- family _ l] Master Builder ❑ Other less to ground, or exceeds 14,000 Commercial-uoo agricultural
108 SITE INFORMATION AND LOCATION amps for all other Installations. ❑ buildings
,soh no,: 100944 I Job site address: 10200 SW Greenburg Rd ❑Fir Pump I_. Installation of 75 KVA or
❑ Emergency system larger separately derived system.
City/State/21P; Tigard Oregon fl Addition of new motor load of El "A", "E", "1.2 ", "1.3 ",
E 100HP or more, ❑ occupancy
5uitc /hid}. /apt:. nn.: 600 Project mime: AXium 11 ❑ Six or morn residential units ❑ Recreational vahlcle parks.
❑ f le.',Ith.Care CicitMtics 1,..f Supply voltage for more than
C:mss Strccr /L)irection;: h, jnh site; ❑ hfa.ardnus locations 0 600 volts noniinai.
- - ._ ❑ Service nr fccdcr 600 amps or more
FEE SCHEDULE
Subdivision: 1 Lot no.: DcscrIption 1 Qty. I tree J Total I "
Tax map /parcel no.: New residential - single or multi - faintly dwelling unit.
DESCRfPTION OF WORK lnikdeS atMC11Cd garage.
Remodel Entire 6th floor, add outlets and light fixtures. 1000 aq ft. or Ices $ 168.54 4
Ea. Add'l 500 sq. ft or portion $ 33.92 1
IJ PROPERTY OWNER 1 LI TENANT Limited energy residential
Name;
(with above sq. ft.) 5 75.00 2
Limited energy, multi- family
residential (with above aq. ft) $ 75.00 2
AJtlresb, Service or feeders installation, alteration, and/or relocation
City/Stale/ZIP:
200 amps or less 5 100.70 2
201 amp to 400 amps $ 1 13.56 2
401 amps to 600 amps 5 200.34 2
Phone: Fax: 601 amps to 1000 amps 5 301.04 2
Owner iMttt0lltttiun: This installation is being made on property thal I own which is 001 Over 1000 amps or volts $ 552.26 2
intended for salc. Isaac, rent or exchange, according to ORS 447, 449, 670, and 701 Temporary services or feeders Installation, alteration, ned /or
Owner signature: _ Date: relocation
200 amps or Icss 5 59.36 1
LI APPLICANT 1 1 CONTACT PERSON 201 amps to 400 amps S 1 25.08 2
401 amps to 599 amps 5 168.54 2
Business Name: -
Branch circuits - new, alteration, or extension, per panel
A. Fee for branch circuits with
Contact name: service or feeder fee, each
branch circuit $ 7,42 2
Address!
D. Fee for branch cirtuil6
City/Stoic/ZIP:
without service or feeder fee.
first branch circuit 1 5 56.18 56.18 _ 2
Each additional branch circuit: 58 4 7.42 2
Phone; fax: Miscellaneous (service or feeder not include
Email; Each manufactured or modular
CONTRACTOR dwelling, service and or feeder 0 67.81 2 _
tlu ;ine55 Name: CAPITOL ELECTRIC CO., INC, Reconnect only E 67.84 2
Pump or irrigation circle 5 67.84 2
Contact name; Sign or outline lighting $ 67.84 2 -
Signal circuit(s) or !United-
_
energy panel. alterations, or
Address 11401 NE MARX ST. extension. Describe! Fire Alarm $ 75,00 2
City /Slate /ZIP: PORTLAND, OR 97220 -1041 ►'age 2
Each additional Inspection over allowable in any of the shove
Phone: 503- 255 -9488 Fax: 503- 257.7121 Pcrins $ 66.25
/ / Invcstikation per hoursl hr min) 5 66.25
71 a CCIi I 48748 IRlecsisal 1ic,; 26.496(' ISuprv, Lie.; 3112 -S / Industrial plant per hour $ 78.19
l/ ' ELECTRICAL PERMIT FEES'
Suprv. Electrician signature, requ' Cd; S ubtotal
.. _,./...., /t ,. J - / Subtotal 485.54
Prins: Name: DARRELL .. - El. Date: 08/16/10 Plan review (25% of permit fee)
Authorized signature State surcharge ( 12n! of permit fee) $ 58.38
,/ / //_ s ww l AA� - TOTAL. PERMIT FRE $ 544.92 /.
?rift( Nam; DARRELL MCNEEL This permitapplleaurmrwpIrew Ira porullrh .ot alga Ined Q `__
am alter It has bean aecaptml ar mitigate.,
" Number or inspections per permit allowed.
it.t171.--