Permit CITY OF TIGARD ELECTRICAL PERMIT
' COMMUNITY DEVELOPMENT Permit #: ELC2010 -00485
T 1 G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/09/2010
Parcel: 1 S 135AB04500
Jurisdiction: Tigard
Site address: 10250 SW GREENBURG RD 212
Subdivision: LINCOLN BUILDING Lot: 0
Project: NVoicePay
Project Description: (1) branch circuit.
Owner: FEES
LINCOLN CENTER LLC Quantity Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL 1 crt Branch Circuits 09/09/2010 $56.18
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 09/09/2010 $6.74
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 $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 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.
r r
Issued By Perm ittee 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' 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.
09/08/2010 13:36 5032577121 CAPITOL ELECTRIC PAGE 02/02
Electrical Permiit ,A lication 6VV roiz 0r FIC E USE ON1.\
Received V
City of Tigard Q� Date/Ely: /� o & Permit no.: 5L c ? 0 _ o
III i "I 113 [25 SW Hall Blvd., Tigard, OR 9 223 Plan Review
_ Phone: 503,639.4171 Pax 503.598- ]9G@ D
Other Permit:
Tnspectian Line: 503.639.417
r I < ; :t n w `
11,C) l01` Da le Ready /fay: tuns /-sue iJ Set Page 2 In
Internet: www.tigard-or,gov Cl' el G � 1
9 NAS Notified /Method; t/ _ Sapplrmtnudinformation
TYPE OP WORK V1 - PLAN REVTEW
❑ Ncw construction I % I A ddition/alteration/replacement Please check all that apply (submil x 0014 of plans wfitems checked below):
❑ Demolition ❑ Other: I_ Service. Cr foodor 400 amps or more
p 0 Building over throe .•,[arias
CATEGORY OF CONSTRUCTION where the available fault current ❑ Marinas and boatyards
L-i 1- and 2- family dwelling U Commercial /industrial I_I Acceswry building exceeds 10,000 amps at 150 volts or Floating buildings
U Multi - family ❑ Master Builder nattier less to ground. or exceeds 14,00o Commerclel -uae agricultural
3OA SITE INFORMATION AND LOCATION amps for all other Installations, ❑ buildings
,lob no.: 100949 1oh site nddrOSS; 10250 SW Greenburg Rd Li Fire Pump I: Installation 0170 KVA or
❑ Emergency system larger separately derived nyelere,
City/State/ZIP: Tigard Or
❑ Addition of new motor load or fJ P " E " , " -2 " -3 ".
100HP or mots. ❑ occupancy
Suite/bldg. /apt no.: 112 project name: Nvolce Ded Outlet ❑ SIx or more residential units 1=1 Recreational vehicle parks.
❑ Health -rare facilities ❑ Supply voltage for more than
Crass Street /Directions to job site: ❑ Hazardous locations
❑ 600 volts nominal.
IJ Service or fccdcr 600 amps or more
Suhdivicion: Lot no.:
FEE SCHEDULE
_ Description I Qtr. 1 pee I non] I ••
Tax mop/parcel no.: New residential - single or multifamily dwelling unit
DESCRIPTION OF WORK Includes attached gsrnge,
Install double duple[ dedicated outlet 1000 sq. ft. or Tess $ 1E8,54 - 4
Ea. Add'I 500 sq. 0 or portion S 37.92 I
U PROPERTY OWNER 1 LI TENANT Limited energy residential
Name;
(with above sq. 0.) S 75.00 2
Limited energy. multifamily
Adtlrrs residential (with above sq. ft.) 3 75.00 2
Service or feeders installntion. alteration, and/or relocation
City/State/ZIP: 200 amps or less S 100.70 2
201 amps to 400 amps _ S 133.36 2
Phone: Fax:
401 arnpS to 600 am $ 200.34 2
601 amps to 1000 amps 3 301.04 2
Owner installation: This installation is being made on pmperty that 1 own which is not Over 1000 amps or volts $ 552.20 _ 2
—
intended for sale, lease, rent or exchange, according to ORS 447, 449, 670, and 701 Temporary services or feeders installation, alteration, and/or
Owner signature; Date: rclocadon
200 amps or less L $ 59.36 I
_
LJ APPLICANT J 11 CONTACT PERSON 201 amps to 400 amps I $ 125.08 2
Business Name: 401 amps to 599 amps J 5 108,5
Branch circuits • new, alteration, or extension. per panel
Contact name: A. Fee for branch circuits with
service or feeder fee. each
Address: branch circuit 5 7.42 2
B. Fcc for hrnnch circuits
City /State/ZIP:
without service or feeder fcc,
first branch circuit 1 5 56.IR 56,18 2
1 Fax: Each additional branch circuit: S 7,42 2
Miscellaneous iservlce or feeder not included)
F..•mail: Each manufactured or nodular
CONTRACTOR dwelling, service and OT feeder S 67.86 2
Reconnect only 5 G7.Ba 2
Pusincas Nam: CAPITOL ELECTRIC CO., INC.
Pump or irrigation circle 5 07.84 2
Contact name: r� Sign or outline lighting 5 07.84 7
oµN rA. Signal circuits) or limited.
Address; 11401 NE MARX ST. energy panel, alterations. or
[tension. Describe; Firc Alamo S 75.00 2
City/State/ZiP: PORTLAND, OR 97220.1041 - Page 2
• Each additional inapecdon aver allowable in any of the above
Phonc: 503,255.9488 Fax; 503 -257 -7121 Pcr inspoetion S 66.25
Investigation per hour (I hr min) ` 3 66.25
CCB Lie.: 48748 [Electrical Lie.: 26.496C TSuprv. Lie.: 3132-S S Industrial plant per hour s 7R.IR
—
Suptv. Electrician siltnnutrc, required: � ELECTRICAL PERMIT FEES"
b '� / � Subtntnl $ 56.18
Print Name: DARRELL /ACNE Ek� T7ntc: 09/08/10 Plan review (25% ofpermit fcc)
Authorized signature: State surcharge ( 12% of hermit ice) $ 6.74
r / J,{gl41 _ a'
�P �i TOTAL PERMIT FEE S 62.92
Print Name; DAftREL 1N EL Thb permit appueollon exedra Ire permit b not eew,In ,.trhtn I R6
OVA after It hee been accepted et complete-
• Number of inspections per permit nllowcd.