Permit q MI
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2010 -00656
TIGAR:D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/19/2010
• Parcel: 1S135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 360
Project: Ameriprise Subdivision: LINCOLN CENTER /FIVE LINCOLN Lot: 0
Project Description: Electrical 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
15 crt Branch Circuits wo /Purchase 11/19/2010 $160.06
Specifics: Service or Feeder
1 ea 12% State Surcharge - 11/19/2010 $19.21
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $179.27
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 -s adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001 -0010 through OAR 952- 001 -0090. You may obtain a c 4413D es or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By L1��^ -E –' � Permittee Signature: –= —_ LJ A-- A.
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.
CaII 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.
11/18/2010 08:59 5032577121 CAPITOL ELECTRIC PAGE 02/02
M'Oli 0IFFICE USE ONLY Electrical Permit ,application J o cc ved
Da[ol8,y: rmi t no.
City of Tigard Pc ' 6
1, 13 3 ]25 SW Hail 131v8., Tigard, OR 9722 P lan Review Other Permit:
rhonc: 503.639.417I i"ax: 503.598.1 Duie /By: 'x, tO - 0.)• •
Inspection i , .i 0 ' S03 1� Date Ready /By: _ 5,, nnitc21hr
'T!- CiARU p \' A S iLO SupplCmenrtlInlbrmnti"•n
Internet: wnvw.tigm•d- Or.g0v N� V Notified /Method:
PLAN REVIEW
TYPE OF WORK I& S
• - p
� —
p * t D 1`t Please check all that apply (submit 2 seas of plena wlltcros checked below):
New litionuctinn E Addition /alteration /rc lacemc�IL
t n 1`t '' I ,
❑ Demolition Other; 1J V - V _ Li Service or feeder 400 amps or more ❑ Building over Ihree stories
CATEGORY OF CONSTRUCTION where the available fault current El Madras and boatyards
LI 1 - and 2 dwelling IJ Commercial /industrial LI Accessory budding (*coeds, 10,000 amps at 150 volts or Floatlnq buildings
El Multi -6 m jy fl Mister Builder ❑ Other Ions to ground, or exceeds 14,000 CommerCIaI• use egriCUllural
.JOB SfTE INFORMATION AND LOCATION amps for all other Installations. ❑ buildings
❑ Fire Pump n Installation of 75 KVAor
Job n0.; 101271 Job sil:e address, 10200 SW GreenbUrg Rd ❑ Emergency system larger separately drlrlvad system.
—• ❑ Addition or new motor loan of ❑ "A ", "E".' -2 ", "1.3 ",
City /State /ZIP: Tigard OR 100HP or more. LI occupanc
_ , ., Six 01 more reaidertlial units ❑ Recreational vehirle parka.
Suite /bldg. /apt. no,: 360 Project name; Ameripriea Ste 360 ❑ i -tcahh -cart f<ncilil {es ❑ Supply voltage for Dante than
Cross Street /Directions to 'ob site:
LJ ,, fln7.ndouslocllinps ❑ 600 volts nominal.
❑ Service or {ceder 600 am .a or more
FEI;. SCHEDULE
Subdivision: Lot no.; DescrtetIoe Qty. Pen 'Lama ""
Tao rn1 / arccl no,: Ncw residential - Single or mniti- family dwelling unit.
DESCRIPTION OF WORK Includes attached go rage.
Relocate oUtelts add li hts /outle Miac te nant im roverttents 1000 S..11. or less 5 160.54
Ea. Add'l 500 s.. ft or •orl:inn 0
PROPERTY OWNER FT NANT — ^ Limited energy residential 11 r M
with above g . ft. $ 75.00
Name: Limited energy, multi-family
residential (with above sq, ft. $ 75.00 2
Address: Scrviee Or feeders ir1St'A11ni1on, altcrolion, and /or relocation
200 am•s or less $ 100.70 2
City /State/ZIP; 201 am.s to 400 am.s 1=EMIEERIIMINE111
-- 401 amps In 600 amps _ 1= $ 200.34 =MOB
Phone: Fax; 601 antis in 1000 am.s 11= $ 301. MIN
Owner Installation: This installation is being made on property Nil own which is not Over 1000 amps or volts 5 552.26 2
—
intended for sale, lease, rant or exchange, according to ORS 447, 449, 670, and 701 Temporary Services or feeders Installation, alteration, and /or
Owner signature: Daie; relocation
200 601.6 or less 6 59.36 1
y.1 I APPLICANT r Li CONTACT PERSON 201 traps to 400 amps — IPMEEI _ ME
—
401 am R to 599101 s MIN 5 10,$4 - E.
Business Name: Tiranch circuits - new, alteration, or extension, per Rand
A. Fcc for branch circuits with
Contact name: service or feeder fcc, cash
branch Circuit S 7,42 III
Addreas: _ A. Foe for branch circuits
without service Or feeder fee,
City /State /ZIP: first branch circuit 1 _ S 56.1 R 56.18
Loch additional branch circuit: 14 $ 1.42 103.88
Phone: Fax: Miscellaneous service or feeder not included
E -mail: Each manufactured or modular
CONTRACTOR dwcllin , service :Inc' or feeder III x 67.84 II
Reconnectonl IM a
Business Name: CAPITOL ELECTRIC CO., INC.
Pm. or irriya�ltlon circle MI 5 67.64 1E.
- Si•n outline li:htin_ MIM S (7,84 MI
Contact name: Signal circuit:(s) or limited•
energy panel, alterations, or
Address: 11401 NE MARX ST. extension, Describe: File Alarm $ 75.00
- Pate
City /State /ZIP; PORTLAND, OR 97220.1041 Each additional Inspection over allowable, in any of the above
'—' Pcr ins .ccti0n 5 64.25 — MI
Phone: 503 -255 -9488 Fax; 503. 257.7121 lnvcsti_ation . or hour 1 hr min MI 'i 66,25 =
CCB Lic.: 4$748 `Electrical Lic.: 26.4960 JSprv, Liu.: 3132 -5 Industrial plant per hour 5 78,18
� �}� f,�r /
ELECTRICAL PERMIT BEES*
Suprv. Electrician signature, require( / ed t dl"w ° jl {ill e if Subtotal $ 160 -06
Print Namc: DARRELL MCN Datc: 11118110 Plan review (25% of . ermit fee
State surchar_c 12% of .crmit fee $ 19.21
Authorized signature: - I
f _AeId. TOTAL. PERMIT FEE $ 179.27
Print Name: DARRELL MCNEEL Tie. permit apnllcntlnn oxl+rrra us, permit b ,,r nnmmed within 1 an
flay. nncr It Awl been •cccpted an rnmpinF..
" Ntlmler of intp00d0nn per permit albwcd.