Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00123
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/04/2011
Parcel: 1S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 800
Project: Mortgage Express Subdivision: LINCOLN TOWER 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
4 crt Branch Circuits wo /Purchase 03/04/2011 $78.44
Specifics: Service or Feeder
1 ea 12% State Surcharge - 03/04/2011 $9.41
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $87.85
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 -0090. You _ in a copy o - ules or ect questions to OUNC by calling 50 .1987 or 1.800. 2.2344.
Issued B �,�� .sr/ Permittee 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 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.
03/04/2011 09:12 5032577121 CAPITOL ELECTRIC PAGE 02/02
Electrical Permit Application FOR 01 US ONLY
Received
1111 City of Tigard Date/By: , MAPermil.ncm. 30 /1 —UU
r 13125 SW 1 Btvd,, Tigard, Olt 97223 /
' .- Phone: 501639.4171 Fax: 503.598 -1960 1L
T I O A R F) InSpectibn Line: 50d.634.n 1 ?5 Date Rcady /By: so t'ate 2 4,r
Internet: www.tigarcf -cir -goy
Notified /Method: soork,, Innm„a 1 „ n
Ty PE OP WORK PLAN REVIEW
_ I New construction .i I Addition /aliernI ion /replacement Please check All !list apply (submit 2 sets of plans w /!tame checked below):
❑ Demolition LI Other: ❑ Service or feeder400 amps or mare 7 Buildin over Ihrrr stories
CATEGORY OF CONSTRUCTION where the available fault current r _ ] Mann5s and bo lyerdn
L I - and 2- family dwelling LJ Commercial /industrial LI Accessory building exceeds 10,000 amps at ISO voile or Floating buildings
❑ Multi - famil LI Master Builder ❑ Other less to ground, or exceeds 14.000 Commerclsl.use ngrieuili rat
200 SITE INFORMATION AND LOCATION amps for all other Installations. 111 buildings
.lob nu.; 110366 I Job site address: 10260 SW Greenberg Rd El Fire Pump n Installation or 75 KVA or
❑ Emergency system larger separately drrivod yth:r,
City /State /71P Tigard Oregon CI Addition of new motor load of n "A ", "E ", "1 -2 ", "1-3",
-_- 100HP or mere. H occupancy
Suildbltll;, /apt, n0.: 800 'Project name: Mortgage Express LI Six or more residential units n Recrealionel vehicle parka.
LI facilities ❑ suppl voltage for nom than
Cross Street /Directions In.joh site: .., a Hazardous locations n 600 volts nominal,
H Service or fccdcr 000 snips or more
Subdivision; Lot no,: -
PEESCHEDULE
_ Dcscrtptann I Qtv• I Tree. I Tutu I "
Tax map /parcel no,: New residential - single or multi - family dwelling unit.
DESCRIPTION OF WORK includes attached enrage.
Tenant lmprovemanel 1000 sq. ft. or leas $ 100,54 4
En. Add'I 500 sq. it orfortion $ 33,92 I
1„_.1 PROPERTY OWNER I I] TENANT Limited energy residential
Name: (with above sq, 11,) $ 75 Of) 2
Limited energy, multi- family
Address: residential (with above sq, I'1.) $ 75.00 2
- Service or feeders iastaiterinn, alteration, nndler relocation
C'i /Slal:c /ZIP 200 amps nr less $ 1on.7n 2
201 amps to 400 amps $ 12356 2
Phone: Fax:
401 amps lo 600 amps 1) 200.34 2
601 anips 10 1000 amps $ 301,04 2
Owner Installation: Thin installation 1$ being made on property that I own which is not _ Over 1000 amps or volts 9 552.20 2
intended for sale, lease, rent: or exchange, according to O.RS 447, 449, 670, and 701 Temporary services or feeders Installation, alteration, and /or
Owner signatu Date: relocation
-LI APPLICANT u 200 amps or less $ 59.16 !
CONTACT PERSON 201 amps to 400 amps h 121.05 2
Business Name: 401 amps to 599 snips $ 1 2
Branch circuits - new. alteration, or cxtcnslon, ,per Eanel
Contact name:
A, Fee for branch Circuits with
service or feeder the, each
Address: branch circuit_ S 1.42 2
B. Fee for branch circuits
City/State/ZIP: without service or feeder fee,
that branch circuit 1 9 50,18 06.18 2
Phone: Pas:
Each additional branch circuit: 3 $ 782 22.26 2
Mlscellanceus (s ervice or feeder nor. included)
E -nail: Finch manufactured or modular
CONTRACTOR dwelling, service and or feeder . $ 67,94 2
Business Name: CAPITOL ELECTRIC CO., INC. Reconnect onl , _ 9 5.7,64 2
- `- t Pump or irrigation circle 9 07,04 2 /
Contact name: `� -..\4�� Act 1 Sign or outline lighting 9 67,84 I 2
f `' t,l s Signal circuit(s) or limited -
Address: 11401 NE MARX ST. energy panel, alterations, or
exisnsien, Describe: Fire Alarm $ 71,00 2
City/State/ZIP: PORTLAND, OR 9 72 20 -1 041 Page 2
Each additional Inspection over atlowslble In any of the above
p
Pcr inspection $ 66.25 '
Phone: 503.25$ -9488 Fax: 503
Investigation per hour (1 hr min) $ 00.23
CCI3 Lie.; 48748 JElecITical Lie.: 26 -496C Suprv, Lie,: 5132.5 Industrial plant per hour 9 78,13
Suprv, Electrician signature, required: ELECTRICAL. PI3RM1T F
(� -.� Subtotal $ 78.44
Print Name; DARR MCN L Date; 03104/11 Plan review (25% anemia': fee)
State surc { 12% of permit fee) $ 9.41
Author'ved signature; TOTAL PERMIT FEE $ 87.85
Print. Name: DA LL MCNEEL T61t permit nppllenllon expires it n permit IA 11111 &Male,”' wi, h6, IRO
dOra nrh.r Ir Imp been accepted n, complete,
• Number of in5pevtiuns per permit allowed.