Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00491
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/06/2011
Parcel: 1S 135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 710
Project: Axiom Subdivision: METZGER, TOWN OF Lot: 9
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: 503-619-3200
FAX: 503 - 257 -7121
FEES
Quantity Description Date Amount
5 crt Branch Circuits wo /Purchase 09/06/2011 $85.86
Specifics: Service or Feeder
1 ea 12% State Surcharge - 09/06/2011 $10.30
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $96.16
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 m toin . . -.y of the les or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued B Permittee Signature: • Lfi`=
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.
or ,
09/06/2011 09:37 5032577123. CAPITOL ELECTRIC PAGE 02/02
lication
FQR (iF'F�IC:E USIs C1N1,;1'
Electrical Permit ,App ‘ ` C .*' ' Rcao;ve0
@`� 9 0 ow ermit no.: _
Cl of Tigard 4 0\=:., Date /13y; J�� II '- 111 R
N. ,� P l a n Review
711 r • 131 SW 1-1111 BIVd.. Tigard, OR 9 7223.' Usher Permit: p -
_ ' '. Phonc: $03,639.4171 F ax: 5D3598:1660 �� Q �t� ` Datc/fiy: I ��
TIGARD
Inspection Line: 503,1539 -Q 75 c -4, e , Date Ready /By: I , .- nee 1Mgc 2 for
Internet VYV4IW[ig&T� 4f -or G ( ` Q ' �� ,t ��.�. Notified/Meted: Sup lomoninl Inlhrnmbon
TYPE OF WORK. JJ ` A7 .4 � PLAN REVIEW -
L New construction LL I Addition /alteration /rcplaccmC t )' Please check all that apply (submit g Sets of plane wlltems cheekrd below):
❑ Demolition IT Other; 0a ❑ S4rvieo or feeder 400 amps or more ❑ Building over three stodos --
CATEGORY OF CONSTRUCTION' where the available fault Current ❑ Marinas and boatyards
LI 1- and 2 - family dwellin LI Commercial /industrial „ Accessory building exceeds 10,000 amps at 150 volts or ❑ Floating buildings
El Multi-family L Willer Builder ❑ Other - less to ground, or exceeds 14,000 ❑ Commercial -use apriCtllural
JOB SITE INFORMATION AND LOCATION amps for all other in5L91latIona. buildings
❑ Fire Pump ❑ Installation of 75 KVA or
Job no,; 1112152 ,soh sito address: 10260 SW Greenberg Rd
Ill Emeroority system larger separately derived system,
LI Addition of new motor load of .1 "A", "E ", "1 -r, "1 -3 ",
City /State /ZIP; Tigard OR 10011P or more. L occupancy
❑ Six or more reeldentlal units ❑ Recreational vehicle parks,
Suitclbltig./ pt- no: 710 (Project name: Axiom Exp ❑ Health -cart facilities ❑ Supply voltage for more than
Cms.s Street/Directions to job nits: ❑ Hazardous locations 600 volts nominal.
❑ Service or feeder 600 amps or more
f _ FEE SCHEDULE
Subdivision: J Lot rte i euerlpttnn Qey- Pee, I Tom, I ""
Tax map /parcel no.: New residential- single or multl- famlly dwelling unit.
DESCRIPTION 0.F WORK Includes attached garage.
Tenant. improvement _ 1 sq. ft. or less $ 168.54 4
Ea. Add'I 500 sq. ft. or portion $ 33.92 1
Li PROPERTY OWNER CJ TENANT Limited energy residential
(with above sq. ft.) $ 75.00 2
Name: Limited energy, multi- family
residential (with above sq. ft.) $ 75.00 2
Addnss: Service nr feeders Installation, alteration, and /or relocation
200 amps or loss $ 100.70 2
City/State/Z1 P: 201 amps to 400 amps $ 133.56 2.
401 amps to 600 amps s 200.34 2
Phone; Fax: 601 amps 10 1000 31172 0 301.04 2
Owner installation: This installation is being made on property that] own which is not Over 1000 am.s or volts 0 552.26 2
intended for sale, lease, rent or exchange. according to ORS 447, 449, 670, and 701 Temporary services or feeders Installation, alteration, and /or
Owncr signature: Date: .- relocation
200 amEsor Icss _ $ 59.36 I
i_ I APPLICANT • CONTACT PERSON 201 amps to 400 amps $ 125.00
401 amps to 599 amps [ $ 168.54 1 2
Business Name; Branch circulta - now, alteration, or extension, per panel
A. Fcc for branch CirCul1a with
Contact name: scrvicc or feeder fee, each
branch circuit S 7.42 _ 2
•
Addreas: B. Fen for branch ci rcuits
without service or feeder fee,
City /State/ZIP: _ _ first branch circuit 1 $ 56.16 55.10 2
Each additional branch circuit: 4 5 7.42 R9,e0 2
Phone: Fax: Miscellaneous (service or feeder not included • •
E -mail Each manufactured Or modular
CONTRACTOR dwcllinucrvicc and or feeder $ 67.84 2
Business Name: CAPITOL ELECTRIC CO., INC. Reconnect only $ 67.84 2
Pump or irrigation circle - $ 67.84 2 -
Contact name: S or outline lighting 5 67.84 2
Signal circuit(s) or limited
Address: 11461 NE MARX ST. energy panel, alterations, or
extension. Describe: 5 75.00 2
City /Statc/ZTP; PORTLAND, OR 97220.1041 - Page 2
Each additional inspection over allowable in any of the above
Phone: 503 - 2553488 Fax: 503 -257 -7121 Per inspection _ $ 66.25
Investigation per hour (1 hr min) $ 66.25
CC3 Lic.: 48748 'Electrical Lic.: 26 -496C ISuprv, I „ic.: 3132 Industrial plant per hour 5 78,15 -,
Suprv. Electrician signature, required' T, 1 trTR1CAL PEWIT FEES.
red' -
Subtotal $ 85.86
Print Name: DARRELL EL • . Plan review (25/oof permit fee) _
Authorized signature, ` State aurchar_e 12% of emit fee 5 10.30
TOTAL PERMiT FEE 5 96 - 111 r
Print Name; DAR MCNFEL Tilts permll nppllcntion mart* If permit la not obtained +Rhin IRO
day* liner It tan been ncceptet. eompIme.
• Nombcr of inapcotiona per permit a1low0,
1Anouning\Permlls1NI.C- PermiIAr ,doe 10/01109 440-1615T(11 lo$ /COM /W4ta