Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00502
Date Issued: 09/13/2011
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503.718 2439 Parcel: 1S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 485
Project: Thorson Pacific Subdivision: ASHBROOK FARM Lot: PTS 1, 2
Project Description: (1) branch circuit for general purpose outlet
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
1 crt Branch Circuits wo /Purchase 09/13/2011 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 09/13/2011 $6.74
Type of Use: COM Electrical
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 92 -011 -0090 You may obtain a copy of the rules or direct questions to OUNC by calling 503 232 1987 or 1 800 332 2344
Issued By ! Permittee Signature: /7/(f 497 L
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.
09/13/2011 09:58 5032577121 CAPITOL ELECTRIC PAGE 02/02
Electrical Permit Application •F(R OFFICE USE ONLY
g Received
City �ITigard B EC E I t! ` i)ate /By: Z f II "serail nn + 050 c J
II 13125 SW Hall Blvd„ Ti ard OR 97 6 Plan Review IX Phone: 503,639.41;71 Fttx: 503 - 598.1960 Dat&By: Other Permit, ��_ , 00/ / -
ins ectibn Line• 503 5390175 igwa
Tic SEP 1 2011 DatcRead /6
I nternet: www Y Y
+ recd 2 rile
Notiticd /Molhod:
sus Iciucn+al inibnnnuna
--�, __ rri v 0c . Ttn Ar,r;
TYPE OF WORK r•St itt rr „ � r „�• � , PLAN REVIEW
❑ New constru Arhlilion/ alteration /rcplace+'Wrirt''ti via Lt Y IJtt,,tl y Please check all that apply (submit 2 sots of plans Wilma checkn0 below)'
DomUlition ❑ Other; L1 SArvice or feeder 400 amps or more
p° ❑ Marinas over three
aty stories
CATEGORY OF CONSTRUCTION
where the ava0ablo fault current
U 1- and 2 dwelling Marinas and boatyards
Y fi Commercial/industrial ACCCasory building exceeds 10,000 amps at 150 volts or Floetln buIidin s
❑ Multi - famil III Master Builder ❑ Other L 9 S7
less to ground, or exceeds 14,000 H Corrlmerclal -use agricultural
.103 SITE INFORMATrON AND LOCATION _ amps for all Other Installatlona buildings
Job nn,: 111264 Job site address; 10300 SW Greenberg Rd ID Fire Pump El Installation of 75 KVA or
-
rJ bI Orgency system larger separately derivod system,
City/State/ZIP; Tigard Oregon ii Addition of new motor load of CI "A”, "E”, "1 -2 ", "1.3 ",
1oomP or more, ❑ occupancy
Suitc/bldg,lapt, no.' 48 5 Project name; Thorson Outlet U S& or more residential units n Recreational vehicle parka
Cross Street/Directions to job site. ❑ Health - cart facilities ❑ Supply voltage for mom than
- El H.<rd0tla Iocati0r15 600 volts nominal.
. ,❑ Service or feeder 600 amps or mom
Subdivision Lot no.: FEE 9CttP_DULE
ticscripilnn I Qt res. J r'dnl ^^
Tax map/parcel no.; New residential -
DESCRiPTION OF WORK-- single or meld - family dwelling unit.
Install General purpose outlet, includes attached garage,
1000 s., ft, or less M $ 168.54 MIME 4
PROPERTY OWNER Ha. Add 500 sq. fl Or portion $ 31.92 ME i
LJ TEN ANT Limited energy residential
Name' whit above s., Q,)
Limited tier
8 750 2
—
energy, multi - family
Address; residential (with above sq, 04 s 75,00 2
Service or ieedora Installation, alteration, and /or relocation City/State/ZIP, 200 amps nr Iess S 10 0,70 2
201 amps to 400 amps _ $ 133,56 2
Phone; Fax: __
401 am s$ amps to 600 amp 200,34 2 -
Owner instnflatlnn' "this installation is being made on property that I own which is not 601 amps to 1000 amps 5 3n1,04 2
intended for sale, lease, rent or exchange, according in ORS 447, 449, 670, and 701 Temporary T amps c volts $ 552,7,6 2
Owner signature: poorara ry acrvles or feeders installalinn, alteration, and /0r
-
Date:
relocation
• APPLICANT 200 amps or less $ 5036 I
CONTACT PERSON 20I am s to 400 amps �-� . P $ 125,08 2
Rusincss Name:
401 ampa to 599 amps $ 168.34 2
Branch circuits • new, alteration, or extension, per panel
Coronet name' A Pee for branch circuits w ith
service or feeder Ice, each
Adtlreys; _ branch ennui $ 7,42 2
B. Fee for branch Circuits
City/State/71r, without scrvico or feeder fee,
first branch circuit 1 $ 56.18 56.18 2
Phone; Fax, �_.■ f ach additional branch circuit: $ 7,42
_
Miscellaneous service or feeder not Included) 2
E - mail:
Each manufactured or modular
CONTRACTOR dwelling, sery ice and or feeder
Business Name: CAPITOL ELECTRIC CO., INC. $ 67 t4 84 Z_
Reconnect 0+1l�^
8 67 84 2
Pump or irraation circle S 67114 2—
Contact n ame - Sign or outline lighting 8 67 84 2
Signal circuit(g) or limited -
Address; 11401 NE MARX ST. energy pant!, alterations, or
- extension, Describe, $ 75,00 2
City /State/ZIP: PORTLAND, OR 97220 -1041
' ch additional ins CCtion ever allowable ih nn of the h a
Phone: 503 - 255.9488 pax: 03,257 -7121 Per inspection
= S$ 66,25
Investigation per hour (1 hr min) 66.25
) Electncal Lie. 26.496C SU.rv, L'c,; 3132 -S
—
Industrial plant per hour
8 75.18
Suprv. electrician aiannturo, required, 1 4, . ELECTRICAL PERMIT FGP$ Subtotal 17ARREL � $ 56.18
L Date 09/13/11 Plan review (259b of permit fcc)
f
•
Print Name: State surcharge ( _ 12% of permit fee) $ 6.74 tv
PERMIT FEE
Pont Name r • ' ' M NEEL TOTAL $ 62,92
' L
_ Thl. PO nPPileatlnn expire. ifs permit ni not obtained within itn
dory titter n har been accepted nn cnni root.
" Number Orinupcciin51 ber permit allowed.
1 1Buneili5 \i'srmils1ELr' -Perms App [Inc 10101 to
4 40- 4615T(I I/05,rn,,f /WLI3