Permit q CITY OF TIGARD ELECTRICAL PERMIT
2 ' • COMMUNITY DEVELOPMENT Permit #: ELC2009 -00204
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/07/2009
Parcel: 1S135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 320
Subdivision: Lot: 0
Project: Ameriprise
Project Description: Alter /Install (3) branch circuits for switches and outlets for TI.
Owner: FEES
LINCOLN CENTER LLC Quantity Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL 4 crt Branch Circuits 05/07/2009 $66.80
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 05/07/2009 $8.02
Contractor: Electrical
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 $74.82
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 t rou•h OAR 952-Q01 -0100. You ma obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.3 .2344.
Issued By: t . ( , Permittee Signature: •••••■- MAi_S 4 'IV OI
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'N 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.
.
Electrical Permit Application FOR OFFICE USE ONLY
Received
Permit no .:8 [Ciccp
City of Tigard Date/By: S „S. CR (j,),
N. "I 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 WI --, Date/By: Other Permit: 6Lt p 2
,.
Inspection Line:. 503.639.4175
T I GARD ' 4 g I Date Ready/By: Juris: E See Page 2 ior
Internet: www.tigard ' ' ' .
L '" -. Notified/Method: -7 I C.N Supplemental Information
7SNOMiWaiilOrtineRtAYPIMVOITWOK IStalWattell4RNkilgillARMAtli4
H New construction H Addition/alteration/replacementcay Please check all that apply (submit 2 sets of plans w/items checked below):
O Demolition 0 Other
El Service or feeder 400 amps or more 0 Building over three stories
t Ptrai':gge where the available fault current 0 Marinas and boatyards
Li 1 - and 2 dwelling H Commercial/industrial H Accessory building exceeds 10,000 amps at 150 volts or Floating buildings
O Multi 0 Master Builder El Other less to ground, or exceeds 14,000 Commercial-use agricultural
ifELE1w.4iiiMM:75:67nitOicVd,OkI))14Alci'ads amps for all other installations. 11] buildings
O Fire Pump 0 Installation of 75 KVA or
Job no.: 290652 Job site address: 10220 SW Greenburg
0 Emergency system larger separately derived system
0 Addition of new motor load of
City/State/ZIP: Tigard, OR
100HP or more. El occupancy
E Six or more residential units . 0 Recreational vehicle parks.
Suite:bldg./apt. no.: 320 Project name: Amerprise
0 Health-care facilities 0 Supply voltage for more than
Cross Street/Directions to job site: 0 Hazardous locations 0 600 volts nominal.
0 Service or feeder 600 amps or more
Subdivision: Lot no.: fk; 5D,
Description I Qty. I Fee. I Total I **
rax.map/parcel no.: New residential - single or multi-family dwelling unit.
--464:4310Z.,FAICV,Iti'aig,::11)gScR10-1931.0FAWQRK':i.1-Wi4:'!OintaillaV,,,,ia6;N Includes attached garage.
NeW and relocated switches, outlets and lighting for tenant improvement 1000 sq. ft. or less $ 145.15 4
Ea. Add] 500 sq. ft or portion $ 33.40 1
ER;1L.11'.-4KORFRVI.O.0:02 .', .'',:' i: .4:K la Limited energy residential
(with above sq. ft.) $ 75.00 2
Name:
Limited energy, multi-family
residential (with above sq. ft.) $ 75.00 2
Address:
Service or feeders installation, alteration, and/or relocation
200 amps or less $ 80.30 2
City/State/ZIP:
201 amps to 400 amps $ 106.85 2
... ... ... 401 amps to 600 amps. 8 160.60 2
Phone: Fax: I
601 amps to 1000 amps $ 240.60 2
Owner installation: This installation is being made on property that I own which is not Over 1000 amps or volts $ 454 65 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: relocation
200 amps or less $ 66.85 1
FALI ill*, ''', 201 amps to 400 amps $ 100.30 2
401 amps to 600 amps $ 133 75 _ 2
Business Name:
Branch circuits - new, alteration, or extension, per panel
A. Fee for branch circuits with
Contact name:
service or feeder fee, each
. .
branch circuit $ 6.65 2
Address:
. .., „ B. Fee for branch circuits
without service or feeder fee,
' City/State/ZIP:
first branch circuit 1 $ 46.85 46.85 2
Each additional branch circuit: 3 $ 6.65 19.95 2
Phone: Fax:
Miscellaneous (service or feeder not included)
E-mail: Each manufactured or modular
KrW'i.V.X1.&,:;MSA,NRraraKl.if,WaOM;.aZtt.*IKUM.rtiaX:zNi,Mn dwelling, service and or feeder $ 90.90 2
Business Name: CAPITOL ELECTRIC CO., INC. Reconnect only $ 66.85 2
Pump or irrigation circle - • $ 53.40 2
C ontact name Sign or outline lighting $ 53.40 2
:
Signal circuit(s) or limited-
energy panel, alterations, or
' Address: 11401 NE MARX ST.
extension. Describe: Page 2 2
■:
City/State/ZIP: PORTLAND, OR 97220-1041
Each additional inspection over allowable in any of the above
• Phone: 503-255-9488 Fax: 503-257-7121 Per inspection $ 62.50
Investigation per hour (1 hr min) $ 62.50
( CCB Lie.: 48748 !Electrical Lie.: 26-496C ISuprv. Lie.: 3132-S ,. Industrial plant per hour $ 73.75
......-- :. Ell%TRIQMOEOIMEEESnkaf-CIANINgir!ti*WMW::,YX,?
Suprv. Electrician signature, required: 7 - 1 ...7.. % ......froivot. 44/te ...... a .# ,
Subtotal - $ 66.80
Print Name: DARRELL MCNEEL Date: 05/01/09 Plan review (25% of permit fee)
• ............,
7 . State surcharge (
) ....." : --- 7 ... - 7- 4 • 1 4 A - '1.- ) , V t i r.... ... I 4 t TOTAL PERMIT FEE 12% of permit fee) $ 8.02
Authorized signature.
$ 74.82
Print Name: DARREL7M This permit application expires if a permit is not obtained within 180
/ days after it has been accepted as complete.
* Number of inspections per permit allowed.