Permit CI TY OFTIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00093
' ` I ' DEVELOPMENT SERVICES DATE ISSUED: 2/27/04
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 PARCEL: 1S135AB -03400
SITE ADDRESS: 10260 SW GREENBURG RD * **
SUBDIVISION: LINCOLN TOWER -TOWN OF METZGER ZONING. C -P
BLOCK: LOT : 014 JURISDICTION: TIG
Project Description: Job #24 -460 Qwest outlet: (2) branch circuits installed near fountain on garage level.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
EOP LINCOLN, LLC CAPITOL ELECTRIC CO INC
10260 SW GREENBURG RD 11401 NE MARX ST
SUITE# 100 PORTLAND, OR 97220 -1041
PORTLAND, OR 97223
Phone: 892 -2500 Phone: 255 -9488
Reg #: LIC 048748
SUP 3132S
FEES ELE 26 -496C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 2/27/04 $53.50
[TAX] 8% State Surcharge 2/27/04 $4 Rough -
Elect'l Final
Total $57.78
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -6699 or 1$032 -2344.
Issued By: ;,,, de_ 1 � � Permit Signature: O W , ( ! . . { e, c
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 639 -4175 by 7:00pm for an inspection the next business day
, r,, .
OFFICE USE ONLY
Electrigalq Application Date received,) Permit no.: ��DV --JOU:R3
e ' Project/appl. nO.: Expire date:
�^ ,. 1 City of Tigard RECEIVED
IP Date issued: By O'Receipt no.:
CITY OF TIGARD Address: 13125 SW HALL BLVD, TIG , . t �t O �72it0I Case file no.: . Payment type:
Phone: (503) 639 -4171 ' Fax (503) 598 ?+ 0
Land use approval:
frt
`I' 4'PE OF PERMIT •
❑ 1 & 2 family dewlling or accessory A Commercial /industrial ❑ Multi- family ❑ Tenant improvement
0 New construction ❑ Addition/alteration /replacement ❑ Other: ❑ Partial
JOB SITE INFORMATION ,
Job address: 10260 SW GREENBURDG RD City: TIGARD Bldg. No.: Suite no: Tax map /tax lot/account no.:
Lot: 'Block: N/A 'Subdivision:
Project name QWEST OUTLET 'Description and location of work on premises: INSTALL (2)DEDICATED CIRCUIT IN ELECTRICAL
Estimated date of completion/inspection: NEAR FOUNTAIN ON GARAGE LEVEL.
CONTRACTOR APPLICATION FEE SCHEDULE _!
Job no: 24-460 Fee Max.
Business Name: Capitol Electric Co., Inc. Description Qty. (ea.) Total no. insp
Address: 11401 NE Marx New residential - single or multi - family per
City: Portland State: OR ZIP: 97220 -1041 dwelling unit. Includes attached garage.
Phone: 503 - 255 -9488 'Fax: 257 -7121 'E -mail: darrell @cepdx.com Service included:
CCB no.: 48748 'Elec. bus. lic.tt 26 -496C 1000 sq, ft, or less $ 145.15 4
City /metro lic.no.: N/A .. / Each additional 500 sq. ft. or portion thereof $ 33.40
2/24/04 Limited energy residential $ 75.00 2
Signature of supervising elec rician (required) Date Limited energy, non- residential $ 45.00 2
Sup. elect. name (print): RICHARD MARTI License no.: 2865 -S Each manufactured home or modular dwelling
PROPERTY OWNER Service and /or feeder $ 90.90 2
Name (print): Services or feeders - installation,
Mailing address: alteration or relocation:
City: I State: 'ZIP: 200 amps or less $ 80.30 2
Phone: Fax: 'E -mail: 201 amps to 400 amps $ 106.85 2
Owner installation: The installation is being made on property 1 own 401 amps to 600 amps $ 160 60 2
which is not intended for sale, lease, rent, or exchange according to 601 amps to 1000 amps $ 240.60 2
ORS 447, 455, 479, 670, 701. Over 1000 amps or volts $ 454.65 2
Owner's signature: Date: Reconnect only $ 66.85 1
• ENGINEER Temporary services or feeders -
Name: installation, alterations, or relocation:
Address: 200 amps or less $ 66.85 2
City: State: ZIP: 201 amps to 400 amps $ 100.30 2
Phone: Fax: E - mail: 401 amps to 600 amps $ 133.75 2
PLAN REVIEW (Please check all that apply) Branch circuits - new, alteration,
❑ Service over 225 amps - commercial ❑ Health -care facility or extension per panel:
❑ Service over 320 amps- rating of Ifi2 ❑ Hazardous location A. Fee for branch circuits with purchase of
family dwellings ❑ Building over 10,000 square R. four or service or feeder fee, each branch circuit $ 6.65 2
❑ System over 600 volts nominal more residential units in one structure B. Fee for branch circuits without purchase
❑ Building over three stories ❑ Feeders, 400 amps or more of service or feeder fee, first branch circuit: 1 $ 46.85 46.85 2
❑ Occupant load over 99 persons ❑ Manufactures structures or RV Park Each additional branch circuit: 1 $ 6.65 6.65
❑ Egress /lighting plan ❑ other: Misc. (Service or feeder not included):
Submit sets of plans with any of the above. Each pump or irrigation circle - _ - _— . S .53.40 • 2
The above are not applicable to temporary construction service. Each sign or outline lighting $ 53.40 2
Signal circuit(s) or a limited energy panel,
alteration, or extension* $ 75.00 2
*Description:
. Each additional inspectionover th allowable in any of the above:
Per inspection ' ' $ 62.50 I
Investigation fee
Other
❑ Visa ❑ MasterCard Permit fee S 53.50
Credit card number: / / Notice: this permit application Plan review ( ) -`$
Expires expires if a permit is not obtained State Surcharge 8% ) $ 4.28
Name of cardholder as shown on credit card
$ within 180 days after it has bee TOTAL $ 57.78
Cardholder signature Amount accepted as complete.