Permit CITY OF TIGARD ELECTRICAL PERMIT
Per
COMMUNITY DEVELOPMENT
Permit #: ELC2012 -00414
T i G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/16/2012
Parcel: 1 S135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 210
Project: Advanced Wealth Management Subdivision: METZGER, TOWN OF Lot: 9
Project Description: (3) branch circuits 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
3 crt Branch Circuits we /Purchase 07/16/2012 $71.02
Specifics:, Service or Feeder
1 ea 12% State Surcharge - 07/16/2012 $8.52
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $79.54
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 OA 9 2 -001- 90. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 2.1987 or 1.800.332.2344.
J' t.
Issued By: Permittee Signature: 0K\ APPLI (! All MI
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.
07/13/2012 13:44 5032577121 CAPITOL ELECTRIC PA(E
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Electrical Permit Apolicati . 1.11k OFFICE ONI.1 4, Dili
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Datc/By: / ( id I 1? t- X()
City of Tigard
.71 • 13125 $W Rail Blvd.. Tigard. Q 97223 Plan Review Other Permit:
• " . PhOne: 503.639.4171 Fax: 503.5913.190L 1 6 2012 Dote/By:
— .
1 1/.R.r Inspection Line: 503.639.4175 Date Ready/By: El Sao Pare 2 fOr
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Internet: werwAl CITYOF TIGARD
sard-or.gov Notified/Method: EM S mi
ittedemsi Informaii0a
• • ' ' .• '
• ,:, ,porwo• • •-•:ati :-.;:lija,...:. -11 : ";., :' AIL % .li'lq : :'••• • lil'.4::;: l'' . 1 ':,•■• ....:. •r. • ''.' .::' ': ' -
• Ncw construction lEl Addition/alteration/replacement Please cheek *Mat apply (submit 2 sets of plans wittems checked below):
0 Demolition 0 Other: in Seneca or feeder 400 amps or more 0 Burling over three atones
IIiiitV,;' iiKtglkiPPIE.OASOW.PVig.::‘ t.,..'1.ttglaFil!'''''iligt:1'.:(11 wham the available Ted Current 0 marinas and boatyards
Li I - and 2-family dwelling ILI Commercial/industrial u Accessory building exceeds 10,000 amps at 150 volts or 0 Floating buildings
0 Multi-family 0 Master Builder 0 Other less to ground, or exceeds 14,060 0 Commercial-use ogrimiTtora1
V amps for all other Installations. buildings
0 Fire Pump 0 tastes:mon of 75 KVA or
lob no.: 120889 Job site address; 10220 SW GreenbUrg Rd 0 Emergency system larger separately derived system.
0 Addition of new motor load at 0 - A", E. "1-2
City/StaterZTP; Portland Oregon i ODHP or more. 0 occupancy
0 Six or mere residential unite 0 Recreational vehicle parka.
Suite/bldg./apt. no.: 210 _IProject name: Advanced Wealth Management .--,
L..1 Health-care facilities 0 Supply voltage for more than
Cross Strect/Directions to job site 0 1 lasardous locations 600 volts nnininal.
0 Service or feeder 600 amps or more
':!:.!!!'iii.:'•!iiZi.;1;'•;.•:::,iiiggiV...•••4!'!••••;•::: .,f,;.••ing•Acgazturig ,..,:f.....' . ,,
::: 7 ;.: ; ....•i• :,•• :' ;,..• •
Subdivision: 1 Lot no.: ncleription 1 Qty. j Fee. r Tat,' 1 '
Tax map/parcel no.: New residential - single or multi-family dwelling unit. .
7.! • :. ..•; •••1'.!!! ;or TIN OF• 0 :.":•,' 'I I;1 Includes attached
Tenant improvement 1000 sq. ft. or less 3 168.54 a
Ea. Add 500 sq. ft or portion s 33.92 1
Limited energy residential
(with abovelg. ft) , 5 75.00 2
Name: Limited energy, multi-family
residential (with above sq, ft.) , s 75.00 2
Address: Service or feeders installation. alteration. and/or relocation
200 amps or less S 100,70 • 2
City/StaterZ1P: 201 amps to 400 amps %
S 11 58
. „ , 2
401 amps to 600 amps 5 200.114 2
Phone!. Fax: 601 amps to 1000 amps S 3171.01 2
Owner Installation: This installation is being made on property that town which is not Over 1000 amps or volts S 55226 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 s 59,36 1
.11„: Airklaairgit; H:i4..,rq.l.M:!,11P2V?;..g.:.'...„.i...,1;iiii,.RocorfrAevii.vstinlim;b4,.. 201 amps to 400 amps 1 S 125.011 2
401 amps to 599 amps S tart.54 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 S 7.42 2
Address: B. Fee for branch circuits
without service or feeder fee.
City/State/ZIP! first branch circuit i s 56,18 843.18 2
Each additional branch circuit; _ 2 • S 7.42 14.84 2
Phone: Fox: Miscellaneous (aervice or feeder not included)
E-mail! 'Each manufactured or modular
.. :•.c• ..'ini:;',:',.!•!:1111:)!-•:•, c., ...
• elope) .:,::.;■"q;', dwelling, service and or feeder s 57.54 . 2
Reconnect only s 67.84 2
13usineas Name: CAPITOL ELECTRIC CO., INC. Pura . or irri ation circle S 67.84 2
Sign or lighting S 67.84 2
Contact name: eery Stalart Signal circuit(s) or limited-
Address: 11401 NE MARX .
energy panel, alterations, or
ST
eXtenstnn. Describe: S 75,00 2
C ity/Statc/ZIP: PORTLAND, OR 97220-1041 Page 2
Each additional inspection over allowable In any or the above
ce, 66.2S
Phone: 503-265-9488 Fax: 503-26 -7121 Per inspec S
Investigatinn per hour (I hr min) S 66.25
.1‘3 Lie.: 48748 Eiarical ' : 26-496C S •.... Lic.: 3 Industrial plant per hour 5 78.18
_.,..
Suprv. Electrician signature, require- ,M 1 1 1111 :0 -1, AulPPF.:-. gm,LrmateMMIWITIEEMiililliiliNDW..'" ;:' •!'"t'!i" ." . •
• Subtotal $ 71.02
Print Name: Darrell , ;,...,-,,Lor ,..- L:.:te: _ 0711311 ,--- Pion reViCW (25% o f permit fee)
Authorized signature: ill IPI.- • 5'f ' - 1 — State surcharge ( 12% of permit fee) $ 8.52
TOTAL PERMIT FEE 9 79•54
Print Name: Da • oNeel Thh perAdt Actplicatton exptraa lin paweth ii no awes...1 within lon
dAys etre ilk., Moen Accepted in cemptele-
• Nipohcr of inspections poi' permit allowed.
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