Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 -00432
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/23/2012
TIGARD Parcel: 1 S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 300
Project: Alton Sakai Subdivision: METZGER, TOWN OF Lot: 9
Project Description: (15) 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
15 crt Branch Circuits wo /Purchase 07/23/2012 $160.06
Specifics: Service or Feeder
1 ea 12% State Surcharge - 07/23/2012 $19.21
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
•
Total $179.27
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 9 - 001 -00 You ay 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: Q� > C�770, ^ "
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 603.639.4176 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.
07/19/2012 11:46 5032577 21 EIVIED CAPITOL ELECTRIC PAGE 02/02
Electrical Permit Application •
Ittxe;vea l t,1< I t: Sh t1..I.'
City of Tigard JUL 19 2012 , D e y : 7o23 42 4j Permit no C.2 0/.2 —0e -
.13125 3W Bali Blvd., Tigard, 4R 9 /Z r ADS Plan Review pi Permit:
Phone; 503.639.4171 Pax: 50 , �l ARD DMe/Ay:
1 - rnsretction Line sa3 .639A11 u1LDI O DIVISION Date Ready/By: durie:�/ /� ■ A Internet: www.ttgord-or.gtly Notified/Method: , .
• New construction El Addition/alteration/replacement Please check all that apply (submit 2 seta of plans wl4ema checked below):
❑ Demolition ■ Other. ❑ Service or feeder 400 amps or more ❑ Building over three dories
f= - y;f•;1 r- 1 11•%_I = .]d ,. 7.?. � ,.
:' . •' 7 4.. : :7TAk �. where the evadable daub arrant ❑ Marinas and boatyerd4
• I I. and 2- family dwelling ei Commercial /industrio • Accessory building exceeds 10.000 amps at ISO volts or ❑ Floating buildings
❑ Multi -femil ❑ Master Builder ❑ Other less to ground, or exceeds 14.000 ❑ Commerdal -use agricultural
1: i" 4 -1, 'irr :6∎ ' 1. + ._- ' _..`e_; ,:i'i S'1- `T , i .1. ': _ : :L ti ;:' amps for all other htatadi:180m . buidinga
Job no.: 120892 Joh site address: 10280 SW Greenburg Rd ❑Fire Pump ❑ Installation of TS KVA or
❑ Emeroency system larger Separately dented system.
City/State/ZIP: Tigard OR ❑ Addition of new motor load of ❑ "A ", "E-, -1-2•, - 1 - ",
_ 100HP or more. ❑ occupancy
Suite/bldg. /apt. no,: Project name: Alton Sakai ❑ or more PeaidOntiel units ❑ Recreational vehicle perks.
❑ Health -core facilities ❑ Supply voltage for more titan
Cmss Street/Directions to 'ob site: 0 Horardous locations 600 volts nominal.
❑ Service or feeder 600 am • or more
Subdivision: Lot no.: Description Qty. Fee. Tent "
Tax ma • areal no.: New residential - single or multi-family dwelling unit.
. , i i ,,.. t 4." W` ,.:.1'.:! J o !, ^ •+ " : -.r :x: r"..., 3 Includes attached garage.
'tenant im,rovement 1000 sq. R, or less a 188.54 4
_ Ea. Adel 500 so, ft or portion $ 33.92 i ,
�� /I ..� n',`•c.,c, ■� ,,i 1:.,p ':. t .F' ;.. EV6 �,"- '.., -" ' LIMited energyresidental
Name; " with above sq. R,) $ 73,00 2
Limited energy, multi - family
Address: residential (with above so, fl.) S 75.00 2
Service or feeders installation, alteration, and /or relocation
City/State/ZIP: 200 amps or less _ S 100.70 2
201 amps to 400 amps S 133.56 2
Phone: Fax: 401 amps to 600 amps S 200,34 2
-
60I amps to 1000 amps S 301,04 2
owner installation: This installation is being made on property that I own which is not Over 1000 amps or volts S 552.26 _ 2
intended for sale, lease, rent or exchange, according to ORS 447, 449, 670, and 701 Temporary services or trcders installation, alteration, and/or
Owner signature: Date: relocation
200 amps or less S 59,36 I 1
I
• 4 ^ . 2�,.
.-r :. \!,.., ?
.� ,._ _ " r_:_7 :i�i _' :��. t,l :' 201 amps to 400 am I ps $ 121.08 ` 2
Business Name: 401 amps to 599 turps 1 S 168.54 I 2
Branch circuits • new, alteration, or extension, per and
Contact name: A. Fcc for branch circuits with
service or feeder fee, each •
Address: branch circuit 5 7,42 2
B. Fee for branch circuits
without service or feeder fox:,
Ciry /Stetc/Z1P: first branch circuit 1 S 36.18 68.18 2
Phone: Fax; Each additional branch circuit: _ 14 S 7.42 103.88 2
Miscellaneous (service or feeder not Included) _
E-mail: . Each manufactured or modular
*a+ , _i r - - - •, . . - a . N n , gi,,A2 rz pP� . .� � T . 4 ;T _ � t., _ - �. dwelling, service and or feeder $ 67.84 2
Business Name: CAPITOL ELECTRIC CO., INC. Reconnect only S 67.84 2
Pump or irrigation circle S 67.84 _ 2
Contact name: Gary Staled Sign or outline lighting $ 67.64 2
Signal circuits) or limited -
Addrns: 11401 NE MARX ST. energy panel, alterations, or
extension. Describe: S 75.00 2
City/State/ZIP: PORTLAND, OR 97220 -1041 Page 2
Each additional inspection over allowable In any of the above
- honk: 503 - 255 - 9488 Fax: • ' - 257 -7121 Per inspector $ 6615 -
Investigation per hour (I hr min) 5 66.25
CCU Lie.: 48748 - Ig -Mirr?.1 industrial plant per itour $ 7R to
' � . r i t1 2 .',.= .r:., y I .• k i } - y � a x. tiR,�ri=,
/fi Suht atal g 1i>�.og ;
Print Name: Darrell ' . Date: 2 Plan review 2(_5°/p of permit fee)
_
State surcharge L 12% of permit fbe) $ 19.21
TOTALPERMfC PEE E 178.27
Print Name: — eA911 McNeal 't'hia Weill apW■nnon mistrial if a permit it not obtained within 180
days after It hm Irma oeerpted km cempirrt,
• Number of inspections per permit allowed.
t' dimiIdineermitsS2LC- PemmitApp.dee 1nmtlao 440.4615TO /051COM/WEB