Permit n CITY OF TIGARD ELECTRICAL PERMIT
C • -• COMMUNITY DEVELOPMENT Permit#: ELC2013 -00312
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/04/2013
Parcel: 1S 135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 200
Project: Experis Subdivision: METZGER, TOWN OF Lot: 9
Project Description: 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
1 ea Services or Feeders - 200 06/04/2013 $100.70
Specifics: amps or less
15 crt Branch Circuits w /Purchase 06/04/2013 $111.30
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 06/04/2013 $25.44
Electrical
Type of Const:
Occupancy Grp:
Total $237.44
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 A ? 60590 90 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800 332.2344.
Alo
Issued By: _.I )/ Pertnittee Signature:
Dit/ ffi°f' e f
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.
06/03/2013 10:58 5032577121 CAPITOL ELECTRIC PAGE 02/02
Electrical Permit Application RECEIVED
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City of Tigard Date/By- t o /I P ermit no.' Piz 2013 —cif ia-
• 13125 SW Hall Blvd.. Tigard, OR 97223 JUN 03 L 2 n 12 Plan Review Other Permit: ' Phone: 503. 639.4171 Fax: 503.598.4960 I'. Date /By:
I . 1, A I f-, Inspection Line: 503.639.4175 Date Ready/By: Juris; I❑ sa 2 a,r
Internet; www.tigartt -gov CITY OFTIGARD Notiftetl/Method: - TICS susoleetosialrnremvoiee
• : 1 ► 1 1 I
`t' ' ,:,.;LiT = ::iFS:,' ~ ::(2:..:1:).: -' : Ti 7i. `.-':;5:= --, : 15 i:�.'
c::;' 7 — - s'
❑ New construction ❑+ Addition /alteration /replacement Please cheek all that apply (submit a sets of plane w/lterns checked below)
❑ Demolition ❑ Other, ❑ Service or feeder 400 amps or more ❑ Building over three Modell
7
Imo' :.. ._ _ ._ .... 72 Kii, ...V..- p,... i ,'._y..,:-77.q. .5�. "_.
L' "�{������'�= ,�- � - 7:i�Ll:i��,_ l'a_ 'd ?:�S1�ti
:;�l iii. , ::_Y��aa��,- ., ? :;:•b:°rw'.�'. V1h019 t110 available fault current ❑ Marinas and boatyards
• I- and 2-family dwelling ❑' Commercial/industrial ❑ Accessary building exceeds 10.000 amps at 150 volts or ❑ Floating bundings
❑ Multi-famil ❑ Master Builder ❑ Other less to ground. or exceeds 14,000 ❑ Common iel -use agricultural
ra... ",. = :Zi : :4.7.11lr� 4.:7.G: ' 1s.ii. �. .-: .u..3. 1� < :;: -. 7t1a =iii amps for an other Installations. buildings
Job no ' 131013 Job site address: 10260 SW Graenburg Rd ❑ Flre Pump ❑ Installation of 75 KVA or
❑ Emergency system larger separately derived system.
City/State/ZIP: Tigard OR ❑ Addition of new motor load of ❑ "A". "E ", "1 -2", "1 -3 °,
10oHP or more. ❑ occupancy
Suitc/bldg• /apt• no . 200 'Project name. Experts Panel and outlets ❑ Slx or more residential unite ❑ Recreational vehicle parka,
❑ Health-care facilities ❑ Supply voltage for more than
Cross Strcet/Directinns to job site: ❑ Hazardous locations 600 volts nominal.
❑ Service or feeder 600 amps or more
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Subdivision: I Lot no : Orac Qrs
y, rte. xehrt "
��rr�� Tax ma • •ertel no.: _ 1I New residential - single or multi - family dwelling unit.
Mtt.A T . i J� . ':0):I''1:'•.7E :L11 n' 21.i:T i�:ll�!i-:. n `1- b,,, . : .t ; 4
.rt':'ft 1 h
�_.. �� � .�; - avn
,,�,. - .:y — Includes npnc ed RnrnRa
Install 100 amp panel and rccireuit outlets 1000 sq R or less $ 168.54 4
Ea. Add'I 500 sq. ft or portion 3 33 l
EMC :i'.. - JTgsaC ii" . :' UT ?:2'-. _.z..4. 2= ^-- - ,;: Limited energy residential
Name. (with shove sq. ft,) I 75.on 2
Limited energy, multi - family
Address, residential (with above sq. R.) 3 75.00 2
Service or feeders Installation, alteration, and/or relocation
City/Srato/711s; 200 amps or less 1 3 100 70 100.70 2
201 amps to 400 amps S 133,56 2
401 amps to 600 amps 3 200,34 2
Phone: Fax: 601 amps to 1000 amps $ 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 feeders installation, alteration, and /or
Owner signature: Date _relocation
200 amps or less $ 59,36 I I 1
�*�L(■ 5 J22: 7 1 ii . rt , ,,•.: =v - , „ yei 2 amps s
S
;:•� s:��::� .S`::.�:�J ',_:l ..v..�. �i P amps
amps to 599 amps S 168.54 125.08 2 2
Business Namc: Branch circuits - new, alteration, or extension, per ianel
Contact name: A. Fee for branch circuits with
service or feeder fee each
Address; branch circuit S 7.42 2
B. Fee for branch circuits
city/State/ZIP: without service or feeder rcc,
first branch circuit 5 56.18 2
Phone: Fax:
F.ach additional branch circuit: 16 3 7.42 111.30 2
Miscellaneous (service or feeder not Included)
E-mail. Each manufactured or modular
L^.c•. S - '. - .4:-• .. r .. �
% ::: �rilk ::: .. 'iM^r 5 ' .1 �.:�--' -” dwellin&serviceandorfeeder
..y '��� 6+•.... S 67.84 2
Business Name: CAPITOL ELECTRIC CO., INC. Reconnect only $ 67,84 2
Pump or irrigation circle S 67.84 2
Sign or outline lighting $ 67.84 2
Contact name: Gary Staled Signal ctrcuil(s) or limited -
Address' 11401 NE MARX ST. energy panel, alterations, or
extension. Describe: S 75 00 2
City /State/ZIP• PORTLAND, OR 97220-1041 Page 2
Eacb additional inspection over allowable in any of the above
Phone: 603 Fax. 5 i . 267 - T121
A Per inspection S 66.25
Investigation per hour (I hr min) S 66 25
CCB Lic : 4B746 • Electrical Lie.: 26 -49GC industrial •cant
-J/ � hour $ 18,18
Suprv. Electrician signature. requir�_d :a'1- _,Ejl7 T:7 ..3.7.. '�.N._ _.� 5 r .., ri r : - - -- — *1 -- ;z-=-....,:
..
s•'_ :::� ••'r:;�ai:- .:..�: •:::�� � .te
�� 4 /�, _ Subtotal a 212,00
Pant Nome: Darrell M — • : , : ' Date: 06103/13 ' Plan review (25 %o permit fee)
State surcharge ( 12% of ermit fee /
Authorized signature: ' j /� n f TOTAL PERMIT FEE p )
$ 237,44
Pant Name: Darrell MCNeeI This Permit application expire, If • pe,mn le ant ohtmh,ed within 180
der, after it hm h..d er"q,,.d n, rempM.
• Number of icurpectimm per permit allowed.
1: laulldlagWermimlw14:- PermliApp doe I wows 440 - 46155(11 /O5/COM/WOD