Permit CITY OF TIGARD ELECTRICAL PERMIT
a.• COMMUNITY DEVELOPMENT Permit #: ELC2013 -00361
Tr CARE) 13125 SW Hall Blvd , Tigard OR 97223 503.718.2439 Date Issued: 06/27/2013
Parcel: 1 S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 495
Project: Hillshire Realty Subdivision: METZGER, TOWN OF Lot: 9
Project Description: (2) 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
2 crt Branch Circuits wo /Purchase 06/27/2013 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 06/27/2013 $7.63
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 952- 090 You may obtain a copy of the rules or direct questions to OUNC by calling 50 /5170/°4-/e,9-770,1 232.1987 or 1.800.332 2344
Issued By: Permittee Signature: anf
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.
06/17/2013 14:30 503257 * 7 ; 121 CAPITOL ELECTRIC PAGE 02/02
ltrlectrical Permit XXCati
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cit Of Tigard ecervc. Date/By; l� �7 /3 . /ii.' . met noELC 20/3— 0 age,
13125 SW Hall 151vd., Tigard, OR 9 Plan Rev cw
• V Phone: 503.639.4171 Fax 503.59 1 7 2013 Date/By. OtherPcnsift.
TIC . l: r:> Inspection pection Litt; 503.639.4175
Date Reddy /6y, Juns.
Internet uvtivw.tigard- or.gov CITY OFTIGARI) 1-f &J ❑ Sterne zrot
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lr..-U. x—.7- r ..h _:.l.. .L✓ � ..i.T.2r . ,1a r� 1; '4.: r .:.e., ,y,„,..27,7"-',-, R r m .. - I.. �. i7 r i '-T ,,, i {'+'.. ; '*cr
r a;_ ly (submit 6 ,: , l a tt9 ms hecko ��r�r. 1 4;r+:
❑ New construction
❑ Addition/alteration/replacement Please check all that appty (submit 2 sets of plane wlrtema checked below),
❑ Demolition ❑ other
11:. - T — r ❑ Service or feeder 400 amps or more ❑ Building over three atnrles
[ �. tr1, l ad � , J , 7ir1 C Jr.yar;'747 _ p� , t ^� �_. is where the available fault current 0 Marinas and boatyards
❑ 1- and 2•fhmily dwelling I] Commercial /industrial ❑ Accessory building exceeds 10,000 amps at 150 volts or ❑ Floating bufldings
❑ Multi -lame) ❑ Master Builder ❑ Other
!
rt ��e�'•p s— g -- d ,._ fees to ground, or exceeds 14,000 Commercial -use agricultural
� 's. 'ii: s `;?�1,ey; . ?aiZ .rPi !E ZlL. 'rt: °_l n .L9'�,i`;.,.��:.'Jt ' .� ,j :;Zz....: - -'- A:.: amps for ell other Inatellatione
buildings
Job no,' 131017 Job site address, 10300 SW Greanburg Rd ❑ Fire Pump ❑ Installetlon of 75 KVA or
—
❑ Emergency system larger separately derived system.
City/Statd7TP' Tigard OR El Addition of new motor load of El "A", "E "1 "1 -3 ".
100HP or more. ❑ occupancy
Suite/bldg /apt, '„ Or Project name: HIIlehlre Realty ❑ Six or more residential units ❑ Reoreedonal vehicle perks.
Cross Street/Dtre.: ens ob site ❑ Health-care facilities ❑ Supply voltage for mom than
❑ Hazardous locations 600 volts nominal
��_ ❑ Service or feeder 600 am or more
Suhdrvlsion r
Lot no
elt�v w_a r 0R � :zti^ -,t i1�r+ e . 1 1'w 7, ±? ,•��� _'je
Descss iyr: o
Tax ran./ reel no •
New residential • dwelling Fee. Total "
4. t �4 �- t � ,.. , � _ y single or multi - family dwelling unit.
Tenant Improvement
1 - ./..3.1 titI a9),a'1nrL ;LSZ. ,... v'�k7 � , -,S-' Includes attached Pine.
1000 sq R. er less S 1 68.54 4
■ i ? r ,�n1 • r � r +' 1 br y r r La. Add'l 500 sq ft or pornan $ 33 92 1
ifs" .raA. Ll...5�.,.r�.!JI�11'a.L.;1 7 r F i t' i.LW;, 'ii ...E45�.ttit —t X7 ,! energy residential
,, x fa _ Limned en
Name; (with above s9 ft .) $ 75,00 2
• Limited energy, multi-family �----
Address. residential (with above sg, it.) $ 75.00 , 2
Service or ( installation, elteratlnn, and /or relocation
City/State/21P 200 amps or less $ 100 70 2
201 amps to 400_ps S 133.36 2
Phone: Fax: 401 amps to 600 amps S 206.34 2
601 amps to 1000 amps $ SO 1 04 2
Owner installation: This installation is being made on property that t own which is not Ovor 1000 amps of volts
intended for sale, lease, rent nr exchange, according to ORS 447, 449, 670, and 701 Temporary services or feeders installation, nkcratfO f S 552.26 2
Owner signature' n, and/or
Date
�_ relocation
y.i; ■ r }. n - > . 200 amps S 59,36 I
J vies- _'J?lr %— �tdsw ,_r:i1e ` :i #ts i■( o w t — ps to 0 ,
� �s r � ` tJ�f, y? 201 a to 400 amps $ 125 08
Austnesa Name; 401 amps amps to 599 8m 2
p 5 168.54 2
_ Branch Circuits. new, alteration, or extension, per panel
—
Contact name: H A. Fcc for branch c1rcU11S with
—
service or feeder fee, each
Address: branch circuit S 7 42 2
B Fcc for branch circuits —
eery /state /ZiP, without service or feeder fee,
first branch circuit 1 5 56.18 86.18 2
Phone, Fax; Each additional branch circuit 1 $ 7.42 7.42 2
E-mail M (servic or feeder not included)
?t ^ r • �- to -,-. �, , r ,. 1 , ,, r _, r � Each manufactured or modular
' s& -P.'— -g: t :1;1!� !Sly _1.C;JaS.,l ..�. +*- :V„ I;>- „' dwelling, service and or feeder
Business Name' CAPITOL ELECTRIC $ 67.84 2
Reconnect only
$ 67.84 2
CO., , INC. ,
Pump or Irrigation circle S 67,54 2
Contact Sign or outline lielLg $ 67.84 2
Signal circuit(s) or limited - energy — See
Address. 11401 NE MARX ST, panel, alterations, or extension, Page 2 _ — 2
Each additional ills , cctlnn Over allowable In an of the above
—
Cit -1041 Additional inspection (1 hr min 6625/hr
y/Stste /ZIP PORTLAND, OR 9722
investi • lion 1 hr min 66.25/ hr
onc, 603-255.948 Fax' 503-257-7121 Tndustrislplan[(117rmin) 76, IS /Ilr
CCA 1, ie ' 4874E Electrical Li ,' 26-0196C Su ry Ltc., 3a3Z -S I ccifc
i a lly for which n0 fee is
S 90 00/ hr
ceifially listed 1/2 hr mm
Suprv, Electrician Signature, required i r / t zb' ?Ai 21 fRil '72.7 : n`.tJ.�. -it�i ?I� CYJ''" r r.�.�E1.2 r r _
Print Print Name, . Darrell ....l - Date; 06/17/13 Subtotal. b 63.60
P lan review 25% of ermit foe),
Authorized signature I _ State surch (12% ofpermit fee).
Print Name. Darrell McNee 1 '' -` TOTAL PERMIT FEB. $ ,0 0
This Permit appr:fpflon apnn■ If n permit is not obtained whhln 150
days ann. II ems boon rimmed on aomplrrr, / t
• Number orv per permit allowed 9 v f••
u LC•permle/tppdoc ID/01/09 „ A//
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