Permit CITY OF TIGARD ELECTRICAL PERMIT
• s . COMMUNITY DEVELOPMENT Permit#: ELC2013 00566
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/24/2013
Parcel: 1S 135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 400
Project: Kforce 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 crt Branch Circuits wo/Purchase 09/24/2013 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 09/24/2013 $6.74
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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 952-001-0090. You ma obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.%
A
Issued By: — - - Permittee Signature:
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 503.639.4176 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.
09/23/2013 10:34 5032577121 CAPITOL ELECTRIC PAGE 02/02
volt()11.1(1,:IINE ONf.1
Electrical Permit Application
City of Tigard - 1/1 _
a 13125 SW 1;a1t Blvd.,Tigard,OR %,.\\,*\ P an Kevlew Other Permit:
B':• Phone: 503.639.4]71 pax: 503 Datc/By:
T I G A R r, Inspection Line: 503.639.4175 rL01 Date Reedy/By C] ace Pnac 3 for
Internet www.tigard-ur.gt2v �0 \`') Notified/Method: _,( , su u lemental tnrormotloa
❑ New construction ❑+ l
Addition/alteration/rcplaccmt t�t )` ' Please check at that apply(submit 2 seta Of plans w/norns checked below):
❑ Demolition ❑ Other: Q ' ❑ Service or feeder 40D amps or mere ❑ Building over three stories
i..TM r �"+:'•`7r."Laa!5 ,,:.h1:%n . 1 _ 7! where the available fault current ❑ Marinas and boatyards
❑ 1-and 2-family dwelling 0 Commercial/industrial ❑ Accessory building exceeds 10,000 amps at 150 volta or ❑ Floating buildings
O Multi-famil ❑ Master Builder ❑ Other Tess to ground,or exceeds 14,000 0 Commercial-use agricultural
•'',.:T- i : tr ic. Tai•" n i 5 r_.ii7n -- �' amps for an other inSteletlons, buildings
Aff T
__�-... ./.-•/t.'1.._.. '..:.,: 1.�=��(... ,_i�.�:--s.0.!�.'ti�\V:�IL�G.���--..-.-.��_:".' :.�.::....:. i�ti� `."::.k6�J.a p g
CIO ❑ Fire Pump ❑ installation of 75 KVA or
Job no.: 131629 )nb site address: • 'W Greenburg Rd
0 Emergency system larger separately derived spasm.
City/State/7_1P: Tigard OR 0 Addition of new motor load of ❑ `A`,"E•',"1-2","1-3•.
100HP or more. ❑ occupancy
Project name: Wore°GP Outlet
❑ Six or more residential units ❑ Recreational vehicle parks.
Suitc/bldg:/apt.no.
❑ Health•care facilities ❑ Supply voltage for more than
Crass Street/Directions to job site: ❑ Hazardous locations 600 volts nominal,
❑ Service or feeder 600 am.s nr mnrc
Subdivision. I Lot no.: Description Qty.' Pee Tom! ••
Tax map/ arcel no,: New residential-single or multi-family dwelling unit.
Includes attached garage.
Install GP Outlet 1000 sq,ft or less S 168.54 4
Ee.Add'I 500 sq.ft or portion $ 33,92 1
.s 1111 1 l'. .tfa n1 T •a.vtr'•. "_ra:r.1 r = _ =o.r..
e.::c �a«�1 � .11��'1f.��.i.�;.dr�..f.���;��x�•�;�:--• M�'. 1.,�±:.�'_;I�x�.;.< ;..=r:�t,:•_..:5:� :. Limited energy residential
Name: - (with above sq.ft.) $ 75,00 2
Limited energy,multi-family
Address: residential(with above sq.ft.) $ 75.00 2
Service or feeder!Installation,alteration,and/or relocation -
200 amps or less S 100.70 f2
City/State/ZIP:
201 amps to 400 amps $ 133.56 2
Phone: Fax: 401 amps to 600 amps $ 200.34 2
601 amps to 1000 amps $ 301,04 2
r 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
1 Owner signature: bate: relocation
200 amps or loss
l 1$ 39,36 i I
( .. ;.M t:s .a&-. P7,..:: : ;7 1_. ':4 d:�9...-- m -L1'_g1� :,r'+`il9l';i`.•r.•;<: 201 amps to 400 amps S 125.08 I
2
401 amps to 599 amps $ 168,54 2
N Business Name: Branch circuits-new,alteration,or extension,per Sandi
~ Contact name: A. Fee for branch circuits with
service or feeder fee,each
r Address: branch circuit $ 7.42 1
B. Fee for branch circuits
.. City/Statel7-,iP: without service or feeder fee,
first branch circuit 1 5 5611 66.18 2
... Each additional branch circuit: $ 7.42 2
�
, )v Phone: Pali: -
` Miscellaneous(service or feeder not Included)
, , Email Each manufactured or modular
` ..:"d 4: "-,,:,--'�2.;7;t :! '1R'.L T'.':41 ),-s.,.�.. L`.::L: : '+' dwelling,service and or feeder S 67.84 2
Business Name: CAPITOL ELECTRIC CO.,INC. Reconnect only $ 67,84 2
Pump or irrigation circle S 67.84 2
Contact name: Sign or outline lighting $ 67,84 2
Signal circuit(s)or limited-energy See
Address; 11401 NE MARX ST, panel,alterations,or extension. Page 2 2
Each additional Inspection aver allowable in any of the above
I City/Statc/ZIP: PORTLAND,OR 97220-1041 Additional inspection(I hr min) 66.25/hr ,
Investigation(1 hr min) 66.25/hr
Phone; 503-255-9488 Fax: 503-257-7121 industrial plant(1 hr min} 78.18/hr
Inspections for which no fee is 90,00/hr
CCB Lic.: 48748 IL•lectricel L.is.;-26-496C ISuprv.LIC.: 3132-S t.ecificall listed 1/2 hr min
Suprv.Electrician signature.required: AMC— -`-�• -°""'"' ""° �'--�
Subtotal: 66.16
Print Name: Darrell McNeal etc: 23/13 0 Plan review(25%ofpermil fee):
State surcharge(12%of permit fee): $ 6.74 /
Authorized signature: TOTAL PERMIT FEE: $ 62.92 ✓
Oil.. I�._.. • .
Print Namc: Darrell MCN:: l - This permit application expires Is permit is not obtained within 180
day.ante 111,11.bee..aeeepled a.ecmprele.
.Number of inspections per permit allowed.
I?9uildinat o mile\81,C.rtnaitApp,,loe 10m1/nt 44 04 G1 ST(I1/OS/COM/WEB