Permit CITY T I ® ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00442
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/4/2007
PARCEL: 1 S135AB -01002
SITE ADDRESS: 10220 SW GREENBURG RD 571 ZONING: R -12
SUBDIVISION: LINCOLN CENTER/THREE LINCOLN LOT: 009 JURISDICTION: TIG
PROJECT: TRELLEBORG
Project Description: HVAC T -stats
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: X PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
SHORENSTEIN REALTY SERVIVES AMERICAN HEATING
ONE SW COLUMBIA ST #300 1339 SW GIDEON ST
PORTLAND, OR 97258 PORTLAND, OR 97202
Phone: 503- 412 -4800 Contact #: PRI 503- 239 -4600
FAX 503- 239 -7038
Reg #: ELE 26- 993CRE
FEES LIC 33135
Description Date Amount SUP 2640LEB
[ELPRMT] ELR Permit 12/4/2007 $75.00
[TAX] 8% State Surcha 12/4/2007 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued B : / Permittee Signature:‹
-
OWNER INSTALLATION ONLY
The installation is being made on property 1 own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
�' tki E � OR OFICOUSEL
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Electrical Permit A p r a t r ' , r «,�
,;'`� � � ice+ . - . • i
City of Tigard i c 0 2001 Rec e iv e d il Permit No. /v -- d
SW Hall Blvd., Tigard, OR 97223 U t — Plan Review
Phone: 503.639.4171 Fax: 503.598.196p F r�C t� ,� Other Permit:
Inspection Line: 503.639.4175 VI� Q ... at I I � Date/B ; ', ; Date Ready/By: Juris: IS3 See Page 2. for
Internet: www.ci.tigard.or.us suilDIN v ��' Notified/Method: fR G �j Supplemental
� In ' formation
a 'sy i rQ�. ' . S11. . C S t` W i' . L i ' ,'" l'i •4; i c , ., - , ta4 3 . : . - 'd ' e 0 1 r ,i �p fai i a ,.
7; °-R,ir _ I' }3 1 - " k:,2 -' . 43.1 ' ; > �I� fi aek,�4r lam 9i ;:& F.-y , .,.;. ? a �! - .us v;EL ', 3:�'Q .v.. _ , x ' t •
❑ New construction V Addition/alteration /replacement Please check all that apply:
❑ Demolition ❑Other: ['Service over 225 amps, comm'I ❑Hazardous location
❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
y . gia'iki3 Y4 .. '' A o" "' i e F a :., *'„ ,gf S of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling - Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Multi family ['Building over three stories ❑Feeders, 400 amps or more
❑ Master builder ❑ Other ❑Occupant load over 99 persons ❑Manufactured structures or
Zr , " a �I & �~ii`� -..a---,,, ' l =' ❑E gress /lightingplan RV park
^ ❑Health -care facility ['Other:
Job no.: Job site address: I 0 d� el et ( I 0.r c 0 (� ` ` a . a J o (�(,( of e - Submit 2 sets of plans with any of the above.
I
City /State /ZIP: I The above are not applicable to temporary construction service
�" �
I ++_ n 11 11 A (; 3
Suite/bldg. /apt. no.: j1 \ I Project name'rrt(,�.' \ Q U Q`((/, 1 U n � Description ` " �' Q Y U s
t Fee. Total
Cross street/directions to job site: J New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
1 �7
5 ° . '4 r t B ` �� �( 0)� i t,. ,. 5a ,y' if f
.,, , A r � v � r � �, � � ;, a ,, �. "�, < Each manufactured or modular
Dh • dwelling, service and /or feeder 90.90 2
0 l/ b ° 0 1 U t r U ACI Services or feeders installation, alteration, and/or relocation
J 200 amps or less 80.30 2
.m •, y caj t ice' r=1 r r " ,s r - .,r - c ? 201 amps to 400 amps 106.85 2
{ ` ��' l,rt 1 , - i n' � 241 :91S4 jF,i - Ja q�# ,, °N, , �;;.
"" �� 401 amps to 600 amps 160:60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
• Reconnect only 66.85 2
City /State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
s L. tr �, - e •w r a :' ,,, R � ; ^ r F " o o s A. Fee for branch circuits with
s _ "z S ri' t5 - 3 � ``� ` service or feeder fee, each
Business name: ` 6.65 2
. branch circuit
��p ( l L C n a�l n o 1 Jo (, B. Fee for branch circuits
Contact name: " I� An e_14-- n ' without service or feeder fee, 46.85 2
Address: 33� &. (._QL.0 ! 1
each a branch ch circuit
circuit 6.65 2
1 Ea ch add'1 branch cir
City/State/ZIP: 1)0 v* l d 0 (2 ._ Cr) a G p- Miscellaneous (service or feeder not included)
t Pump or irrigation circle 53.40 2
(�(
Phone: )) 0 13 C I _ lf ( 0 I Fax: : 3 )a ct ! 6---ai;
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
t �2,' z ., a a t , y{' P' y I'�'�o s �} o �, r .r �, M,V, ,,��{ energy panel, alteration, or
'X 4 L'T�ibu � f� ] ' F' --u G t io .A L
��.,��nn extension. Describe: t Page 2 2
Business name: Alm ,r I (. . i (c� ,.L(1 C ,
s � ` Each additional inspection over allowable in any of the above
Address: r J3 G � � 1 r Per inspection 62.50
�
City/State /ZIP: (( k. ( no i . q— o
qva. Investigation per hour (I hr min) 62.50
Phone: (15n) a39.A.1 6 0 0 I Fax. ( ) a _ 10 Industrial plant per hour 73.75
00 4 n . c ol r '" ° ttl c'- j. .. t S ' `1 . ':
CCB Lic.: 3313 3 Electrical Lic.: 96go`3 (e,L Sup . Lic.: ,t LEE Subtotal
Suprv. Electrician signature, required: ,,, ill Plan review (25% of permit fee)
v s� �� `! S tate surcharge (8% of permit fee)
�' ^ .
Print name. 1 5't�v yo n, Date.
t "•", TOTAL PERMIT FEE 51 )
t 1917
Authorized signature:
d (4 This permit application expires if a permit is not obtained within 180
4 � - Jaya after it has been accepted as complete
Print name: e, m m 0, 'C �U • d n Date: • Fee methodology set by Tri- County Building Industry Service Board
J •' Number of inspections per permit allowed.
i:t Building \Pemits\ELC- PennitApp.doc 12/03 440- 4615T(10 /02/COM/WEB , 5 5 1 • 3
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007..00442
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: .1214/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1/4/200a TIME: 7 :01AM PAGE: 69
SITE ADDRESS: 10220 S1?1! G E,ENBURG RD 571 CLASS OF WORK:
SUBDIVISION: LI NCOLN CENTER/THREE LINCOLN LOT #: 009 TYPE OF USE:
PROJECT NAME: TRELLEBORG
DESCRIPTION: HVAt: T scat::.
OWNER: SHORENSTEIN REALTY SERV1VE S, PHONE #: 503.417 -4800
CONTRACTOR: AMERICAN HEATING PHONE #: 503 - 239.4600
Inspection Request Scheduled For: Date: 1/4/2008 Pour Time:
Code # Inspection Description Contact # Message
109 Electrical final 06253( -01 503 209-0469 N
Corrections /Comments/ Instructions:
j'C PASS ❑ PARTIAL APPROVAL ❑ CANCEL 1 1 NO ACCESS
�� n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: 00 Date: 1 ' '`' 0 8 Phone #: (503) 718 - U40
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007.00442
13125 SW Hall Blvd., Tigard, OR 97223 • DATE ISSUED: .)/4/2 07
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 17/31/2007 TIME: 7 :00AM PAGE: 3,
SITE ADDRESS: 10220 SW GREENBURG RD 571 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/THREE LINCOLN LOT #: 009 TYPE OF USE:
PROJECT NAME: TRI' LLEI3ORG
DESCRIPTION: HVAC T - tats
OWNER: SHORENSTEIN REALTY SERA VES, PHONE #: 503-412-4600
CONTRACTOR: AMERICAN HEATING PHONE #: 503-239-4600
Inspection Request Scheduled For: Date: 12/31/2007 Pour Time:
Code # Inspection Description Confir-m_# Contact # Message
199 Electrical final 05: -01 503-209-0469 N
Corrections /Comments /Instructions: N 0 ANS W
?tzoyt p c %Li
iiLG� �ti 6,0 :- '��
Ce'1L
ThR electrical installation defects noted
on this report shall be corrected and
an inspection request made within 20
calendar days per OAR 918- 271 -0030
n PASS PARTIAL APPROVAL ❑ CANCEL 1 I NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G. N tg Le Date: 12' 31.01 Phone #: (503) 718 - W