Permit CITY TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
At DEVELOPMENT SERVICES PERMIT #: ELR2006 -00250
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/16/2006
PARCEL: 1S126DC-03300
SITE ADDRESS: 09900 SW GREENBURG RD 245 ZONING: C -P
• SUBDIVISION: LEHMANN ACRE TRACT LOT: 005 JURISDICTION: TIG
Project Description: Voice and data
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATAITELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: .
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
ATHERTON REALTY PARTNERSHIP PROCOM COMMUNICATIONS INC
MARTHA ATHERTON 8326 SE 17TH AVE
2100 S WOLF PORTLAND, OR 97202
DES PLAINES, IL 60018
Phone: 847 - 298 -8600 Contact #: FAX 503- 233 -8052
PRI 503- 233 -8037
FEES Reg #: ELE 3- 397CLE
LIC 109929
Description Date Amount
[ELPRMT] ELR Permit 10/16/200E $75.00
[TAX] 8% State Surchart 101161200E $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 1es adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through AR 952 I I S. You may obtain copies of these rules or direct -ue tions to OUNC at 503- 246 -6699.
Issue B
dit Permittee Sign. ur e: —"RP
OWNER INSTALLATION ONLY .----71
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'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.
Oc 13 16 01:37p Procom Communications 5032338052 p.2
Electrical Permit Application 'c'' -- - ''' FOR OFFICE USE ONLY
"' . City of Tigard Recen'eS h 0(v
IN 4
�D Permit No
l3 L25 SW Hall Blvd., Tigard, OR 9 � e) 2006 Plan Review
2 - Phone: 503.639.4171 Fax: 503.598.1960 Date by • caller Permit
"!` i.{; I:
•� : R t) Inspection Line: 503.639.4175 q . - Date Ready . Sec I'unc 2 for
Internet: www.tigard- or.gov 1/4L,11 3I �i ,1 -1`�C Notificd/Methadl
tutu t21 t Supplemental Information
a rTelW�R_ •
TYPilcill ORk PLAN REVIEW
❑ New construction Addition /alteration /replacement
Please heck all that apply {submit 2 sets • f plan:: ,. near.: checked l 1•
❑ Sereice or fwder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other:
where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at ISO volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling g Commercial/industrial ❑ Accessory building amps for all other installations. buildings i
❑ Multi-family ❑ Master builder ❑Other: 0 Fire pump ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived sc:,ern,
Addition of new motor load of ❑ "A" "E" "1 2' "1 -3'
Joh no.: Job site address: I /lam <, /� �7 ,��r 1001W or more occupancy
VW ('JUut ❑ Six or more residential units. ❑ Recreational vehicle parks
City /State/ZiP: -77 A ,� D n,T 223 ❑ Health -care facilities. ❑ Supply voltage for more than elf? 7 ❑ I iazardous locations. 600 volts nominal
Suite/bldg./apt. no.: j4 5 Project name: Fiw2ihEeS /1� " tom ❑ Service nr feeder 600 amps or more.
'�
FEE. SCHEDULE
Cross street/directions to job site: C 1 _ Q7 nm.rrt 1 1,,i.. ( Fre. I Total l
v New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdi vision: Lot no.: 1,000 sq. U. or less 145.15 4
Ea. add'! 500 sq. ft. or portion 33.40 1
fax map /parcel no.: Limited energy, gy, residential 75.00 2
DESCRIPTION OF WORK _ ( «'tth above „ 1 III
�� � Limited energy, multi - family
/ /et <e . ! n residential (with above sy ti.) 75'00 2
Services or feeders installation. alteration, and /or relocation
200 amps or less 80.30 r 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps I 240.6(1 2
Address: Over 1,000 amps or volts I 454.(1 2
City /State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is heine made on property that I own which is not 201 amps to 400 amps 100.30 2
intended liar sale, lease_ rent. or exchange, according to ORS 447. 449, 670, and 71)1. 401 amps to 599 amps 133.75 2
Owner signature: Date:
circuits — new, alteration, or extension, per panel
Dah . ' A. Fee for branch circuits with
I APPLICANT ❑ CONTACT PERSON above service or feeder fee,
n ,, �/�
each branch circuit
Business name: 6 2
fA�Pt Co A4A4 Lief �'/A'r7P K� r . 44.. B. Fee for branch circuits
without service (Sr feeder fee,
Contact name: Q 46.85 2
r .1/4,9 ita i / LE `j first branch circuit
Address: R326, S'c / 7 ' ' , ✓e Each add'! branch circuit 6.65 2
Miscellaneous (senicc or feeder not included)
City/State./ZIP: P/.1 QR - /j L G r .� •- D Each manufactured or modular
/ 7 dwelling. service author feeder 9090 2
Phone: (SC 3 ) 9 _944 Fax: : ( 3 )) z-12._ gti 37 Reconnect only 66.85 2
E - mail: �41. �tyt1 p TO ire asaLQ rust 1 t!.tt M t C-4f i a Kt; :16.... Pump or irrigation circle 53.40 2
C'ONTRACT'OR Sign or outline lighting 53.40 2
Bl1S1ne Ss name: pp�' ��h / Signal circuit(s) or limited -
/5[' 6 ltl/LLl9i)Qld' At - energy panel. alteration, or
_ r
Address: 2Zn Q� /7 a /je extension. Describe: Page 2 75 2
city'/State/ZiP: TRk
G v / ®q 7 /! - Z2 5 97 Per inspection Each additional inspection over: allowable in an; of the above —
Phone: (5c' z33 ' 7 /S Fax: (5 ) 62.50
.J Z 33- �� SZ Investigation per hour (1 hr min) 62.50
CCB Lie.: /d 99z '? Electrical l.ic.: 3 _3g70E Suprv. Lie.: , ills Industrial plant per hour 73.75
/) 7/t 1.e4 �
ELECTRICAL PERMIT : S
Suprv. Electrician signature, required: c....4 Subtotal: — 5"e•
Print name: r !Lmt.c•t.r/ eiLE,S Date: /D t 3 _414., plan review (25% of permit fee): ,
�ti State surcharge (8% of permit fee):
4th
Authorized sigltatt e. /� — _ K TO'T'AL PERMIT FEE: S ( 00
Print name' /t C //�� This permit application expires if at permit is not obtained within 180
,: ail/ f D ate: 7 • ,,,p4,
7 �t� days after it has been accepted as complete.
11/27/2006
Case Activity Listing 9:26:05AM
Case #: ELR2006 -00250
E r� �;� �D "�ne °'F U dated:.'"
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Actt v i . .�, escrt t on.. , , ,,, , Date.l ., � - "'
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ELR1010 Application received 10/13/2006 None RECD FAX 10/16/2006
DEB
ELR1020 Permit created 10/16/2006 None DONE DEB 10/16/2006
DEB
ELR1030 Check for parcel tags 10/16/2006 None DONE DEB 10/16/2006
DEB
ELR1280 Issue permit 10/16/2006 None DONE DEB 10/16/2006
DEB
ELR2135 Low voltage 11/14/2006 11/14/2006 11/14/2006 None FAIL GN 11/14/2006 039755 -01 —503-233-8037— VM -
GN N
ELR2135 Low voltage 11/15/2006 11/16/2006 11/16/2006 None PASS HS 11/16/2006 039833 -01 — 503- 314 -0360 — VM -
HS N
ELR2199 Electrical final 11/16/2006 None DONE HS 11/16/2006
HS
ELR1740 Case finaled 11/16/2006 None DONE HS 11/16/2006
HS
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