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Permit •A 1. CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELR2006 -00301 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/8/2006 PARCEL: 1 S135AB -00900 SITE ADDRESS: 10200 SW GREENBURG RD 200 ZONING: C -P SUBDIVISION: LINCOLN CENTER /FIVE LINCOLN LOT: JURISDICTION: TIG Project Description: Low voltage for HVAC wiring. 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: EQUITY OFFICE PROPERTIES TRUST AMERICAN HEATING ONE SW COLUMBIA ST #300 1339 SW GIDEON ST PORTLAND, OR 97258 PORTLAND, OR 97202 Phone: Contact #: PRI 503- 239 -4600 FAX 503- 239 -7038 Reg #: ELE 26- 993CRE FEES LIC 33135 Description Date Amount [ELPRMT] ELR Permit 12/8/2006 $75.00 [TAX] 8% State Surcha 12/8/2006 $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 • ct questions to OUNC at 503.246.6699 or 1.800.332.2344. Issued Permittee Signature C /.y / �c� ---� 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'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. Electrical Permit Application FOR O FFICE USE ONLY i City of Tigard Received /2-. e a, PermitNo.:l�4.40.....-0, 0/ 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review rm Phone: 503.639.4171 Fax: 503.598.1960 / / ifi ,il Other Permit: Inspection Line: 503.639.4175 • ' J . Date Date/13 Ell See Page 2for Internet: www.ci.tigard.or.us Notified/Method: " Supplemental tx Info � r r mation !iF , f , z� .�± ..s s z a rr ; . `H `' ` ^' %rf r1` . �.. :' td3 E x ( �`_ . FJ.. v .x+ B �"'1 � -. 5 1 � ' 'ii C i- „tSi. ' ` yy - tg � -fit#"° ^3:...d Ira,© k o © .- X'.£ite4' lY - ,. ?&f',--f �' - s ', ? t? ?- ,':r - .. ''' .. tl a ' . 4 '''' ".'..'2..w - .. , : c:' x • ❑ New construction /,1 Addition/alteration /replacement Please check all that apply: ❑ Demolition CI Other: ['Service over 225 amps, comm'l ['Hazardous location ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., ti -f t�"r • �� ® `p'0 of 1- and 2- family dwellings 4 or more new residential ❑ 1 and 2-family dwelling :� Commercial/industrial ❑Accessory building DSystem over 600 volts nominal units in one structure ['Building over three stories ['Feeders, 400amps or more ❑ Multi - family ❑ Master builder ❑ Other: ['Occupant load over 99 persons ['Manufactured structures or . . gr '".�f � i'' .'- ay 7` • E f'' f Fh 7 37 ' .f i r;'7 RV ark ` , i ° IW r '1 ® � t• c`•lta � , . ❑Egress/lightingplan p ❑Health -care facility [Other: Job no.: 5 5 1. 1 8 Job site address: 0 200 (0({ e 1 b r, RD Submit 2 sets of plans with any of the above. City /State /ZIP: ( 11 Or d a R The above are not applicable to temporary construction service. �--• . ,'.. �0 :±_i9�ik^1't �`.lv,; � ,.:� Suite/bldg. /apt. no.: ZO 0 I Project name: Fact-vier 1 � >r... =r'�.n n 5 Description Qty- Fee. Total • Cross street/directions to job site: L 1 i coin 5 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 4 1 r s e ,t`t' t� 1 c :ff w ' t { .:.:a�.,. z „ ��Sc ,.f;Ya., > x..m �ub� �s.L•.�m.��.5,*+n� a._v? ., � � S,_FOR Each manufactured or modular dwelling, service and /or feeder 90.90 2 H VAC. - Loh/ V b V C' WI c fri �J Services or feeders installation, alteration, and/or relocation �/ 200 amps or less 80.30 2 i ii.o i �� ":;� r A` "- ` ;� ` to 'T" �< ,rr r 1 /4a, ,.} ,w, Y . 201 amps to 400 amps 106.85 . 2 z,e :_ � i-Iffi.le -*' : Eta tl'v t lAk, ala z l e. - ^ :.m i ra . % ' 160.60 2 401 amps to 600 amps 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 relocatio n Phone: ( ) l 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 - _!,. 'ice r A'rt r c r 0 ?' aL i A. o bn __ ,. �' as� se -f rvice r or ra feeder ch feecircuits eac w circuit 6.65 2 (gy �, Business name: m Q ( � (~inn • (a � 1 1 ( branch ci B. Fee for branch circuits Contact name: � VV j�rt 1 &'o d O ✓i without service or feeder fee, 46.85 2 3G � �' each branch 1 Address: - l t a � �1 Each dd 'I branch ncch circuit 6.65 2 City/State/ZIP: . I)U �('i 1 '2 d i 0 q� p D D - Miscellaneous (service or feeder not included) /�� p Pump or irrigation circle 53.40 2 Phone: ( a3ii ) _ q 660 I Fax: • (drib ) aYi-1 6 - O Sign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited- , r s r ® (� a�!{ t.� f 7 :. energy x Panel, alteration, or PIKE a`'b - , .l .. il '` b. �..�V �rr�'st EE W c�i2u%:a L3 ABM, 2 extension. Describe: Page 2 Business name: 4- ei i s i ' / ' 41 ry Ic C • ' ,^ °) �� ��. � \ ` � D � ■ � Each additional inspection over allowable in any of the above Address: r Per inspection 62.50 City/State /ZIP: "--P( lCiu' l4 i 0 q- ava Investigation per hour (1 hr min) 62.50 ( ) a3n (0O v I ) '. . , . 7o3 p Industrial plant per hour 73.75 Phone: "�- U �~t r'�5 Fax: air .:4,4 a ` lgR I' -:.1 � %,•; CCB Lie.: 53 t 35 Electrical Lie.: 9.6e1 Ut Sup . Lie.: ).,(oy 0 LEIS Subtotal Suprv. Electrician signature, required: ,' i I . Plan review (25% of permit fee) • j State surcharge (8% of permit fee) Print name: --v \(� �O ( Date: {�//� / TOTAL PER FEE Authorized signature: ( " ' J ' , / This permit application expires if a pe rmit is not obtained within 180 ///���fff 111 111 days after it has been accepted as complete print name: �i C U d Date: 2 I I o( ` Fee methodology set by Tri- County Building Industry Service Board •' Number of inspections per permit allowed. is 5.Building \Permits\BLC- PennitApp.doc , t 7/03 440 4615T( I0 /02/COM/WEB . CITY OF TIGARD BUILDING DIVISION PERMIT #: FIR2006-00301 13125 SW Hall Blvd., Tigard, OR 97223 • DATE ISSUED: 12J8/2006 Phone: (503) 639-4171 i ghrjo t o l i i f i l■ Inspection Requests (24 Hrs.): (503) 639-4175 1.11. INSPECTION WORKSHEET FOR DATE: 12127/2006 TIME: 7:00A1v1 PAGE: 3 SITE ADDRESS: 10200 SW GREENBURG RD 200 CLASS OF WORK: SUBDIVISION: LINCOLN CENTER/FIVE LINCOLN LOT #: TYPE OF USE: PROJECT NAME: FARMERS INSURANCE DESCRIPTION: Low voltage for HVAC wiring. OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #: CONTRACTOR: AMERICAN HEATING PHONE #: 503-239-4600 Inspection Request Scheduled For: Date: 12/27/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 041544-02 503-572-9557 Corrections/Comments/Instructions: PASS PARTIAL APPROVAL E CANCEL NO ACCESS I FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Z Date: 1 6 Phone #: (503) 718- 1-"Alf CITY OF TIGARD A . BUILDING DIVISION PERMIT #: ELR2006- 00301 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 18/2008 Phone: (503) 639 -4171 Jr: l i Inspection Requests (24 Hrs.): (503) 639 -4175 __ INSPECTION WORKSHEET FOR DATE: 12/27/2005 TIME: 7 PAGE: 4 SITE ADDRESS: 10200 SW GREENBURO RD 200 CLASS OF WORK: SUBDIVISION: LINCOLN CENTER /FIVE LINCOLN LOT #: TYPE OF USE: PROJECT NAME: FARMERS INSURANCE DESCRIPTION: Low voltage for HVAC wiring. OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #: CONTRACTOR: AMERICAN HEATING PHONE #: 503 - 239-4600 Inspection Request Scheduled For: Date: 12/27/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 041544 -01 503.572 -9557 N Corrections /Comments /Instructions: PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: G v C Date`s 2 I Phone #: (503) 718- a I