Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
Er COMMUNITY DEVELOPMENT PERMIT #: ELR2006 -00292
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/30/2006
PARCEL: 1 S135AB -00900
SITE ADDRESS: 10200 SW GREENBURG RD 200 ZONING: C -P
SUBDIVISION: LINCOLN CENTER /FIVE LINCOLN LOT: JURISDICTION: TIG
Project Description: Voice /Data. FARMERS INSURANCE.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
EQUITY OFFICE PROPERTIES TRUST TELEDIGIT INC
ONE SW COLUMBIA ST #300 PO BOX 22287
PORTLAND, OR 97258 PORTLAND, OR 97269
Phone: Contact #: PRI 503- 722 -8084
FAX 503- 722 -9914
FEES Reg #: ELE 3- 414CLE
LIC 116188
Description Date Amount
[ELPRMT] ELR Permit 11/30/200E $75.00
[TAX] 8 State Surcha 11/30/200E $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 By: %� Permittee Signature. i " _�►
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.
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.: -Electrical Permit Application ,•L____,E0R.oEFIGE=IT's — --__•,•-,---------...-: :
,„..__„.
-' Ciy of Tigard
97
1 111 1 E CEIV tj R
Ti
.:, ...___ . - sny Hall Pluct., ganl int Plan Review
Other Permit:
7 17- 7 '.":7 1""e "''''''''' 1 a '' ''''.:. />."' 'NO V 3 0 2006 Date/By: — : inspcution : - Linc' S03 619 ' - 4175 Date Ready/By: Juri El See Page 2 for
- -TFUNATY - .. -
Internet: www.tiettra NotifiediMethod• k Supplemental Information
CITY OF TIGARD
.
TYPE OF watALDING DIVISiON PLAN REVIEW
Please check all that appl (submit 2 set, of plans w/iteme, checked below:
Li New constr action 12 Additionlaiterationireplacement
0 Service or feeder 400 m
amps more or or? n Bt.:ding over three stones
LI DetitOliii011 r --1 Other: . I where thc available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION i exceeds 10,000 amps at 150 volts or Li Floating butidmgs.
. 1 less to ground, or exceeds 14,000 0 Commercial-use agricultural
U I- and 2-family dwelling E; Commercial/industrial 0 Accessory biuiuiii I I atTIPS for all other installations buildings.
II Militi-faiiiiiy Li lylas-ter builder 0 Other: n F‘ru purop ii M:lalinli on -f 75 i9 A nr
0 Emergency system, larger separately derived system,
•
JOB SITE INFORMATION AND LOCATION 0 Addition of new motor load of
100HP or more. occupancy.
Job no.: Job site address: 10200 SW Greenburg Rd
0 Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: Tigard, OR 97223 1:1 Health-care facilities. 0 Supply voltage for more than
0 Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: 200 Project name: Farmers Insurance 0 Service or feeder 600 amps or more.
1 I FEE SCHEDULE
Cross street/directions to job site: Hwy 217 Description I Qty. I Fee. I 'total I .
New residential single- or multi-family dwelling unit.
Includes attached garage.
•
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map/parcel no.:. Limited energy, residential
OKSCRIPTURN OF WORK (with above sq. 0.)
I 75.00
I I 1 2
I Limited energy, multi-family I
1 2
1 Voice/Data Cabling • ling residential (ovith above sq. ft.) 1 1 75.00 i
Services or feeders installation, alteration, and/or relocation
200 amps or less I
i 80.30 1 1 2
0 PROPERTY OWNER 1 0 TENANT I 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State/ZIP:
Temporary services or feeders installation, alteration, and/or
. : relacatian
1 I I !
Phone:( ) I Fax: ( ) I a, amps or less 1 i 66.85 I 1
1 1 1 I
Owner installa".-- This installation is being made on property that I own winch is not 201 amps to 400 amps j 100.30 2
1 I
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps '..)''
ps to 599 amps I 7",i ''' '7C 2 1
I i
Branch circuits — new, alteration, or extension, per panel I
Owner signature: Date: A Fee. for branch circuits with 1 I I
i 1 1 l
fl CONTACT PERSON above serAce or feeder fee, I
0 APPLICANT I 6 2
each branch circuit -
•
Busmess name: . B. Fee for branch circuits
without service or feeder fee,
Contact name: first branch circuit 46.85 2
.
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
90.90 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -1
1 1--Tilait: 1 Pump or irrigation circle I 53.40 ,
I '
CONTRACTOR Sign or outline lighting * 53.40 ' 2
Signal circuit(s) or limited-
.
Business name: Teledigit Inc
energy panel, alteration, or 1 75
Address: PO Box 22287 extension. Describe: Page 2 2
I I I
' ' t
City/State/ZIP: Portland, OR 97269 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 722-8084 Fax: (503) 212-2249 Investigation per hour (I hr min) 62.50
, 73.75 1
CCB Lie.: 116188 ' tlectrical Lic.: 3=114CLE Suprv. Lie.: 815LEA 1 Industrial plant per hour 1 i ■
ELECTRICAL PERMIT FEES '1
Suprv. Electrician signature, required: °-- Subtotal: 75
..
Print name: Art Rosado Date: 11/30/06 Plan review (25% of permit fee):
State surcharge (8% of permit fee): 6
Authorized signature: ---------- TOTAL PERMIT FEE: 81
.
This permit application expires if a permit is not obtained within 180
Print name: Art Rosado Date: 11/30/06 days after it has been accepted as complete.
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR200 &.00292
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/30/2005
Phone: (503) 639 -4171 ��4Py�rry��l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2/2/2007 TIME: '7:03AM PAGE: lei
SITE ADDRESS: 10200 SW GREENI3URC RE) 200 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/FIVE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: FARMFPS II= I RJRANCE
DESCRIPTION: Vo.tol ,t :, FARMERS fi4SURANCE.
OWNER: '.: ?' "i° :,' 0 _,FF . F , i; ' "ST, PHONE #:
CONTRACTOR: TELEDIGI l• INC PHONE #: 503-72/8084
Inspection Request Scheduled For: Date: 212/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 042923-01 503 -784 -3059 N
,,�,
Corrections /Comments / Instructions:
oev.
PASS PARTIAL APPROVAL I I CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: NO P cc. Date: 2 .-/2-- -- 0 rj Phone #: (503) 718 - / i4
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2006-00292
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/30/2006
Phone: (503) 639-4171 1 /47 dive
Inspection Requests (24 Hrs.): (503) 639-4175 _4.4 ell!.
INSPECTION WORKSHEET FOR DATE: 2/1/2007 TIME: 7:01AM PAGE: 7
SITE ADDRESS: 10200 SW GREENBURG RD 200 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/FIVE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: FARMERS INSURANCE
DESCRIPTION: Voice/Data. FARMERS INSURANCE.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: TELEDIGIT INC PHONE #: 503-722-8084
Inspection Request Scheduled For: Date: 2n/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 042850-01 503-784-3859
1 ot 1.)4s,L,
Corrections /Comments/ Instructions:
LL •
6 T 81 r BogNib-
■••■--
[I PASS fl PARTIAL APPROVAL fl CANCEL I NO ACCESS
AIL I I CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED
. Inspector: q- lb Date: SI 0r1 Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2006-00292
13125 SW Hall Blvd., Tigard, OR 97223 _ ,-. DATE ISSUED: 11/30/2006
Phone: (503) 639-4171 ' '1 040 I n`
Inspection Requests (24 Hrs.): (503) 639-4175 ff .ALL -IL
INSPECTION WORKSHEET FOR DATE: 1/2/2007 TIME: 7:00AM PAGE: 17
SITE ADDRESS: 10200 SW GREENBURG RD 200 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/FIVE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: FARMERS INSURANCE
DESCRIPTION: Voice/Data. FARMERS INSURANCE.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: TELEDIGIT INC PHONE #: 503-722-8084
Inspection Request Scheduled For: Date: 1/2/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
_...----
135 Low voltage 041685-01 503-784-3859 Y
. ...---
Corrections/Comments/Instructions:
A PASS fl PARTIAL APPROVAL n CANCEL Ei NO ACCESS
I FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: cl" 0 ) (------' Date: 1 22 % 6 7 Phone #: (503) 718- A140