Permit CITY TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
1 � �� I 11 DEVELOPMENT SERVICES PERMIT #: ELR2006 -00041
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 2/1/2006
PARCEL: 1 S 135AB -00900
SITE ADDRESS: 10200 SW GREENBURG RD 150 ZONING: C -P
SUBDIVISION: LINCOLN CENTER /FIVE LINCOLN LOT: JURISDICTION: TIG
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:
EQUITY OFFICE PROPERTIES TRUST AMERICAN HEATING
ONE SW COLUMBIA ST #300 1339 SW GIDEON ST
PORTLAND, OR 97258 PORTLAND, OR 97202
Phone: Contact #: PRI 239 - 4600
FAX 503- 239 -7038
FEES Reg #: LIC 33135
ELE 26- 993CRE
Description Date Amount
[ELPRMT] ELR Permit 2/1/2006 $75.00
[TAX] 8% State Surchar€ 2/1/2006 $6.00 REQUIRED ITEMS AND REPORTS
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through OAR 95 01 -0100. You may obtain copies of these rules or direct questions to O UNC at 503-246-6699. ,L
Issued By: (� Permittee Signatu /
j% (.
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N DATE:
LICENSE NO:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
•
Electrical Permit A` fII (I E® . ` FOROFFICE'USE ONLY '
City of Tigard Received ., ' 7...4 rf ' Permit N.. l �6I — �1
13125 SW Hall Blvd., Tigard, OR 01 2 00 Date/By: • t
g 6 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 / / / � Date/By: Other Permit:
Inspection Line: 503.639.4175 CITY OF TIG S ,...L Date Ready/By: Jur H See Page 2 for .
Internet: www.ci.tigard.or.us BU ILDING D ARD . Notified/Method: Supplemental Information
��t_.�,,. K. � .:, A ua. arf;°�.: My'uex - a � .� �"' - - �. !."• ,;.`sue �""*:' "t.SFr� -- �" 'aY. i�� • , :'''''.S.- 3 r' �.. 0 �k '�. ` : `_ Z PIS. I?<s. -
. - . ., n- ;YAL O . ,x ..,,,,,` "> ' , A1vRE �G�: >' >=Ns; .
�. :z � ��eW# ?�iveFS ;< �?:'- 'S;r`ah��iY•._, . ��`,.!; k.�...- ��i`•' ,� - '�:.f� >:,>:sC^.��� � .. �;i''„ '�� >�. ���a,�'Tr,':m�_T,.:�..4 Iry ,- s : -
❑ New construction t$ Addition/alteration /replacement Please check all that apply:
❑ Demolition ❑Other: EService over 225 amps, comm' I EHazardous location
� ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
' r Yea _z -� IWE t^:' 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
❑Building over three stories ❑Feeders, 400 amps or more
❑ Multi family ❑Master builder ❑Other ❑Occupant load over 99 persons ❑Manufactured structures or
i _u Lv t � .' -+ } '- - F } : r� RV ark
.. a. ' '.,,.n ..t.'� . ; u,,, Yx.,', :s n aces Q' .. O - . .n` 2a rv" -, :1 '':. ` - --- ` x , < ❑ Egress lighting plan p
�� ❑ Heal th -care facility ❑Other:
Job no.: Job site address: /dt�of7SCd (x /•},41 i f?
Submit 2 sets of plans with any of the above.
��
City /State /ZIP: Q art ®,e The above are not applicable to temporary construction service.
Suit 6.ldg. /apt. no.: t r�' Project name: f f j t t f s:d -, 1,;,K.: -. ,;, : :
e�V I /L�j•- ��Cp�'r o f'' r Description I Qty. I Fee. Total
. Cross street/directions to job site: New residential single - or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no
Limited'
�� .• - _. 1 G � , energy, non - residential 75.00 2
a;� 44,— ;, o r s', , , - I . y ' ' � t r s k'`� � �„ Each manufactured or modular
7-0.11 dwelling, service and /or feeder 90.90 2
lien' e Gr.errs /z T4W7C Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
a. 201 amps to 400 am 106.85 2
9 x W1s9 „ t . 0 , L to 0 A a s '� r � l;s �7�Sa y• ,�t p amps.
401 amps to 600 amps 16060
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 l
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
yh ' "f V ' 14 ""'t ` " r ' ° f A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: fe ✓� t ,,, without service or feeder fee, 46.85 2 •
_ / .y each branch circuit
Address: /, 2 / „5 c / &✓so') Each add'I branch circuit 6.65 2
City /State /ZIP: f 0,e .2245, - Miscellaneous (service or feeder not included)
t .,, Pump or irrigation circle 53.40 2
Phone: ( �'°r F ax:: )
Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited-
F energ y panel, alteration, or
exten ion. Describer Paget 2
Business name: , I'?'a e -/"J e d`� era,././AE'
ra. /` „aa c . / �,
* y r°° ` ' Each additional inspection over allowable in any of the above
Address:
., f - S4 "£ r $ '° P er inspection 62.50 1
City/State /ZIP: i' !:1e' t+ afe .g Investigation per hour (1 hr min 62.50
x,63) 23q,._,4,4 0 f _ r ay) 21 2 r � Industrial plant per hour 73.75 '
Phone: Fax: 3 ;': n n rdaeg j10,W f , fi ' V
47:g.4'7 f7t''X.?.� l' w"`.` t.' a�- (�rb?a��.f.'.;F,'- �2._S�' -3Ya�
CCB Lie.: 3 3 / Electrical Lic. _ -- Suprv. Lic. c_ 0 _ , Subtotal 7 S
Suprv. Electrician signature, required` t, ) Plan review (25% of permit fee)
Date: State surcharge (8% of permit fee) &, —
Print name:
6 - / ^a5 ' ) � 27 _p TOTAL PERMIT FEE
Authorized signature: Y: ` ,� '
This permit application expires if a permit is not obtained within 180
> +' r
days after it has been accepted as complete
Print name: e , / , r / �, * Fee methodology set by T i- County Building Industry Service Board
�/' •` Number of inspections per permit allowed.
is\ Bui !ding \Prnnits\ELC- PernutApp.doc 12/03 440 -461 ST(10 /02/COM/WEB
CITY OF TIGARD A ,
I ' • BUILDING DIVISION
Ali PERMIT #: ELR2006-00041
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2J112006
Phone: (503) 639-4171 kg/40i A\
Inspection Requests (24 Hrs.): (503) 639-4175 ....4.14- 411.
INSPECTION WORKSHEET FOR DATE: 2/10/2006 TIME: 7:04AM PAGE: 41
SITE ADDRESS: 10200 SIN GREENBURO RD 150 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/FIVE LINCOLN LOT #: TYPE OF USE:
• PROJECT NAME: FIELDSTONE MORTGAGE
DESCRIPTION: HVAC t-stats.
OWNER: EQUITY OFFICE PROPERTIES TRUST, . PHONE #:
CONTRACTOR: AMFRICAN HEATING PHONE #: 239
Inspection Request Scheduled For: Date: 2.11012006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
Electrical final 026671 503 N
Corrections/Comments/Instructions:
, p 9
' PASS 0 PARTIAL APPROVAL 0 CANCEL H NO ACCESS
n FAIL fl CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector: , 1 A-- . ... / __," . Date: 2— / ' Phone #: (503) 718-.2 4 / Z4"
CITY OF TIGARD _ _.
BUILDING DIVISION PERMIT #: ELR2006-00041
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/1/2(%
Phone: (503) 639 -4171 4 4 , u4 1 �,ypN ll�
Inspection Requests (24 Hrs.): (503) 639 -4175 .4141-
INSPECTION WORKSHEET FOR DATE: 2/912006 TIME: 7:04AM PAGE: 48
SITE ADDRESS: 10200 SW GREENBUPO RD 160 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER /FIVE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: FIELDSTONE MORTGAGE
DESCRIPTION: HVAC t-g tats.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: AMERICAN HEATING PHONE #: 239-4600
Inspection Request Scheduled For: Date: 2/912006 Pour Time:
Code # Inspection Description Confirm Contact # Message
199 Electrical final 02W37 -02 603.5 -9667 N
Corrections/Comments/Instructions:
S upper 06.A � �,
Li PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
MI FAIL P5ICALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: v NVk1 Le Date: 211f do Phone #: (503) 718- 2046'
CITY OF TIGARD - t., - •
BUILDING DIVISION 7 A PERMIT #: ELR2006-00041
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/1/2006
Phone: (503) 639-4171 *Al ll,
Inspection Requests (24 Hrs.): (503) 639-4175 . 6-1 -1.
INSPECTION WORKSHEET FOR DATE: 2/9/2006 TIME: 7:04AM PAGE: 49
SITE ADDRESS: 10200 SW $REENBURG RD 150 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/FIVE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: FIELDSTONE MORTGAGE
DESCRIPTION: HVAC t-stats.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: AMERICAN HEATING PHONE #: 23941600
Inspection Request Scheduled For: Date: 2/9/2006 Pour Time:
Code # Inspection Description / - ' . - ' Contact # Message
135 Low voltage 026667-01 503-572-9567 N
Corrections/Comments/Instructions:
C. RN)Q...1 T . 61 KT cts.guig- feaL
. 7 W 0
I PASS 0 PARTIAL APPROVAL El CANCEL 0 NO ACCESS
A FAIL , CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: Cri NNS (---> Date: 2 . 06 Phone #: (503) 718-1)44
. .