Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
AL, DEVELOPMENT SERVICES PERMIT #: ELR2006 -00047
- - II 13125 SW Hall Blvd., T igard, OR 97223 503 - 639 -4171 DATE ISSUED: 2/8/2006
PARCEL: 1S135AB-00900
SITE ADDRESS: 10200 SW GREENBURG RD 150 ZONING: C -P
SUBDIVISION: LINCOLN CENTER /FIVE LINCOLN LOT: JURISDICTION: TIG
Project Description: Voice and cabling.
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 PROGRESSIVE TELEPHONE SYSTEMS
ONE SW COLUMBIA ST #300 710 NE CLEVELAND # 120
PORTLAND, OR 97258 GRESHAM, OR 97030
Phone: Contact #: PRI 503 665 - 4900
FAX 503- 655 -4830
FEES Reg #: ELE 26- 1117CCLE
LIC 150175
Description Date Amount
[ELPRMT] ELR Permit 2/8/2006 $75.00
[TAX] 8% State Surcharl 2/8/2006 $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 95 - 001 -0100. You ma btain copies of these rules or direct quest • s to OUNC at 503 -246 -6 99.
Issued By: �G C Permittee Signature/
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.
E . L' ,! ' El ectrical Permit App EivED i ation • FOR OFFICE USE ONLY
g F CB O H 2006 Received IT O - i �� b —p 2 2 1- /7
City of Tl and Date/B : Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 1 Plan Review
Phone: 503.639.4171 Fax: 5 1. 6 (4x,d "�r)P (' DateBy. Other Permit:
Inspection Line: 503.639.417SL/A �F .UJA.R&J '� I Date Ready/By: 1, - El See Page 2 for
Internet: www.ci.tigard.or.gjJTy 11 J T " TT Div,, OI Notified/Method: J F� Supplemental Information
)11I I
TYPE OF WORK 10! PLAN REVIEW
❑ New construction .® Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑Other: ❑Service over 225 amps, comm'l ❑Hazardous location
❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling [J Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family ❑ Master builder ❑ Other: ❑Building over three stories [Weeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
❑Health-care facility ❑Other:
Job no.: Job site address:
C D Z 00 51,) G, IZe _y_-r' 0c t o4 . Submit 2 sets of plans with any of the above.
City/State /ZIP: 1 g A > e . p ) d 2 The above are not applicable to temporary construction service.
Suite/bldg. /apt.no.: )5p Project name: r AA L t.i%-a\cs,ai,� FEE* SCHEDULE
Description , Qty. ` Fee. I Total I
Cross street/directions to job site: G,t.- _ , B04 Z H � 1 , y New residential single or multi family dwelling unit.
f / Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'( 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
' dwelling, service and/or feeder 90.90 2
Vo) e.-e- `a-- 17 A TA ( 0 " 2 Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ _PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
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: ( ) 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
„ ❑ APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
i B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
Address: first branch circuit
Each add'l branch circuit 6.65 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax:: ( ) Sign or outline lighting • 53.40 2
E -mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or a
s 1- '
, extension. Describe: 1 Page 2 1 2
-
Business name: 7 h 0c �� � J
Address: ) p Each additional inspection over allowable in any of the above
Lt.L6 UCt14...)0 .57. /
DO Per inspection 62.50
O City/State /ZIP: G rLe___S /4.74 /''l 0/7 97 p Investigation per hour (1 hr min) 62.50
r ( Phone: (y—p ;) &, &,G,5" y'Oc) Fax: (.5583) 6 65 ys-3 c> Industrial plant per hour 73.75
n( 7- -/ _ Vs- ELECTRICAL PERMIT FEES* a
i CCB Lic.: l $o i - Electrical Lic.: Z.. //i 7G�Suprv. Lic.: 32) LE A Subtotal 7,5-
Suprv. Electrician signature, required: „ /e_ / ' i! Plan review (25% of permit fee)
Date: l State surcharge (8% of permit fee)
Print name:
� L�.�J ..4--
" � 4... ,-.�� as z / y ! D � TOTAL PERMIT FEE j '-- Authorized signature: 10r1 This permit application expires if a permit is not obtaine within 180
` days after it has been accepted as complete
Print name: 57z-Lie--A} ����� vs Date: 2.1F/06, • Fee methodology set by Tri ^ County Building Industry Service Board
CITY OF TIGARD
BUILDING DIVISION
PERMIT #: ELR2006
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 20
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 7J1O/2006 TIME: 7:Ct4AM PAGE: 40
SITE ADDRESS: 10200 SW GREENI3URG RD 150 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTERIFIVE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: FIEL.DSTONE MORTGAGE
DESCRIPTION: Voice and cabling.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: PROGRESSIVE TELEPHONE SYSTEMS PHONE #: 503•665-4900
Inspection Request Scheduled For: Date: 2/10/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 V Low voltage Ca jt 026673-01 503-969-3773
Corrections/Comments/Instructions:
tvAt3 5 Mc )4,0T L 0(v Ca)1,110, N L rYt-
PASS I PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
0 FAIL 0 CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
.(ztA_L
Inspector: • " Date: -/c7 ( Phone #: (503) 718-