Permit .' ., CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00208
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/19/2007
PARCEL: 1 S 135AB -00900
SITE ADDRESS: 10200 SW GREENBURG RD 180 ZONING: C -
SUBDIVISION: LINCOLN CENTER /FIVE LINCOLN LOT: JURISDICTION: TIG
PROJECT: GROUP ONE LENDING
Project Description: Install limited energy data wiring twisted pair.
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 SUPERIOR TEL
ONE SW COLUMBIA ST #300 PO BOX 69599 •
PORTLAND, OR 97258 PORTLAND, OR 97239
Phone: Contact #: PRI 503 242 - 1543
FAX 503- 241 -3704
Reg #: ELE 26- 712CLE
FEES LIC 78741
Description Date Amount SUP 1664LEB
[ELPRMT] ELR Permit 6/19/2007 $75.00
[TAX] 8% State Surcha 6/19/2007 $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 direc • :stions to OUNC at 503. 6.6699 or 1.800.332.2344.
Issued : • if' • Permittee Signature: n
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.
''19 07 12:11p Superior Tel 503 -241 -3704 p,2
•
Eft, lead Permit Appticatio Fora OFFICE l SE ONLY -
City of Tigard ivEt Received
_ Datr1B d• i tI 1 � Permit No.: E • •f 0 D ,
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.19 N 1 9 2007 DateB : Other Permit so t �S � -- ' . ;
TIGARD Inspection Line: 503.639.4175 Date Ready/By: Iwis: 21 See Paget for
Internet: www.tigard - or.gov CITY OF TIGARD Notifcd/Method: ( " Supplemental Information
a
TYPE OF IIM L WSON PLAN REVIEW
❑ New construction ® Addition/alteration/replacement Please check all that apply (submit it 2 sets of plans w/items checked below):
❑ Service or feeder 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 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION
El Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A "E , "1 - ", "l - ",
Job no.: Job site address: 10200 SW Greenburg Road 1001 -IP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: Tigard OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 180 Project name: Group One Lending ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Lincoln Tower 5 Description I Qty. I Fee. 1 Total 3
New residential single or multi family dwelling unit.
Near entry door, back parking lot Includes attached garage
Subdivision: Lot no.: 1,000 sq. it or less 145.15 4
Ea. add'1500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. fr.) 75.00 2
Limited energy data wiring twisted pair Limited energy, multi family 75.00 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER 1 ❑ TENANT 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
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 599 amps 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPL ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
without service or feeder fee,
Contact name: first branch circuit 46.85 2
Address: Each add'] 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 Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: Superior Tel Signal circuit(s) or limited -
energy panel, alteration, or
Address: PO Box 69599 extension. Describe: 1 Page 2 75 2
City/State/ZIP: Portland OR 97239 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 242 -1543 Fax: (503) 241 -3704 investigation per hour (I hr min) 62.50
CCB Lic.: 78741 Electrical Lic.: 26 -712CL Suprv. Lie.: 1664LEB Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: 75.00
Print name: Vance Broady Date: 6/14/07 Plan review (25% of permit fee):
State surcharge (8% of permit fcc): 6.00
Authorized signature: . 2 7: TOTAL PERMIT FEE: 81.00
Print name: ' V p _c2.__ `v g j Date: This permit application expires if a permit is not obtained within I80
days after it has been accepted as complete.
t :\Buildingu'cr ts\ELC-Pcmni App.doc 05/23/06
• Number of inspections allowed per permit.
4401 ST(i 1(05 /CO&tlWEti
t
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00208
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/19/2007
Phone: (503) 639 -4171 A
Inspection Requests (24 Hrs.): (503) 639 -4175 favlt
_..
INSPECTION WORKSHEET FOR DATE: 7/5/2007 TIME: 7:03AM PAGE: 12
SITE ADDRESS: 10200 SW GREENBURG RD 180 C LASS OF WORK: �� 3)'710
SUBDIVISION: LINCOLN CENTER /FIVE LINCOLN LOT ##:- TYPE OF USE: - "-----, 7 7� a
PROJECT NAME: GROUP ONE LENDING _�`�
DESCRIPTION: Install limited energy data wiring twisted pair.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: SUPERIOR TEL PHONE #: 503-242-1543
Inspection Request Scheduled For: Date: 7/5/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
• 136. -.d.- a 051478-01 503-502-2595 N
Corrections /Comments /Instructions: --
j A)
PASS n PARTIAL APPROVAL n CANCEL I I NO ACCESS
I FAIL ❑ CALL FOR INSPECTION — ADDITIONAL FEES ASSESSED
Inspector: r Iv C% 1 Date: 1. &-• t Phone #: (503) 718- 1-414 •
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007- 00208
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/19/2007
Phone: (503) 639 -4171 i 11,1
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/3/2007 TIME: 7:03AM PAGE: 49 ,
SITE ADDRESS: 10200 SW GREENBURG RD 180 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER /FIVE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: GROUP ONE LENDING
DESCRIPTION: Install limited energy data wiring twisted pair.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: SUPERIOR TEL PHONE #: 503 - 242 -1543
Inspection Request Scheduled For: Date: 7/3/2007 Pour Time:
Code # Inspection Description - `Confirm,# Contact # Message • 135 Low voltage 051358 -01 503- 502 -2595 N
Corrections /Comments /Instructions:
sCio G23 0 LADQ (ZAc -: Cr. V- C 6 OD t •
PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL )4 CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector; ' N 6Z L Date: 1. • 3' 01 Phone #: (503) 718 -1A4)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00208
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/19/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/25/2007 TIME: 7:01AM PAGE: 17
SITE ADDRESS: 10200 SW GREENBURG RD 190 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER /FIVE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: GROUP ONE LENDING
DESCRIPTION: Install limited energy data wiring twisted pair.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: SUPERIOR TEL PHONE #: 503 -242 -1543
Inspection Request Scheduled For: Date: 6425/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 050869 -01 503-502-2595 N
Corrections /Comments /Instructions: -- -
'►= PAS ( f PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6v‘ Date: 1 6 1 Phone #: (503) 718- 1414)