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Permit CITY TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT DEVELOPMENT SERVICES PERMIT #: ELR2006 -00220 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/14/2006 PARCEL: 1 S135AB -00900 SITE ADDRESS: 10200 SW GREENBURG RD 340 ZONING: C -P SUBDIVISION: LINCOLN CENTER /FIVE LINCOLN LOT: JURISDICTION: TIG Project Description: Voice /Data. 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: 503 -412 -4800 Contact #: PRI 503- 722 -8084 FAX 503- 722 -9914 FEES Reg #: ELE 3- 414CLE LIC 116188 Description Date Amount [ELPRMT] ELR Permit 9/14/2006 $75.00 [TAX] 8% State Surcha 9/14/2006 $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 direct questions to OUNC at 503 - 246 -6699. Issued By: "� 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. f 1Electrical Permit Application_ Foa.orl l cl use ONLY. Re . � City of Tigard Date/B : --/ - I . i Permit No.: '-- C,, 14 'I Ai 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ,' C Phone: 503.639.4171 Fax: 503.598.196 E P 1 4 2006 Date /By. Other Permit: TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: WM H See Page 2 for Internet: www.tigard- or.gov Notified/Method: Supplemental Information R1111 DING DIVISION TYPE OF WORK PLAN REVIEW • El New construction Addition/alteration/replacement Please check all that apply (submit 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 0 Emergency system. larger separately derived system. • ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.: Job site address: 5 )d l Six o or more residential R occupancy. Recreational t �Z00 �'�� ❑ Six or more residential units. ❑Recreational vehicle parks. City /State /ZIP: ❑ Health - care facilities. ❑ Supply voltage for more than � ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: j yQ Project name: R c. /t/ 7 /GO ❑ Service or feeder 600 amps or more. • FEE SCHEDULE Cross street/directions to job site: 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 Tax map /parcel no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) Limited energy, multi - family 75.00 2 Up /` C - /'(2.1 >L4 � 4.47A., residential (with above sq. ft.) Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 0 PROPERTY OWNER ❑ 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 ❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 6.65 2 each branch circuit Business name: B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 2 first branch circuit Address: Each add'l branch circuit 6.65 2 ' Miscellaneous (service or feeder not included) City /State /ZIP: Each manufactured or modular dwelling, service and/or feeder 90.90 2 Phone: ( ) Fax: : ( ) Reconnect only 66.85 2 E - mail: Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting 53.40 2 Business name: !e a.r � / Signal circuit(s) or limited - 9 I L "7 G energy panel, alteration, or Address: 1 fi x Z z_2, 7 extension. Describe: / Page 2 2 0 City /State/ZIP: d O, t /a, o! ! 9rl r'7 2— Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: (52",) 7 Z 2.-cira may' Fax: (5'o,3) 72_ z_ 4, ? / ' Investigation per hour (1 hr min) 62.50 • CCB Lic.://67 5-7' Electrical Lic.:3-y/Yy4 - Suprv. Lie.: •75-L L--,4 Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: • Subtotal: 75 -,- oQ Print name: /,, -,/ /905 �,/ Date: /l t1/4"6.— Plan review (25% of permit fee): State surcharge (8% of permit fee): 6' . ©O Authorized signature: TOTAL PERMIT FEE: " 7 ., oe . This permit application expires if a permit is not obtained within 180 Print name: / 4 7 ps .. 2G Date: ` /• O 6' days after it has been accepted as complete. * Number of inspections allowed per permit. 1:\ Building \Permits\ELC- PennitApp.doc 05/23/06 4404615T(11/05 /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTTAL, WORK ONLY: M . Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY .: . Fee for each commercial $75.00 system (SEE OAR 918 - 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems Data Telecommunication Installation • ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: G *No licenses are required. Licenses are required for all other installations • I:\ BuildingPermits \ELC- PermitApp.doc 03/23/06 CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2006-00220 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/14/2006 Phone: (503) 639-4171 I1 ` Inspection Requests (24 Hrs.): (503) 639-4175 ..4.4. - '''-..... INSPECTION WORKSHEET FOR DATE: 9/29/2006 TIME: 706AK4 PAGE: 30 SITE ADDRESS: 10200 SW GREENBURG RD 340 CLASS OF WORK: SUBDIVISION: LINCOLN CENTER/FIVE LINCOLN LOT #: TYPE OF USE: PROJECT NAME: PNW TELCO DESCRIPTION: Voice/Data. : OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #: 503-411480g CONTRACTOR: TELEDIGIT INC PHONE #: 503 Inspection Request Scheduled For: Date: 9/29/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 037400-01 503-784-3859 Y Corrections/Comments/Instructions: . : • 9 PASS n PARTIAL APPROVAL n CANCEL n NO ACCESS I FAIL I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: Ctt 1\) 68 1 - Date: 912. Phone #: (503) 718 CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2006-00220 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/14/2006 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 ... INSPECTION WORKSHEET FOR DATE: 9/18/2006 TIME: 7:01AM PAGE: 22 SITE ADDRESS: 10200 SW GREENBURG RD 340 CLASS OF WORK: SUBDIVISION: LINCOLN CENTER/FIVE LINCOLN LOT #: TYPE OF USE: PROJECT NAME: pNW TELCO • DESCRIPTION: Voice/Data. OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #: 503 CONTRACTOR: TELE.DIGIT INC PHONE #: 503 Inspection Request Scheduled For: Date: 9/18/2006 Pour Time: Code # Inspection Description • Confirm # Contact # Message 135 Low voltage 036696-01 ' 503-7B4-3859 Corrections/Comments/Instructions: 4 NIZ1 CatRa.s_ ' 4I PASS fl PARTIAL APPROVAL CANCEL NO ACCESS I I ' n CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: Q q)sei LE° Date: I( (4 Phone #: (503) 718- 1 44 „ _ •