Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2005 -00244
X111 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/24/2005
PARCEL: 1S135AB-01004
SITE ADDRESS: 10220 SW GREENBURG RD 150 ZONING: C -P
SUBDIVISION: LINCOLN CENTER /TWO LINCOLN LOT: JURISDICTION: TIG
Project Description: Phone and 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 OMNI WIRE INC.
ONE SW COLUMBIA #300 15621 SE MORRISON
PORTLAND, OR 97258 PORTLAND, OR 97233
Phone: Phone: (503) 906 - 6356
Reg #: LIC 151222
ELE 26- 1132CLE
FEES SUP 3525JLE
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 8/24/2005 $75.00
[TAX] 8% State Surchart 8/24/2005 $6.00
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� S01 -0100. You m > ,.btain copies of these rules or direc questi• to OUN at 503 - 246 -6699.
Issued By: �i — �� Permittee Signatur . '
OWNER INSTALLATION ON
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 Ap ewi q t FOR:OI l ICE: USE: ONLA
Rece ived
City of Tigard Permit No.
13125 SW Hall Blvd., Tigard, OR 97223 AUG 2 4
Date/ Rev c2 /r i _� "t�U j'
2005 Plan Revte ■
Phone: 503.639.4171 Fax: 503.598.1960 Gu'r..v:Ar ari,.. I'°'`- Date/By. Other Permit:
Inspection Line: 503.639.4175 o'I Date Re adyBy: s: 0 See Page 2 for
Internet: www.ci.tigard.or.us CITY P TIGARD Notified/Method: \ ` Supplemental Information
TYPE o1G K)Iv . - PLAN RE ,
❑ New construction Addition /alteration/replacement Please check all that apply:
❑ Demolition ❑ Other: ❑Service over 225 amps, comm'l ❑Hazardous location
OService 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 Commercial /industrial ❑ Accessory building 0 System over 600 volts nominal units in one structure
❑ Multi - family ❑ Master builder ❑Other: ❑Buildin over three stories ❑Feeders, 400 amps or more
DOccupant load over 99 persons ❑Manufactured structures or
JOB -SITE INFORMATION AND LOCATION . - ❑Egress/lighting RV park
Job no.: Job site address: — SCJ � .2ev.,�l5�2c 2() ❑Health - care facility DOther:
0.a...J7 Submit 2 sets of plans with any of the above.
City /State/ZIP: I. \6, (--a o • 0 ( —72,Z3 The above are not applicable to temporary construction service.
FEE* SCHEDULE
Suite/bldg. /apt. no.: 150 Project name: [ f) 2 t lt 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 energy, non - residential 75.00 2
DESCRIPTION OF WORK . Each manufactured or modular
fl--( Oo.e_ Sr ^ dwelling, service and/or feeder 90.90 2
p � ` 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
"1-7\--co � 401 amps to 600 amps 160.60 2
Name: (_ --- \ c',-1 e__ • 601 amps to 1,000 amps 240.60 2
Address: 1 Z s � 6,_,62, Q.P Over 1,000 amps or volts 454.65 2
C Reconnect only 66.85 2
City / State/ZIP: (-17G /►-2 a2 /�7 223 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 21 CONTACT P ERSON A. Fee for branch circuits with
. service or feeder fee, each
Business name: t ^ �� � branch circuit 6.65 2
Contact name: K e - �..J f B. Fee for service circuits fd
without service or feeder fee,
46.85 2
each branch circuit
Address: ( 1�e-S C
Each add'I branch circuit 6.65 2
City /State/ZIP: 0 1. UZ 9/0 I 3 Miscellaneous (service or feeder not included)
Phone: 0 ) 5 ( UCH Fax: : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited-
CONTRACTOR energy panel, alteration, or
• / } 2 extension. Describe: 1 Page 2 2
• Business name: 0 M N1 W1 4 (,
Address: IS6 2 I S t= /y
— I' / o (1 a, so,,) Each additional inspection over allowable in any of the above
' ^� � Per inspection 62.50
City /State/ZIP: fe,2.., j��> n 1..� ,, 1' j f 3 3 Investigation per hour (I hr min) 62.50
Phone: (603) 2( ( — B9 5 Fax: ( )
Industrial plant per hour 73.75
/�
ELECTRI_C_AL PERMIT FEES*
CCB Lic.: 1 S 12.2 2 Electrical Lic.: . _ 11 CLC Suprv. Lie.: 92.5 /�71 Subtotal
Suprv. Electrician e signature, required: / l Plan review (25% of permit fee)
Print name: ` Date: g ki / o State surcharge (8 %ofpermit fee)
fff TOTAL PERMIT FEE _9 I
Authorized signature:. i . This permit application expires if a permit is not obtained within 180
� days after it has been accepted as complete
Print name: e Date: 8 7iy / O S * Fee methodology set by Tri- County Building Industry Service Board
*• Number of inspections per permit allowed.
• i:\ Building \Pennits\ELC- PermitApp.doc 12/03 440- 4615T(10 /02/COM/WEB
Electrical Permit Application - City of Tigard
•
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
•
RESIDENTIAL.WORK.ONL'Y:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
n A _a r. _ o_._. __
r%uwv auu )Lcre0 ) NterCIS
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System *
El Vacuum Systems*
El Other: -
COMMERCIAL WORK ONLY:
Fee for each commercial system $75.00
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
El Boiler Controls
❑ Clock Systems
Data Telecommunication Installation
n Fire Alarm Installation
❑ HVAC
El Instrumentation
•
El Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
El Nurse Calls
El Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems: I
*No licenses are required. Licenses are required
for all other installations
\ Building \Pennils\ELC- PermitApp.doc 04/03
CITY OF TIGARD
l BUILDING DIVISION PERMIT #: ELR200f -00244
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/24/2005
Phone: (503) 639 -4171
A q � I
Inspection Requests (24 Hrs.): (503) 639 -4175 `'' �..
INSPECTION WORKSHEET FOR DATE: 9/8/2005 TIME: 7:09AM PAGE: 61
SITE ADDRESS: 10220 GREENBURG RD 150 CLASS OF WORK:
SUBDIVISION: LINCOL CENTER/TWO LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: TICOR TI
DESCRIPTION: Phone and d '.a.
OWNER: EQUITY OFFIC 'PROPERTIES TRUST, PHONE #:
CONTRACTOR: OMNI WIRE INC, PHONE #: (503) 906.6356
Inspection Request Scheduled For: Date: 9/8/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 volta 015167 -01 971-506-1300 N
tyc, F-- Ob.L
Corrections /Comments ns ructions:
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL n CA L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: ! I or Phone #: (503) 718-
CITY. OF TIGARD •
BUILDING DIVISION PERMIT #: ELR 006 00244
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/242006
Phone: (503) 639 -4171 .. ug
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/2/2005 TIME: 7:07AM PAGE: 86
SITE ADDRESS: 10220 SW GREFNI3URG RD 160 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/TWO LINCOLN • LOT #: TYPE OF USE:
PROJECT NAME: TICOR TITLE
DESCRIPTION: Phone and data.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: OMNI WIRE INC PHONE #: (J03) 906 -6356
Inspection Request Scheduled For: Date: 9/2/2005 Pour Time:
Code # Ins l escription Confirm # Contact # Message
• • a • e 014816-01 971-606-1300 Y
� I' C � rt�e C ti8ns /Co is ns r c 'ens:
e.e/v /IL h 1 o
Ce
9. ' "8- oi
FNLL a ■
PASS ❑ PARTIAL APPROVAL n CANCEL I I NO ACCESS
❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
/ /
Inspector: �r..gAit i__— 1 Date: 9 " O-. Phone #: (503) 718-
® TIGARD 1• _. ,.
B ` �. G DIVISION PERMIT #: ELR2005-00244
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 8/24/2005
Phone: (503) 639 -4171 lu iiq� � I
Inspection Requests (24 Hrs.): (503) 639 -4175 ...' L.
INSPECTION WORKSHEET FOR DATE: 8/31/2005 TIME: 7:03AM PAGE: 63
SITE ADDRESS: 10220 SW GREENBURG RD 150 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/TWO LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: TICOR TITLE
DESCRIPTION: Phone and data.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: OMNI WIRE INC. PHONE #: (503) 906 -6356
Inspection Request Scheduled For: Date: 8/31/2006 Pour Time:
Code # Inspection Description ' en i Contact # Message
135 Low voltage 01467 01 971 -506 -1300 N
Corrections /Comments /Instructions:
? KtV % Dg (\c-c 5 A ?)avt e;gv LI 1 N c ,„
L0.. . A 0 1 14 1 ►NA\ Nit,
I PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CAL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
71,
Inspector: ` Date: I Phone #: (503) 718- 2ili