Permit ELECTRICAL PERMIT -
C ITY OF TI GARD RESTRICTED ENERGY
-,
' DEVELOPMENT H BMEIVa Tigard, 639 -4171 DATE PERMIT
8/18/2004 00263
SITE ADDRESS: 10220 SW GREENBURG RD 201 PARCEL: 1S135AB -01002
SUBDIVISION: THREE LINCOLN -TOWN OF METZGER ZONING: R -12
BLOCK: LOT: 009 JURISDICTION: TIG
Project Description: Low voltage voice & data 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 TELEDIGIT INC
ONE W COLUMBIA #300 PO BOX 22287
PORTLAND, OR 97202 PORTLAND, OR 97269
Phone: 503- 412 -4800 Phone: 736 -3316
Reg #: ELE 3- 414CLE
LIC 116188
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 8/18/2004 $75.00 Elect! Final
[TAX] 8% State Surchar€ '8 /18/2004 $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 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699.
Issued by � ) Lii." 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 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Aug -18 -04 09 :13A P.
Eleetri.c l Permit Ap y '�i _ IVED -- FO1( 04FF1(y f til :0\I.A - -
Received ` _ N. / Permit No.: I [/
City of Tigard Date,B : , , G� � L 1r pi) 7 o _ ._ 1 3
13125 SW Hall Blvd., Tigard, OR 97223 I( AA 1 O T Plan Review
Phone: 503.639.4171 Fax: 503.598.196 1 v LOU �' 4*,
'"•?' Date/By: Other Permit:
hi�, l '
Inspection Line: 503.639.4175 I i Date Ready /By: iur la See Page 2 for
Internet: www.ci.tigard.or.us CITY OFTIGARD Notified/Method: / Supplemental Information
, .......... . n;a;u :::;,-
❑ New construction Ni Addition /alteration /replacement Please check all that apply:
ElService over 225 111 Demolition El Other:
c rating DBu d g over c l0 000 sq. t3.. amps
.,. :; ::: ;_ >;;'_: ::, ': »iii iii_-_;
i;,,t' : "Gili;y a;� � , i• ;s .�,..,,�,. ,. ❑ ofl/ and 2
r familydwellings 4 or more new residential
. .. ...•.:�•:: .........-. n . �' �•,. .,��i;is sii.Efna.p:.e:::::
❑ 1- and 2-family dwelling 0 Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
El Building over three stories :Weeders, 400 amps or more
❑ Multi - family ❑ Master builder ❑ Other:
persons EManufactured structures or
d l '.'S> i' ' : j :j; i?; 1i:. :IM r "Egress/lighting /lig RV park
µ lar•• ht p load over 99
Job no.: vii 54 L l Job site address: t )1 O -5 At Vi n . Za ❑Health -care facility ❑Other: _�
Submit 2 sets of plans with any of the above.
City /State /LIP: p `do O VI` The above are not applicable to tempor:ey construction service.
1���� I ia ;f ii i:: rr'siiti3r,.i.'" "7 r? ` If' � i'`:
Suite /bldg /apt. no.: Zvi Project name: (dW el Ai- Description I Qty. I Fee. I Total 1 '"
Cross street /directions to job site: \ „,1, 4 ,1„. ^ �#D U�c. New residential single- or multi- family dwelling unit.
Includes attached garage.
SW Grr4A 4- 1,04.,"54- 4- . 1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 l
Limited energy, residential 75.00 2
Wax map /parcel no.:
.... � :......... ..CRWTI .` ..F iii ° -' I I(' l ' �• w�,: rce LliSiz. � '�ii4 energy, or odular
75.00
...: ' � ... ... ....... :!R' i ?.:m. ..... ...,.. : ., .kt ,r,.r... �. manufactured mod 1
[IOW VD H L VO t G L a q�� a t (_ 1 N/i dwelling, service and /or feeder 90.90 2
�J t Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
. . ::; , 201 amps to 400 amps 106.85 2
. ... ❑ PROPER'.'.`.,...:: ;:; :.. ._
. _. .. ;; ,.,... - ..:. mi . ...
.,. �r r . • . , ' ,. . ,.,1 , ....,. 401 amps [0 600 amps 160.60 2
Name: �r�)k 0 t/t,AC 601 amps to 1,000 amps 240.60 2
Address: (0= G rec, l R • Sve .245t Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
• City/State/ZIP: ? AA� 612- l q� 7 3 Temporary services or feeders installation, alteration. and /or
5,3 / _ relocation
Phone: ( ) 10 A I Fax: ( ) 200 amps or less 66.85 I
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
0 r . : : - " +" ` :' ; <''"'°"' A. Fee for branch circuits with j
1 ' " ' " "" ' ' ' �`' service or feeder fee, each
Business name: "'r�` � � ` L • branch circuit 6.65 2
� _` � B. Fee for branch circuits
^
Contact name: Ye t C without service or feeder fee,
each branch circuit 46.85 2
Address: P 22.Z�7 Each add'. branch circuit 6.65 2
City /State /ZIP: ` dr k t Q I errun Miscellaneous (service or feeder not included)
Phone: () �'L l Fax: : ( ) 72.2 ° Sump or irrigation lig lighting 53.40 2
Sign or outline lighting 53.40 2
-
i e
E -mail: �O ter 1.4191+ . i
Q8
: :. . ... energy alteration, or
Signal panel, limited-
ion
:; ' .... ;.... ...
{
extension. Describe: ag 2 � �
• ensiun. P c 2
Business name: 't ``)::: t,ik trIC •
Address: pa g0 Z ZZ�S"1 Each additional inspection over allowable in any of the above
?C Per inspection 62.50
City /State /ZIP: ° Pari 9 Investigation per hour (I hr min) 62.50
Phone: ( ) F ax: ( ) ' plant per hour 5a3 "12Z - 5�3 7 Z 1°II� Industrial pla h 73.75
: .. :..,� .,1,.T.:::-�,.Ii .. ,,_ > ...
CCB I.ie.: 1'6 'tot Electrical Lic.:3 Supr . .:/'] � Subtotal / eV
r
Suprv. Electrician signature. required: � . 111 5��.1 Plan review (25% of permit fee)
(V \ , ] fi�e iJS Date: • is- State surcharge (8 %ofpetmit fee) Gou
Print name: V
1 TOTAL PERMIT FEE .b i
Authortled signature: This permit application expires if a permit is not obtained within 180 .. / 07, -- Z . ,.... ----
days after it has been accepted as complete
Print name: A '4, Date: F ee methodology set by Tri- County Building Industry Service Board
' •. Number of inspections per permit allowed.
i \auilding`.Pcrmil Lc- PermitApp.doc 12.03 440 - 46157(10 /02 /COMM'ER
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line.(503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 9 '� 7 AM PM BUP
Location l ? av t.1 .1..4 Suite c--/ MEC
Contact Person Ph (2_t _) 7 FY-- 41/4) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation .ELC
Access:
Ftg Drain ELR , 4/ ° 6 '3
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear W4N,
Framing
Insulation 1, • Pic / /A/ .
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
=Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan •
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
•
Low Voltage
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
ASS PART FAIL
❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Date � y � A -' ' "
Approach/Sidewalk �� l Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL