Permit F
CITY T I G A R D ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2006 -00049
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 2/9/2006
PARCEL: 1 S 135AB -01004
SITE ADDRESS: 10220 SW GREENBURG RD 220 ZONING: C -P
SUBDIVISION: LINCOLN CENTER /TWO LINCOLN LOT: JURISDICTION: TIG
Project Description: Thermostat -HVAC.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: X PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
EQUITY OFFICE PROPERTIES TRUST
ONE SW COLUMBIA #300
PORTLAND, OR 97258
Phone: 503- 412 -4800 Contact #:
Reg #:
FEES
Description Date Amount
[ELPRMT] ELR Permit 2/9/2006 $75.00
[TAX] 8% State Surcha 2/9/2006 $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: i v Permittee Signature: , " C/ ' Cs� e �
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.
=-- 'Electrical Permit Appl' t_' i,:- oi ENEDA FOR OFFICE USE ONLY
•
City of Tigard DDateBre z/� 4- Permit No.: tl 6 op ce
13125 SW Hall Blvd., Tigard, OR 97223 FEB O $ 200', Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 / /� 6;i�y1'1 1 1 DateB Other Permit:
II
- .� ' t
Inspection Line: 503.639.4175 t' I Date ReadyBy: H See Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIG ' - ' p . Notified/Method: Supplemental Information
.3°^cw^-�- - g,;r.,,, ', 'iA F#se•.' 7 � , � Il'it - =rat :;,5. - , ^.:a:�nr'> -- - „a; ;., .: .;k:
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❑ New construction Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑ Other: • ❑Service over 225 amps, comm'l ❑Hazardous location
F e k Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
r ' ,0,_ T # GO t7 fl , : . : - ` � , of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2 family dwelling Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family ❑ Master builder ❑Other: ❑Building over three stories ['Feeders, 400 amps or more
, it ,„ , .. 7,-.. - ? -. ',•v. -r a s , ;mss .4 i 7,f .i �
r 'ice CAVd'Slil -' 1 O' ' 4 , T Oi t a- al : & ❑Occupant load over 99 persons ❑Manufactured structures or
['Egress/lighting plan RV park
. ,rf �� , .tsx..:.` -. nn ag+n;� :!as.a�.�, PSSaxr3y . � _�.k � r- �-,. �1.' - :
❑Health -care facility ❑Other:
Job no.: 1 Job site address: 1'4220 � �, /�
14220 V �r n �dt1 oe Submit 2 sets of plans with any of the above.
City /State /ZIP: " 7 « d ) a� ✓ ✓ ✓✓ The above are not applicable to temporary construction service.
atIrtA' dg. /apt. no. 2 Project name: s:w• :;ir;,;`.;`'- ;;
Descdptlon [ Qty. Foe. Total
Cross street/directions to job site: tA... 7 7 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
ads. s : ,�, A , �, �. , �4p =3 :' ''''O• Limited 'energy, non - residential 75.00 2
_-� � a,. .,.��., row _ - 4: ^� t ? -'- Each manufactured or modular
.. 1q dwelling, service and /or feeder 90.90 2
Ale/ �, �v •* f A..e4r Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
: ` �n �--r. f r M g :iig «'. Q � , "', ` . si ?sl -, e i, j - , ' . 201 amps to 4 00 amps 106.85 2
- ii
9 rr r - ...a 9 � .1-_ ..., , . e - � A s P r* 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
Phone: ( ) I Fax: ( ) relocation
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
x . 7 m ' 7;i'' ' ;'7. ' te, AVO A. _ " p rr t i f ; •,. A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: / / e , ep JC2,, A ctvi c l , branch circuit
B. Fee for branch circuits
Contact name:
p Ari,e , without service or feeder fee, 46.85 2
�r each branch circuit
Address:
ia 9 „se- .) Each add'l branch circuit 6.65 2
City /State /ZIP: 7 e , 7 4/ an d J are 972,02-- Miscellaneous (service or feeder not included)
r Pump or irrigation circle 53.40 2
Phone: ( �
) /a ,y6Q'' I Fax: : ( ) : - 241 Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited -
'Pra.,aE't - - -Y.rtNy "t.` fix.- x..z:xwxis :y..," �"'7• �'.: t p,- .�_" i:3'd5 .p: -.i4 #4+; a'�
z'�_ 'i-'_•--'.t' energy anel, alteration, or
a ?, ?v : <�y- =5 . £ - ^ NIgA I R sr w' w : n a s : ns P
extension. Describe: I. Page 2 2
Business name:
Address: � .5 9 S� 6a✓ c %.KJ r j�/. Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State /ZIP: - c,,,r> di cf, fo7d42,.. Investigation per hour (1 hr min) 62.50
Phone: ( 2. 3 9c, '6O I F ax: _ )05> Industrial plant per hour 73.75
f Subtotal ; : ,tll, "'SSY �.,EI E . WOMA)2 [3' ' FE, „s ;: is O
6- •6A3Ct.� p lay D'o -
CCB Lic.�� ) 3 Electrical Li Suprv. Lic.:
Suprv. Electrician signature, required Plan review (25% of permit fee)
Print name: I ` � 1// Date: �^ State surcharge (8% of permit fee)
�T C V(° T Oft Yj q a _� 6� TOTAL PERMIT FEE
Authorized signature: Y a... � This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: e A1„, ef..7 Date: 2 7_, to 6 " Fee methodology set by Tri- County Building Industry Service Board
"" Number of inspections per permit allowed.
i.\ Building 'iPem \ E 440-4615T(10/02/COW
WEB
12103 440- 4615T(10 /02/C0WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR 2006.00049
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/912008
Phone: (503) 639 -4171 + I I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR • DATE: 2 /2006 TIME: 7 :01A1v1 PAGE:
SITE ADDRESS: 10220 SW CREENE3URG RD 220 CLASS OF WORK:
SUBDIVISION: LINCOU \ CENTER/IWO LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: CAE No HWEST
DESCRIPTION: • � - herrnostat- VAC.
OWNER: EQUITY OFFI OFF PROPERTIES TRUST, PHONE #: 503-412-4000
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: \ Date: 2/23/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
'199 Electrical final 0273%01
503-7934001
00i N
Corrections /Com - - s ructions:
•
PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: as Date: 2 1 2, 3/ 6 6 Phone #: (503) 718- 1.4114,•