Permit S o'i a 107 4c11-t c6 de-K-17--/
C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00140
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/15/2007
PARCEL: 1 S 135AB -01004
SITE ADDRESS: 10220 SW GREENBURG RD 310 ZONING: C -P
SUBDIVISION: LINCOLN CENTER /TWO LINCOLN LOT: JURISDICTION: TIG
PROJECT: SHORENSTEIN
Project Description: Low voltage for 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 AMERICAN HEATING
ONE SW COLUMBIA #300 1339 SW GIDEON ST
PORTLAND, OR 97258 PORTLAND, OR 97202
Phone: Contact #: PRI 503- 239 -4600
FAX 503- 239 -7038
FEES Reg #: ELE 26- 993CRE
LIC 33135
Description Date Amount
[ELPRMT] ELR Permit 5/15/2007 $75.00
[TAX] 8% State Surchar€ 5/15/2007 $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 direct questions to OUNC at
503.246.66' • • .; 10.332. 44.
Issued :y: . ✓ III � Permittee Signature et(�
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 Application ff • FOR OFFICE USE ONLY
—
City of Tigard U 6 (EG,�Ai.a ° Received ed c D ; / /%) PemutNo.: � J 7C/0 1 v
13125 SW Hall Blvd., Tigard, OR 97223 Plan R
1 • V y�' II
Phone: 503.639.4171 Fax: 503.598.11A 1 5 2007 ,, . i& Deem Other Permit:
Inspection Line: 503.639.4175 -MO. Al' Date Read fB a See Page 2 for
g CITY O TIGARD Ready /By:
Internet: www.ci.tigard.or.us � Not ified/Method: Supplemental Information
an eOS Aee Pr MI 1
- ma : , v , l `. $ 8 � n i aps � "
� �t�.. -, .� ar�.r .. .a s,:n -- ;. XA:mow`:=_ - - ;, -,::.. ; �i 1 .
r x � ...'s.C �: F r'vr : � ; ..d yi' ". 'sk: Wi .A �' „ ,, .x S - - . 'Y r. .,.1 - - -�
❑ New construction 01, • ddition/alteration/replacement Please check all that apply:
[II Demolition • Other: ❑Service over 225 amps, comm'I ❑Hazardous location
" ID'mx ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
"€�. %lgeiNfWe ' ka ,w , . !It_ h ry . `. of 1- and 2-family dwellings 4 or more new residential
❑ 1 and 2 family dwelling Commerciallindustrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
['Building over three stories ['Feeders, 400 amps or more
❑ Multi family Master builder ❑ Other: Occupant load over 99 persons ❑Manufactured structures or
- •, S+t �' i:-. - S"'C ¢ i;y fFy'" .�_T' -T,° Y +. f i _ r' ,
.`'1.;8r }�3 X 1"' =, r >.s �az 0 , � nr ,.. ® i� T ❑Egress/lighting plan RV park
1 ❑Health -care facility Other:
Job no.: Job site address:
0 aaO 5-L t &r arLlatir e Submit 2 sets of plans with any of the above.
•
City /State /ZIP: U (Ck Of- • J The above are not applicable to temporary construction service. m
Suite/bldg. /apt. no.: 5t I Project name: SpVSF (l �� .
_ " J Description l Qty. I Fee. Total
Cross street/directions to job site: k u nn,e, a New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I 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
r s � -: 4 ®' ' s , k �,$ I Each manufactured or modular
Q u � + dwelling, service feeder 90.90 2
1
1 ` ` Services es or feeders rs installation, alteration, and/or relocation
0 t p 'T ' f f ')' l ; 1( 6 . • 200 amps or less 80.30 2
,�-,� e ,fir T a € r f 201 amps to 400 amps 106.85 2
- Crr d , 4, , .“� }' 5�t4o 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: ( ) (Fax: ( ) relocation
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 "'r T A.- Fee- for-branch circuits with -
service or feeder fee, each 6.65 2
Business name: p ( ( ual Wa" fl :O ( , branch circuit
+ 1 B. Fee for branch circuits
Contact name: a • Tl( it 1LJ.�! without service or feeder fee, 46.85 2
- -3G 3 e �, each branch circuit
'
Address: l a Each dd'1 brancch circuit 6.65 2
City /State /ZIP: 1 Y'-\- o- 'i J I 0 12_ - cii a o Miscellaneous (service or feeder not included)
e� )D.:01.4
°� Pump or irrigation circle 53.40 2
a3�
Phone:) () I Fax: : ( 6 �J g Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited -
1`- '' energy panel, alteration, or
extension. Desc be n' � L
1
Address: °) l a Page 2 2
Business name: All (1 1 I, � (A C . V I7
1 •'" " ci s e a; IQ D Each additiona inspection over allowable in any of the above
Per_ inspection 62.50
Cit State/ZIP: � l f 0 Fax. qi -- Investigation per hour (i hr min) 62.50
G�
( ) « <.
Phone: ( ) t `� (O U - � r��D Industrial plant per. hour 73.75
r n ,..,� , Q
aatk,�. ���II�:'E�� � ����,�. .. "'�,� !try ;'-
CCB Lic.: 33 t 3 5 Electrical Lic.: a 6q�3 (-(: Sup . Lic.: any 0 L Subtotal ?5 4,0
Suprv. Electrician signature, required: _ `s1. • �� Plan review (25% of permit fee)
Print name: "` C yr /
State surcharge (8% of permit fee) `f' .00
1 t v �d ( .0 n Date: �/ ti _ v7 TOTAL PERMIT FEE ,
Authorized signature: I , A ` /a, This permit application expires if a permit is not obtained within I80
■ days after it has been accepted as complete
Print name: a� U • o trt Date: 5.-1 ._-1 * Fee methodology set by Tri- County Building Industry Service Board
** Number of inspections per permit allowed.
1:\ Building \Pemvts\ELC- PcrmitApp.doc 12/03 440- 4615T(I0 /02/COM/WEB •
CITY OF TIGARD
Ah:
BUILDING DIVISION PERMIT #: ELR2007 -00140
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/1512007
Phone: (503) 639 -4171 t yliit
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/21/2007 TIME: 7:02AIVi PAGE: 47
SITE ADDRESS: 10220 SW GREENBURG RD 310 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/TWO LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: SHORENSTEIN
DESCRIPTION: Low voltage for HVAC
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 5/21/2007 Pour Time: .
Code # • •- 'en Description ,- Confir-m # Contact # Message
Low voltage 04\8656.001 503-519-05M N
orrections /Comments /Instructions: - �-- °
/(1
X PASS n PARTIAL APPROVAL ❑ CANCEL NO ACCESS
I I FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: , N L' Date: 5121 1 9 Phone #: (503) 718-141L