Permit it
CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
e n I DEVELOPMENT SERVICES PERMIT #: ELR2004 -00204
_1116. - ' " 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/14/2004
SITE ADDRESS: 10220 SW GREENBURG RD 350 PARCEL: 1S135AB -01002
SUBDIVISION: THREE LINCOLN -TOWN OF METZGER ZONING: R -12
BLOCK: . LOT: 009 JURISDICTION: TIG
Project Description: Relocate (4) t- stats.
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 MCKINSTRY CO.
10260 SW GREENBURG RD #100 5400 NE COLUMBIA
TIGARD, OR 97223 PORTLAND, OR 97218
Phone: Phone: 503 997 - 0234
Reg #: LIC 40981
ELE 26- 1190CLE
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 7/14/2004 $75.00 Elect'I Final
[TAX] 8% State Surchart 7/14/2004 $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 quest J OU. C at (503 46 -66 9.
J � • •
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 639 -4175 by 7:00 P.M. for an inspection needed the next business day
E .l Permit Application + } 'r" FOR OFFI USE O? L \ ` ,
Ke eeived 7
L .., ` igard Date/By: / / (Pi 136 Permit No.:,•••■ Q �t' _0049124/
""���
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review a v_ ��/
Phone: 503.639.4171 Fax: 503.598.1960 *r jl. Date/By: Other Permit:
Inspection Line: 503.639.4175 4 -.�11, Date Ready/By: tuffs: et See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: - t Supplemental Information
TYPE OF WORK PLAN .REVIEW
❑ New construction ® Addition/alteration/replacement Please check all that apply:
0 Service over 225 amps, comm '1 ❑Hazardous location
❑ Demolition ❑ Other: ❑ Service 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 ❑System over 600 volts nominal units in one structure
❑Building over three stories ['Feeders, 400 amps or more
❑ Multi - family ❑ Master builder ❑ Other:
DOccupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION . ' . ❑Egress/lighting plan RV park
❑Health -care facility ❑Other:
Job no.: Job site address: 10220 SW Green berg Road Submit 2 sets of plans with any of the above.
City /State/ZIP: Portland, OR 97223 The above are not applicable to temporary construction service.
FEE* 'SCHEDULE .
Suite/bldg./apt. no.: 350 Project name: Soft Source .
nescrlPrion I Qty. I Fee. Total ••
Cross street/directions to job site: Two Lincoln Center • New residential single or multi family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lincoln Center Lot no.: Ea. add'I 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
Relocate (4) thermostats / V dwelling, service and/or feeder 90.90 2
C►- . Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
201 amps to 400 amps 106.85 2
• • :0 PROPERTY. OWNER . . . . '❑ TENANT '' -, .
401 amps to 600 amps 160.60 2
Name: Equity Office 601 amps to 1,000 amps 240.60 2
Address: 10260 SW Greenberg Road Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State /71P: Portland, OR 97223 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
CONTACT PERSON . A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: Mcklnstry Co. branch circuit
B. Fee for branch circuits
Contact name: Clif Hazen without service or feeder fee,
46.85 2
each branch circuit
Address: 5400 NE Columbia Blvd Each add'I branch circuit 6.65 2
City /State/ZTP: Portland, OR 97218 Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: (503) 331.0234 Fax: : (503) 331.0234 Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited-
�: 3: energy panel, alteration, or
- � �,: >;� d °x ;:`CONTRACTOR' = �: �:,. !.:.;,!,:i.. i -,r - . � , �. . °,f" :•::
extension. Describe: Page 2 2
Business name: McKinstry Co.
Address: 5400 NE Columbia Blvd Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State/ZIP: Portland, OR 97030 Investigation per hour (1 hr min) 62.50
Phone: (503) 331.0334 a-' ELECTRICAL Fax (503.) 331.6906 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES *';.' `:' -'
CCB Lic.: 40981 a. Electrical Lic 26- 1190CLE Suprv. Lic.: 2274LEB Subtotal J f ' , 0,49 V' U
Suprv. Electrician signature, required: 0,1/1\12_ �z Plan review (25% of permit fee)
State surcharge (8% of permit fee) 4:, Od
Print name: kkAg N e- tw O (LfU 5 Date: 7 - 2 - 04
. TOTAL PERMIT FEE g � • 00
Authorized signature:. �7 , - — This permit application expires if a permit is not obtained within 180
f/ t�" 6 days after it has been accepted as complete
Print name: l t /�/ �� e v i l 7 -2-04 * Fee methodology set by Tri- County Building Industry Service Board
G ** Number of inspections per permit allowed.
CITY OF TIGARD 24 -Hour
BUILDING Inspection Lune: 403) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 7 - AM PM BUP
Location ) t 2 7i(.) Suite ast MEC
Contact Person Ph (20 �) v -/ D PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access:
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam —
Shear Anchors
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation H Yom- � flown.
Drywall Nailing I , //� �1/
Fire wall r t w
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
`ir 'I ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
a PART FAIL
SI 111 Please call for reinspection RE: ❑ Unable to inspect – no access
Fire Supply Line �ryj �Q �,p
ADA D ate 7 ` - i 8 0 Ins actor Ket-- 16 " ► 1 I ` Ext
Approach /Sidewalk P
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL