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Permit
,_ REST ,,v CITY OF TIGARD RESTRICTED E NE G - RESTRICTED ENERGY r E� l li ' DEVELOPMENT SERVICES PERMIT #: ELR2004 -00342 '` 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/4/2004 SITE ADDRESS: 10220 SW GREENBURG RD 500 PARCEL: 1S135AB-01004 SUBDIVISION: TWO LINCOLN - TOWN OF METZGER ZONING: C -P BLOCK: LOT: JURISDICTION: TIG Project Description: Limited energy for data telecommunications. Job No. 606095 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 BROADWAY ELECTRIC - COCHRAN INC ONE SW COLUMBIA #300 626 SE MAIN PORTLAND, OR 97258 PORTLAND, OR 97214 Phone: 503 -412 -4800 Phone: 503 -6564 Reg #: LTC 72942 SUP 3447S ELE 37 -546C FEES Required Inspections Description Date Amount Low Voltage Inspection [ELPRMT] ELR Permit 11/4/2004 $75.00 Elect'I Final [TAX] 8% State Surchart 11/4/2004 $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 fol w- r.u.les adopted by the Oregon Utility Notification Center. Those rules are set •rth in OAR 95 -401 -0010 throw OAR 952 -001 -0100. You may obtain copies of these rules or direct questions to ill C at ,0.) 246 I 6699. Issu d by k , 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 1 4 C Electrical Permit Application . . . . . . .. . FOR OFFICE USE ONLY cit . .. A , Kw . A-a; P O e th nni er t P N erlt 6C9( -67° Plan Review 2- y Or Tigard 1,-) 6 13125 SW Hall Blvd., Tigard, OR 97223 RDeacte/Biveyd: Phone: 503.639.4171 Fax: 503.598.1960 4 :014 1 10. Date/B : Inspection Line: 503.639.4175 ;-3,J,,,g fr al i Date Ready/By: 121 See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: FIER Supplemental Information aAliiwmawirwimmarg 0: 7 l - 0 1 g 0 : T4Z.:taliM fatrA3p::T '' "gr'-! ' ' ' ',` . 6441, '' :16 - , : , °V#W-AlkWJIgW-4,'-iiU 1 W41 W 1- 1- 22: , --?:,; - : 4.4X01-1131::NYS2:W4,":*, ,t1WW7,;41. i.,1 , ,„) ' ,•, : ___ 0 New construction pAddition/alteration/replacement Please check all that apply: ['Service over 225 amps, comm'l Hazardous location I:1 Demolition El Other: , , ,_„,,,,,,,,. E Service over 320 amps - rating ElBuildng over 10,000 sq. ft., 0 '601 iiiidireik;= W W Aiii,,W: -htn5 oft - and 2- family dwellings 4 or more new residential ,,, .11A,me.a, •*-i. $:, ..1 4.1,:.. .Vg=,,,,,A. •:SZAK6., ,''' - , a'it. , .,; 4244 ID 1- and 2-family dwelling 2 111 Accessory building ES over 600 volts nominal units in one structure EBuilding over three stories ['Feeders, 400 amps or more 0 Multi 0 Master builder El Other: " ['Occupant load over 99 persons ['Manufactured structures or Fr gess 1 8 In8 0 E /1 ht • plan RV park •Il'AU,at-,''. : A^ ', ..S,AV`i agi ,°. ,,,',.., - 0 : ' ;N" , , ..--r, .6- , I EHealth-care facility DOther: Job no.: 6 Job site address: LL..jiic_ .07 7 Submit 2 sets of plans with any of the above. City/State/ZIP: -7- 0 ,, 2 ,d 01 , 0 ___ su coo The above are not applicable to temporary construction service. / Suite/bldg./apt. no.: Project name: Cery,_ o 6 Description Qty. Fee. :•S 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 azzinatv:.iiA!ar.7 Each manufactured or modular dwelling, service and/or feeder 90.90 2 . rP't- 5 Tot/ 1 ( V() ; C e ((f) 0.,--rci., C-A- re_ Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 lnalaritaiiiifitiMgiiV,4WEIWIVIREAtkiiiikkNYV'ilignA ' am to amps 201 ps 400 106.85 - 2 ' '' 4 .4 ' . ' ''''''"'">....""`'''''''''"•""'''' - ' 4 '''" ''' ' • '''''' 4 "" It '''"' - '''''''''''''''' 401 amps to 600 amps 160.60 2 Name: cr---a_o„e 601 amps to 1,000 amps 240.60 2 Address: I i- , 2 : -2_ 0 5 LA) GItt..-e 6e-44■1 Id Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City/State/ZIP: 1 0 0 4. Temporary services or feeders installation, alteration, and/or relocation Phone: (5'0 ) g z.3 i if I 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 , i .;.rayirblowitlotikm-,. 4 1-: weirz;•„511g0. A. Fee for branch circuits r with service or feede fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 2 each branch circuit Address: Each add'I branch circuit • 6.65 2 City/State/ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: ( ) Fax: : ( ) Sign or outline lighting 53.40 2 E Signal circuit(s) or limited- tM.1:fxl.'t,xaZw'Si*jrz:Iatgro:o:FtAooxg'::E;:::,I'k.:.;ltalm:toiv.,;Asz,:glf,- energy panel, alteration, or extension. Describe: 1 Page 2 15,06 2 i Business name: , c-c, ex14.1 c.......1 '''Ae--j7 i Each additional inspection over allowable in any of the above Address: (`"2.-C, S G V \-c.-..‘ .i■ Per inspection 62.50 ' City/State/ZIP: 1? ,,,,, 09, 'V'? 2_V-V Investigation per hour (1 hr min) 62.50 Phone: (63) .2-3(*- (9(4 Fax: (565 ) 2:32) - 2-ck S Industrial plant per hour 73.75 NAINIMPCCOMEAPARA:77 TRTit*r *p3i. CCB Lie.: -72_<20-2 Electrical Lic.:37-4(C. Suprv. Lie.: -1-kl.n. Subtotal . e a Suprv. Electrician signature, required: \. .._. C .4..... K --__ Plan review (25% of permit fee) State surcharge (8% of permit fee) 6 c 0 Print name: \e,... st \ .C \AIN. V C. Date: TOTAL PERMIT FEE E3 ( t 0 0 Authorized signature: This permit application expires if a permit is not obtained within ISO days after it has been accepted as complete Print name: Date: * Fee methodology set by Tri-County Building Industry Service Board ** Number of inspections per permit allowed. 13Building 3 PermitskELC-PermitApp.doc 12/03 440-4615T( 10/02/COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDE h IAL WQ o , Y araw . A Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: r O M1V ERCI L WOitk t NL,,IRi i t µ. ` ili a l Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Cloc Systems Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations is \ Building \Permits\ELC- PermitApp,doc 04/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested / I — /e AM PM BUP Location l C) Z 2-0 � Suite 5-6 d MEC Contact Person R 11YL/ Ph ( ) PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner AR. _4 _. _AWL" r i ELC Footing ELC Foundation Access: Ftg Drain ELR �Q Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: • Final PASS PART FAIL (,7 � t 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 C l-. t-4 , ()c 3 �, v UG /Slab Low Voltage I- -G 67 (a l' C j ©/ .7R fr / . Fire Alarm Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. 41WEDIP PART FAIL SITE. Please call fir reinspection RE: • ❑ Unable to inspect - no access Fire Supply Line / ADA // /� 7 Gl�iti /,S Ext Approach /Sidewalk Date Inspector b ' ` Other: Final DO NOT REMOVE this inspection record from site. PASS PART FAIL •