Permit g . CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00524
DEVELOPMENT SERVICES DATE ISSUED: 7/26/2005
��'�" � I111 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1 S 135AB -01004
SITE ADDRESS: 10220 SW GREENBURG RD 420 ZONING: C -P
SUBDIVISION: TWO LINCOLN - TOWN OF METZGER LOT: JURISDICTION: TIG
Project Description: T.I.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: . . CLASS AREA/SPEC OCC:
Owner: Contractor: •
EQUITY OFFICE PROPERTIES TRUST WILLAMETTE ELECTRIC INC
ONE SW COLUMBIA #300 PO BOX 230547
PORTLAND, OR 97258 TIGARD, OR 97281
Phone: Phone: 503 - 624 - 3631
FEES Reg #: LIC 75059
SUP 1965S
Description Date Amount .
ELE 34 -283C
[ELPRMT] ELC Permit 7/26/2005 $46.85
[TAX] 8% State Surcharge 7/26/2005 $3.75 REQUIRED ITEMS AND REPORTS
Total $50.60
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 or
1- 800 - 332 -2344.
i
Issued By: . 1 A ` Ar- - Permittee Signature: , v., e , -� e1
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.
JUL 25 2005 12:52PM HP LFISERJET 3200 p.2
. illectrical Permit Application FOR OFFICE. U ONLY
•
City of Tigard `
Bar K � 1 I� DateJBea
-- ‘c ✓� 0 ' ' ''Permit No.. ' Plan Review ' 13125 SW Hall Blvd., Ti a . 0 9 2 UU
Phone: 503.639.4171 Pax: 5I'!59$1960 . �.M "I'il \ D ate : Other Permit:
Inspection Line: 503.639.4175 5 � __� Date fteady/By: See Page z for
Internet: www.ci.tigard.or.us 3UL U Notified/Method: Supplemental information
lllltty' }y "cvk. k'F"..r�1 :1`. �,. i. rs �`sa �il�,f ° l
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' lr A l e ttifi { '�ti$J! f ..a�is i<oI l 1 *" I ?' r t r m . y , f il a t , tl1E. . s - ;.`x T, .. ; I
❑ I '
-=w a srL: ti"in' 1NF .�:�i �� ,t� � ' 4 p �'s . ry �,- ! 1�
� i h_+.,i.�'sLsu -.x t:::.'w�. i,k'f 1 73%'R ,.�L•: i d•fi.IL.C�. ;k Y,..,w s ✓Ns � :" y�j�y
New construction B s ;w A tl8rj/. ) ill e ' replacement Please check all that apply:
❑ Demolition Other: ['Service over 225 amps, comm'l ['Hazardous location
• �qto i 3 N ata yt r �.- . ['Service over 320 amps - rating ❑Bulking over 10,000 sq. ft ,
x "-s^ IHII:t i' 11,{�r s " r �M1 ' � I '�96�`. 0 :`At i t f til R'1.?)� 14 96 :
Illih 11,. a _1 - a ; ,i„ a_r tl. ,,,,. .s .a, ` 1,; ; "s", +Vii„ o I- and 2- fa dwe llings 4 or mo re new residential
❑ t and 2 family dwelling _A 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:
:. n t ® , t 'r' a t " t a = wa, , - s a ..,, ❑Occupant load over 99 persons . ❑Manufactured structures or
i l l 8 )' f ru t' ti k o n i t a t i t t tlr!" 1 1 ; :; s"p g T4
r � x � � �� I &,,,s:� . :��� � ! , . � � l� ` � �? , yv��� l�n: l; tli' hnt' �u, L "�rli� :��� 1�.'�.�+ifti' I �"�; ❑ESrass/lightingPlan RV park
Job no.: lob site address: 10 LZO S`w ❑Health care facility ['Other:
t .1.Gr L5 " . Submit 2 sets of plans with any of the above.
City /State/Z1P: 'r g u .r� The above are not applicable to temporary construction service.
t
` li 3 t w nro dl i1 g yi l'g. , ; ' 4 t ! D 'i`.:
Suite/bldg./apt. no.: 2 to I Project name: �, A cu, r h r L S S
�i� r�� , ..
Deteripdoo Qty. Fee. Total
Cross street/directions to job site: 2 L t k , „JLw StJ 2,( v 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
n H s ] z'i ltr �� it �'��y x : + r �a 6 t.1�71 Ht ' 77 9 rA1 j e{ tw r n dr tier 11 � 3p q I ail l i ' y -
' , it 1 , , �I i t., , ii li , :toId�Ntl °iT.1 i ,, t4 W1 " 7 f 4_ ;I qf o
r: - � r u� ,r a -1,11' ,. Each manu or modular
• dwelling, service and /or feeder 90.90 2
T P "" xx, e 1 (w /'f .. "' - Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
�"` -N i i r!r i i vA. ara�� ni,17gl"r! 111 iii ll . fil i'� 1? R tdtl'aii , 201 amps to 400 amps
r 106.85 2
la7 a. ` ' " t _ 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 seeps to 600 amps t 133.75 2
Owner signature: Date
Branch c'uruits - new, alteration, or extension, per panel
l ' ll + ifi 1 t i t lil lllll y y r en ds : Iii ,, v rid a u a li lete s ul.tis ls+sl��u �I r , A. Fee for branch circuits with
.
�pp ,, I t i ,iI t ,,„ al
�tkl ±3� ��'��' . i�� ' '� ,, Fau.FrC5na�s�av
Business name: service or feeder fee, each 6.65 2
branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 y g S 2
Address: each branch circuit
Each add'l branch circuit 6.65 2
City/State /ZIP: Miscellaneous (service or feeder not included)
Phone: ' Pump or irrigation circle ' 53.40 2
( ) Fax. ( ) _ Sign or outline lighting 53.40 2
E - mail
alitl ° � a a r 1 piy 1; ,r a�,'w'.,,p�'a ] ua � a Signal circuit(s) ar limited-
at c E t t€ ryy� {x �l' t it i •9 }y 1.1,':12 at It' I ',i�n 1A t ^ ` (`f iii r , ? i enerBY Panel, alteration, or
1���tf�lllt!i'�I !�t } ����'t�"+r••IR:��'�t- Yoh- r,�tSn b7h��tsuarrtll'��,,z}Ci.1S � S�Jt��' 't� �I�. ,
/ �p extension. Describe: Page 2 2
Business name: 49 t (l may. Q,, rd'f ,;> c /,r e
Address: $ Each additional inspection over allowable in any of the above
` x �'� �� Per inspection 62.5D
City /State/ZIP: 7- 5 1 , 1 t7 () ,,s In vestigation per hour (1 ]v min) 62.50
Phone:
( ) 624 _ 34, `3 i I Fax: (s-0 ' ) (c L`f 2 Industrial plant per hour 73.75
i' ri ,1t1.732P uifip" ill rn e I 4.19,1 ". :.7. t, ;,
CCB Lic.: .7� Q y - c ( Electrical Lic.: , z, � . 4 , .57...c ` Suprv. Lic i Subtotal � -
Suprv. Electrician signature, required: A r . Plan review (25% of permit fee) _
„....... ,- ' .../
Print name: (r+ ,�, Date: State surcharge (S% of permit fee) j 1
q t l"C. "ZS d \ TOTAL PERMIT FEE j , f
Authorized signature: This permit application expires tf 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.
is tBuilding PerniltApp.doc i1/03 440- 46]5T(te/oVcoM(WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005-00524
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/26/2005
Phone: (503) 639-4171 „ I ,\
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/29/2006 TIME: 7 :07AM PAGE: 69
SITE ADDRESS: 10220 SW GREENBURG RD 420 CLASS OF WORK:
SUBDIVISION: TWO LINCOLN - TOWN OF METZGER LOT #: TYPE OF USE:
PROJECT NAME: LA WEIGHT LOSS
DESCRIPTION: T.I.
OWNER: EOUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: WILLAMLI I E ELECTRIC INC PHONE #: 503 -624 -3631
Inspection Request Scheduled For: Date: 7/29/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 012438 -01 503 -624 -3631 N
Corrections/Comments/Instructions:
SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: D ate: - ,Z - - nip #: (503) 718-