Permit A • CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00602
DEVELOPMENT SERVICES DATE ISSUED: 8/18/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S135AB - 01002
SITE ADDRESS: 10220 SW GREENBURG RD 417 ZONING: R - 12
SUBDIVISION: LINCOLN CENTER/THREE LINCOLN LOT : 009 JURISDICTION: TIG
Project Description: Cleanup and demo for shell space, (3) branch circuits. Job No. 946
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: 3 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 ST #300 PO BOX 230547
PORTLAND, OR 97258 TIGARD, OR 97281
Phone: 503 - 293 -2745 Phone: 503 - 624 -3631
FEES Reg #: LIC 75059
ri tion Date Amount SUP 34
Description - 28
p ELE 34 -283C
[ELPRMT] ELC Permit 8/18/2005 $66.80
[TAX] 8% State Surcharge 8/18/2005 $5.34 REQUIRED ITEMS AND REPORTS
Total $72.14
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Spedalty 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 fo •-- - than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are forth in O• - 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these s or direct questions to OUNC at
503 -246 .699 or 1- 800 -3 -23•
•
Issued =y: / Permittee Signat 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: /?6S-5
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.
AU . 18 2005 8: 09AM HP LFISERJET 3200 p. 2
EL e trical Peruait A v0 . FOR OFFICE USE ONLY
City of Tigard Gtr R ecei ved • - • PermitNo.:
13125 Hail Blvd., Tigard, OR 97223 p Plan Review
Phone: 501639.4171 Fax: 503.598.1960, . • l .'l ' .t) ` "" ' l ft\ Date/B tither Permit:
Line: 503.639.4175 OP ,„,„11.--, •`'1 ,,,, Date Ready/By: RI See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: � Supplemental information
TiC ARC
am ('a � +�Y�'��� 2a ��- � :� 1 { „ ,C •..�s, , :1�1, ai A•c- i)' "� A" ��" q .. i •; �^y'idt 3 K•;ie r i !,. �3'� '.�
,, � r• "r t 'F;T ,F ` " _ p�g� ,�> t; yr �!'- ::••�z'1;�, <z:.
pl aid ?" RM '- t N1 n J P"W 1 't1 i t� `{tt r t'A I�1'�e ._ '•691 i n ,}„, �,` -,'4�P �,` i; ' 1 '" k 's s fC :: ^. l * t .•- ,• _ , � .
.�., � r d.w., ,ll'�'. ` y ,�. ( k ii v%y` H. ��,�•�.; :, . ��.
❑ New construction 0 A; d Please check all that apply:
❑ Demolition El Other OService over 225 amps, comm'1 ['Hazardous location
f ^+ � r , rx flk. ,: f.h t raar rl l fist tl . lit.. r!,.,,jw k • �f ❑ of t - a eovef 2-family l rating ❑4ordngover residential
sq.
t *�4f 4 : ?i f �` l � �xn, ,. q al a ,T c7 �1 t ����,�� "$ `�y"' A,i # 3' icy i r Q
';! q . of 1 - and 2- family dwellings 4 or more new residential
�� ��� ��,_,. 9�M..:�.�7.__ _• ;,,�rg„a,,,.t�Sa _a�� l
❑ l- and 2- family dwelling [tCommercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Mu lti - fam ❑Master builder ❑ Other: ❑Building over three stories ❑Feeders, 400 amps or more
❑Occupant i load over tan 49 persons ❑Manufactured structures or
' ,rtu"f `' II ika3 it a°byk §'i"t' S a� !;:' {� ' �' 'CIS ° a�l���ir"� 3t b � � '�' l ❑E • ess,l trtin RV park
iy11 l U:.d ikle tlliftalii&I, Bill iii i , .:Paiikai ..1 , i ?i , U trout iA i : �.iiiinst . ` .' iih raalu S g P
+ + Job site address: zQ 1 ❑Health -care facility ❑Other: • Job no.: I Submit 2 sets of plans with any of the above.
City /State/Z1P: -"t S e 1 - c t Z es, / The above are not applicable to temporary construction service. •
Suite/bldg./apt na.3 -tn� Z to Project name: ` nErall T l u t c I^ _ ..
v si�:Cvaw c_%../ Deseriptinn Qty, Pee. Total
Cross street/directions to job site: 3 Li w ra /..� S'V L-{ 1 } 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. 11. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: /0/.35 4/1
i�� 0 1 t < " l . 13 i a v u Rt "'; gt lF �'p� , p n g ' �v pr f r , i L energy, non - residential 75.00 2
ts4;ls194 ryl W r sir :F "rg Ti l( . 1:t ii i u �Aa i ; 1 li i" au'i Each manufactured or modular
Q dwelling, service and /or feeder 90.90 2 .
-- ke.P {.rrt t./r g ..b.en -t.� Q t C '&& K'- .__- Services or feeders installation, alteration, and/or relocation
rt
200 amps or less 80.30 2
r ' '' t l * • ,U fir"" (! Tit "� i ' isk git.4� $ q , i + "sir s ,
y t ; yip i 201 arms to 400 amp& 106.85 2
i
' Itialkllia;",*„''tI i 1 `' ti , ts� .1.. r a � " t1ali .1-9 .- nl
'. a 'ii, ... � Y::,� a 160.60 2
401 amps to 600 amps
Name: 60 C Lt du ,c,c� � 601 amps to 1,000 amps 240.60 2
Address: \ Over 1 amps or volts 454.65 2
Reconnect only 66.85 2
City /State/ZIP: Temporary services or feeders installation, alteration, and/or
( .3) X93 _ A , 7 ` r- I ( ) relocation
Phone: J J F 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
gvi�, F 1 °� , m xt tairuy g i € j •, t tt � E t lu l ?r P x .aQ w1§F1= 6*i ;a} A. Fee for branch circuits with
° h ;! t lla ., - ,;. y i , l 1 ? k �n t at, .,;. Pi,t4 s? 1 ' A alt ga . " t ,i_ - i'..:,1 et «a
l M ' ' 113 r 7 . ' 7 l'?
�' service or feeder fee each
6.65 2
Business name: branch circuit .
B. Fee for branch circuits
Contact name: without service or feeder fee, ! 46.85 / r &S 2
each branch circuit
Address: Each add'l branch circuit 3 6.65 /'9 F.,:_ 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2 _
Phone: ( ) I Fax: ) Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
�> i ;+' ' tEil�llt�,i ��'" :��sY`" ( i' "I • • n r ; a u , i , . , .. a r` . •. energy panel, alteration, or
;�;,. rid .Iil�t,iC'. a ? iiri,.a._,3,� �i � l dual.af ..7.J.e.xLtxr1,.o.,��:_,I 1 " J
extension. Describe: Pagc 2 2
Business name: (A) t ( - I ki . v . -e , Fl et i n it ' e_
Address: Each additional inspection over allowable in any of the above
G I ,� �� C� `{ - Per inspection 62.50
City /State /ZIP: r � ,a. 6,t.. - 9 I 2 -I Investigation per hour (1 hr min) 62.50
5 Industrial plant per hour 73.75
Phone: ( S't ) 4,2,1k j - 3403 I I Fax: ( ) !�`t 2-1 3 S' imr l � nl ' p ' if�°t, gy p - . s �--,� ,;; .
CCB Lie.: 3'j c 4 ! Electrical Lic.: pi. 2 ,r3 C,1 Suprv. Lie.: (9 f s c ~ - Subtotal 4 `
•
Suprv. Electrician signature, required: Plan review (25% of permit fee)
.••1 permit . State surcharge (8% of pmit fee) 3 q
Print name: it r i. Date: i � , -
�r 11 ! TOTAL PERMIT FEE 7 2, ( y
Authorized signature: This permit application expires if a permit is not obtained within Ig0
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.
if 8u ilding\P ertoitslELC -P crnutApp.
tire t2J03 440 461 5T(I0ei/CoM/waB
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: ELG2005-00602
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/18/2005
Phone: (503) 639 -4171
Ata, n p�u4l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/15/2005 TIME: 7:03AM PAGE: 75
SITE ADDRESS: 10220 SW GREENBURG RD 417 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/THREE LINCOLN LOT #: 009 TYPE OF USE:
PROJECT NAME: SPEC SPACE
DESCRIPTION: Cleanup and demo for shell space, (3) branch circuits. Job No. 946
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #: 503- 2932745
CONTRACTOR: WILLAMEI I E ELECTRIC INC PHONE #: 503624 -3631
Inspection Request Scheduled For: Date: 9/15/2005 Pour Time:
Co e # Inspection Description Confirm # Contact # Message
139 Electrical final 015764 -01 503-624 -3631 N
Corrections /Comments/ Instructions:
PASS I I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: /Date: ? ' !6 ✓ Phone #: (503) 718 -