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Permit ELECTRICAL PERMIT -\ CITY TIGARD RESTRICTED ENERGY DEVELOPMENT H PMEIVa r S o ERV SERVICES 1 639 -4171 DATE PERMIT E1 24/003 -00333 13125 SITE ADDRESS: 10220 SW GREENBURG RD 540 PARCEL: 1S135AB 01004\ SUBDIVISION: TWO LINCOLN - TOWN OF METZGER ZONING: C -P BLOCK: LOT: JURISDICTION: TIG Project Description: Installation of limited energy for HVAC wiring. 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: EOP LINCOLN, LLC MCKINSTRY CO. 10260 SW GREENBURG RD 5400 NE COLUMBIA SUITE 100 PORTLAND, OR 97218 PORTLAND, OR 97223 Phone: Phone: 503 997 - 0234 Reg #: LIC 40981 ELE 26- 1190CLE FEES Required Inspections Description Date Amount Low Voltage Inspection [ELPRMT] ELR Permit 10/30/03 $75.00 Elect'I Final [TAX] 8% State Surchart 10/30/03 $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 irk is not st within 'h80.days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oreg la requires you to follow rules as lolled by the Oregon Utility Notification Center. Those rules are set forth in OAR 9:2 -00 -0010 throuc ued b T' e � / ' %� Permittee Signatu e }7 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 - I,, � `Electrical Permit Application �._ _ �R e - Ol l «h US C N1 Date received: 4,�� Permit no.: z . , 3.41,50V � , 1 , �I j l' : City of Tigard Prroject/appl. no.: Ex•ire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: ' M Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: �e--,019 // —QD C ' — . _ _ _ __ .,_ TYPE OF'PERMIT. ❑ 1 & 2 family dwelling or accessory )4Commercial /industrial ❑ Multi - family ❑ Tenant improvement ❑ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial ,. JOB SITE INFORMATION - Job address: /0 26) 5w &Ia. 7V &E"2v,.o Bldg. no.: Suite no.: 5 Tax map /tax lot/account no.: Lot: Block: Subdivision: 7j .) 6- //IIC:06. /L/ Project name: PAY TON- /v I -2 Description and location of work on premises: X./L/554-UP L6(. — VOLT /4 7 - A Z Estimated date of completion/inspection: / —/5" 3 CONTRACTOR. ,APPLICAT.ION. . , • , FEE SCHEDULE ' Job no: Fee Max Business name: 1 /N ST(Z co . Description Qty. (ea.) Total no.insp New residential - single or multi -family per Address: SLf sip NE • (J)M LvD dwellingunit . Includes attadiedgarage. City: 1 \J D State: 0 to ZIP: 9 - 7 # Servicemdudea: Phone: b3 33/, oz.-3 Fax: / (9 p / , 1000 sq. ft. or less 4 CCB no.: 240q E ( Elec. bus. lie. no: 24 > C LE Each additional 500 sq. ft. or portion thereof __ Limited energy, residential MIME 2 City/metro tic, no.: 1/7 Limited energy, non - residential ___ 2 /t�- � ' � CZY S /a -2-q--O? Each manufactured home or modular dwelling ■■. Signature of super(;ising electrician (required) Date Service and/or feeder 2 Sup. elect name (print): wNAlE moaeds' License no: Z2.'7 Services or feeders— installation, • alteration or relocation: ME PROPERTY OWNER ' 200 amps or less 2 Name (print): 201 amps to 400 amps ___ 2 Mailuikm address: 401 amps to 600 amps �M� 2 601 amps to 1000 amps a 2 City: State: ZIP: Over 1000 amps or volts ___ 2 Phone: Fax: E -mail: Reconnect only ___ t Owner installation: The installation is being made on property I own Temporary services or feeders - which is not intended for sale, lease, rent, or exchange according to installation, alterration,orrelocation: ORS 447, 455, 479, 670, 701. 200 amps or less 2 201 amps to 400 amps ___ 2 Owner's signature: Date: 401 to 600 amps — __ 2 ENGINEER . Branch circuits- new, alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 City: State: ZIP: B. Fee for branch circuits without purchase Phone: Fax: E of service or feeder fee, first branch circuit: ■■• 2 Each additional branch circuit: —__— PLAN' REVIEW (Please check all that apply.)" Misc . (Serviceorfeedernotincluded): ❑ Service over 225 amps- commercial ❑ Health -care facility Each pump or irrigation circle ME 2 ❑ Service over amps- rating of l&2 El location Each sign or outline lighting ::: ? family d ngs ❑ Building over er 100,000 sgtuire feet four or Signal circuit(s) o s) or a limited energy panel ❑ System over 600 volts nominal more residential units in one structure alteration, or extension ❑ Building over three stories ❑ Feeders, 400 amps or more {De scription: ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above: ❑ Egress/lighting plan ❑ Other: Per inspection __ Submit sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Permit fee S Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application ❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at %) $ Credit card number: I / within 180 days after it has beets State surcharge (8%) S Expires TOTAL $ accepted as complete. Name of cardholder as shown on credit card $ Cardholder signature Amount 44(1-4615 (6/1111WCOM) CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (563) 639 -4175 MST INSPECTION DIVISION - Business Line: (503) 639 -4171 tt BUP Received 11,2- I Z L` Date Requested f LZ5 M PM BUP Location / (9nn 2 2-0 e r Suite 5" MEC Contact,Person LLV Ph ( D 3) 337 C) 2 3 9 PLM Contractor 11 _Fes, S` - 1"1 CO Ph ( ) SWR BUILDING Tenant/Owner 1 Pa., rn. — Mr !Loy ELC Footing ELC Foundation Access: �(� Ftg Drain Ot. �+ ©D ,333 Crawl Drain Slab Inspection Notes: SIT Post & Beam . Shear Anchors Ext Sheath /Shear kit Sheath/Shear • Framing Insulation Drywall Nailing Firewall 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 Low Vol age ire Alarm 1 0210 PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE ❑ Please call for reinspecti.n RE: ( Unable to inspect — no access Fire Supply Line / / ADA Date C1 I ns e or ��1� i 4.4 Ext Approach/Sidewalk P Other: Final DO NOT REMOVE this inspection record from the Jo site. PASS PART FAIL