Permit y -
CITY OF TIGARD
I N
ELECTRICAL RESTRICTED ENERGY PERMIT
= C OMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00126
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/27/2008
PARCEL: 1 S135AB -01004
SITE ADDRESS: 10220 SW GREENBURG RD 600 ZONING: C -
SUBDIVISION: LINCOLN CENTER/TWO LINCOLN LOT: JURISDICTION: TIG
PROJECT: FARMERS INSURANCE
Project Description: Installing (1) low voltage data system.
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:
SHORENSTEIN REALTY SERVICES COCHRAN ELECTRIC
ONE SW COLUMBIA #300 BROADWAY ELECTRIC -
PORTLAND, OR 97258 626 SE MAIN
PORTLAND, OR 97214
Phone: 503- 412 -4800 Contact #: PRI 503- 234 -6564
FAX 503- 238 -2098
Reg #: ELE 37 -546C
FEES LIC 72942
Description Date Amount SUP 3447S
[ELPRMT] ELR Permit 5/27/2008 $75.00
[TAX] 12% State Surch 5/27/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
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 questions to OUNC at 503.246.6699 or 1.800.332.2344.
�� � Permittee Signature: - / Gtj
Issued By:
/ice %!�� _- ,
" ,
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.
Electrical Permit Application FOR OFFICE LSE ONLY
Cl of Tigard RECE E Received No t at e
City g 1 V Da[e/B : 5 F,L,e,4 ��`
III
13125 SW Hall Blvd., Tigard, OR 9722 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date(By: Other Permit: (/t / (xx) 79
luris: 1 See pa 2 for
7 1 G A R L) Inspection Line: 503.639 MAY 2 7 2008 N otiliei/Mel od: Su lemen Information
Internet: www.tigard -or.gov pp
TYPE OF W pft�q , • �+ n Pi AN.. R •:. . i - a ' = ' ' .;.
'Ls l X OF 1 av�� N Please check all that apply (submit 2 sets of plans w/items checked below):
❑ New construction E] Addition/alte�t� I ��VISI�IV ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. • . CATEGORY OF CONSTRUCTION .. exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 0 Commercial - use agricultural
❑ I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
y
Emergency system larger separately derived system.
JOB SITE .INFORMATION AND LOCATION ❑ Addition of new motor load of 0
Job no.: b 393' 3 Job site address: /07...743,9A) 6retjti 19Z,.08 gdc- 100HP or more occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: d.,,, ❑ Health -care facilities. 0 Supply voltage for more than
❑ Hazardous locations. 600 volts nominal-
Suite/bldg. /apt. no.: 6 Project name: I WG y
w S
l .s 1;e N J • ❑ Service or feeder 600 amps or more.
-.. -, . , ",,:-:,,'....•
... FEE SCHEDULE''.` .,_
Cross street/directions to job site: - Description 1 Qty. I Pee. I Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: - Limited energy, residential
75.00 2
y, . -`. t i i,:, t1 - :'- DESCRIPTION OF K
WOR', _x -_ ;;r = •.:" ' (with above sq. ft.)
1 7 _� 1 b g a Limited energy, multi -family 75.00 - 2
V V l�-vI ��`r/ � residential o al (with above installation, ft.)
Services or feeders instaltation, alteration, and/or relocatio
200 amps or less 80.30 2
".. ❑. PROPERTY OWNER?,' -: ;,. : : :.: ❑. TENAN_ T '..: ':' . ;.: : ". -, ;.1 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
.Address: • Over 1,000 amps or -volts 454.65 2
City /State /ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) 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 599 amps 133.75 2
Branch circuits- new, alteration, or extension, er panel
Owner signature: Date: A. Fee for branch circuits with
' ,, ❑. APPLICANT `:;:'• ` - :' .'`° :;. ❑ CONTACT PERSON;. ,; above service feeder fe
ce or eee, 6.65 2
I each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E - mail: Pump or irrigation circle 53.40 2
--
CONTRACTOR- ' :- . -: ' :. . .:.:. . ...:... ..... .::.`� a,: Sign or outline lighting 53.40 2
t_ f C Signal circuit(s) or limited -
Business name:
�,AA rA" � a �VLy C keL � energy panel, alteration, or 7S------
Address: 6Z i C5 ` extension. Describe: j Page 2 2
Cit /State/ZIP: T - I S cc_ g 7 If q Each additional inspection over allowable In any of the above
Per inspection 62.50
Phone: ( T') Z 3t4 -62 (.9(-L Fax: ('p3) Z 3 — 2....05 Investigation per hour (I hr min) ' 62.50
CCB Lic.: VgLi Elec trical Lie,:31 -59 Suprv, Lic.: We industrial plant per hour 73.75 ,ij ���� t / _ ELECTRICAL PE Suprv. ElecalYt�l'gniture, required: 7� l,tS l� Subtotal: -
75
Print name: ��_ `^ ^' � Date: 51 ct ` tf:9, Plan review (25% of permit fee):
State surcharge (12% of permit fee):
Authorized signature: TOTAL PERMIT FEE: 4 g . „---
Print name: Date: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
• Number of inspections allowed per permit.
1 ■Building \PermitslFLC- PermilApp.doc 05/23/06 440- 4615T( 1 1/05 /COM/WES
t• • . . .
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR20013-00126
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5127/2000
Phone: (503) 639-4171 isolp
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 6/18/2008 . TIME: 7:02A1v1 . PAGE: 59
SITE ADDRESS: 10220 SW GREENBURG RD 600 CLASS F WORK:
SUBDIVISION: LINCOLN CENTER/TWO LINCOLN LOT #: YPE OF USE:
PROJECT NAME: FARMERS INSURANCE
DESCRIPTION: Installing (1) low voltage.fdata systern,_../
OWNER: SHORENSTEIN REALTY SERVICES, PHONE #: 503-412-4800
CONTRACTOR: COCHRAN ELECTRIC PHONE #: 503-234-6564
Inspection Request Scheduled For: Date: 6/18/2008 0. , Pour Time:
4 / .
Code # Inspection Description Confirm # Contact # Mes(Ce
195 Misc. inspection 071626-01 503-307-9413
2 tfj
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0 1. ks..
1/ ‘4; ..% C1V•44 __--- (%
orrections/Comments/IhsOctions:
--,.,, .....-------
....._
(leiii,ia.e_x,a7/ dZe,
44
-
,e) ,./ ----------------
ASS 7 PARTIAL APPROVAL fl CANCEL pi NO ACCESS
pi FAIL r7 CALL FOR INSP CTION 7 ADDITIONAL FEES ASSESSED
Inspector: 44 1 ,1—Aarie Date: -
"4110° Phone #: (03)78. °361-3
CITY OF TIGARD
• BUILDING DIVISION PERMIT #: ELR2008-00126
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/27/2008
Phone: (503) 639- 4171 anUll�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/27 /2008 TIME: 7 :01AM PAGE: 13
SITE ADDRESS: 10220 SW GREENBURG RD 600 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/TWO LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: FARMERS INSURANCE
DESCRIPTION: Installing (1) low voltage data system.
OWNER: SHORENSTEIN REALTY SERVICES, PHONE #: 503- 412 -4800
CONTRACTOR: COCHRAN ELECTRIC PHONE #: 503 - 234 -6664
Inspection Request Scheduled For: Date: 6/27/2008 Pour Time:
Code # Inspection Description 90 fn ri m Contact # Message
135 Low voltage 0171947 -01 503 - 307 -9413
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Cortectidns /Com t uctions:
N
\ A. \I\
\ v
TX PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 4 N O® Date: 4 2 Phone #: (503) 718- 29LfL.