Permit ELECTRICAL PERMIT
�%' CITY OF TIGARD„
PERMIT #: ELC2005 -00633
DEVELOPMENT SERVICES DATE ISSUED: 8/29/2005
5.11
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S135AB-04500
SITE 'ADDRESS: 10250 SW GREENBURG RD 212 ZONING: C -P
SUBDIVISION: LINCOLN CENTER /LINCOLN BLDG LOT : 001 JURISDICTION: TIG
Project Description: (4) branch circuits.
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 - 412 -4800 Phone: 503 - 624 - 3631
FEES Reg #: LIC 75059
Description Date Amount SUP
ELE 34-28
4 -283C
[ELPRMT] ELC Permit 8/29/2005 $66.80
[TAX] 8% State Surcharge 8/29/2005 $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. 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. _
Issued By: .Th. ,., Permittee Signature: , e — 0 .
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.
AUG 29 2005 8:07RM HP LRSERJET 3200 p.2
ri L�s1i�., °& K i1 PCrl p ICatIUI ,, ,x r xv FOR OFFICE USEO \EY �
City 4i 'Tigard �� f rr+nd�
��p Permit No. G
13125 SW Hall Blvd ; Tigard, „, ` E °" i Ja j r / �l - _ { �i lN , IN �
i ' IA.' ' cZ ^t t P.L'.
Phone: 503.639.41':`1 Fax: 503.� 1950 100 Ate,4 ^, dill „ +) i Da,,c/EY: CitherPermit:
Inspection Line: 503.639.4175
Internet www et ti rd.or.us P`` ,G 2 9 y' Nate Notified/Method:
lu s: F21 See Page 2 for
!' r 4v " N otthediMetln // �
Na ��� �� -- T CtifaR� T)t.L� Supplemental Information r' '' :a v' 1 11 S �.,ii {i . + ct. aq , t .i . * qrF �I •s "w 3.✓r, 1 ,,. ....Y. „._ . VV
F. t t 'h ikAZI LeMif it'ri s `a t^'.•' .- .r'~.'y ::}.n -m i �. .,..�: _
,.y ,'.. j���J�ki �.� € � y � �14:d� { � , � r a:�is4��a C�^,.ti.��t�;xc , ; 1 ° 3 µ�;� r. i� , a o ' �' f� �y} . •
El New construction q Ad b"n a • - ration/replacement Please check all that apply:
['Service over 225 amps, ccmm'i ['Hazardous location
❑ Demolition ❑Other
F l " lil as �m i :n , ,m .m y, �ra w ,� ^c‘ a„ s - . rating q.
" { : iaiii'U' l" .,k. a k s I t a . 1 ; g t,k�„ „� ' t . ❑Service over 320 a of l - and 2-family dwellitt s g ❑ 44 or m new residential
ore de ntial t
rt��`' : Y g
❑ 1- and 2- family dwelling ,K Commercial/ industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Huitding over three stories ❑Feeders, 400 amps or more
❑ Multi - family ❑ Master builder 0 Other:
a[� 1 = t 1 . ,{ '] v ru n s t {, t , @r a , ,,, , n, r a ., , ❑Occupant load over 99 persons ['Manufactured structures or
t 1 5.:R 1 nti... .,R? 4•�i.. �- li45, 4 t.. �* .:1.11 li' 1 �, ',cll t �!'; F � }4
.tx r f.3�slit)ac. ❑Egress /lighting RV park
Job no.: ?co lob site address: 0 2 . .t 01 facility DOther:
‚.- �. A. Subn it 2 sets of plans with any of the above.
City /State /ZIP: 'N The above are not applicable to to
1. 7,-.0.. ri OA 9 PP nrpariiry construction service.
Suite/bldg./apt. I Pro �n I ''� v i �` '" �'' i tats ti '
g� �' no.: z - ! Project � � Lt w C SC.f z I L .,�r,vx:�,�._,.,�..4�;,
Description Qty. Fee. Total
•
Cross street/directions to job site: va New residential single- or multi- family dwelling unit.
Includes attached garage.
. Lt r" c - Sv 2 / Z- 1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map/parcel no.: Limited energy, residential 75.0 2
r F ,r ti , a sip t r ill z ' z l uaa�G _ I „cz s i tnr + Limited energy, non - residential. 75.00 2
3 � a Ott:.:"L.gli -ka, i � �. a 1 ....6lt�.{„21 mo 2: 11 §1 :t'i�1`d: z Ft+ i . `. s lily •
a 2 :wvi_ l4 ei� . ..0 . ` Each manufactured or modular
L 24 ,,, 44 c)Asl l I/ dwelling, service and /or feeder 90.90 2
J Services or feeders installation, alteration, and /or relocation
200 amps or less 8030 2
4. 1' i
.; ii n if rifirii -iet ?,'�' ,.' t rsr ;l t ,r ,i se rno . - r to +i,' , i t rk _ -- 401 a 201 a ps to 400 amps 106.85 2
.. , _�i E .3 t. u� t t �.r..�aia z. )ti��{ir ' amps to 600 amps 160.60 2
Nye iiU y L , C -wL-* 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 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
I t1�+, ilb�me` r r i .£ -t,,: r+ q n ja �st .fi a - r 76 vlr+ r 't rd�` y"i�`Y` '� +'
all f 1* „ 1 ,f M1 Fi t i ' u 4 .i M s „ r i � r ,r 4 r I� r t u; ti A . Fee for branch circuits with
service or feeder fee, each
Business name: branch circuit 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee, t,
Address:
each branch circuit 46.85 y‘ f S 2
Each add'] branch circuit K? 6.65 if °f.2 , 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) I F es; ; ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail Signal circutt(s) or limited -
t'Nl h� xs' f Ala' a i 0 tfi x r ;,`� 7 +�,�"� z s 1 �i3 � o €' , 4' t } " -
ri' s riti ,�..�,a,°t .`r. a y , ' !,cr ilib` ' , ; ARKIE �iriga`rkagi energYPanel alteration, or
Business name: We �^ rr extension. Describe: Page 2 2
1 s 1+ A/AA,t (-1fiLjAIC fr.. L_-
Address: p z_ ���
Each additional inspection over allowable in any of the above
City /State/ZIP: � ',1
Per inspection 62.50
yt_n o d r'L- 9 I Z'O I Investigation per hour (1 hr min) 62.50
Phone: (�(j') ( _ 3 63 i Fax (5713) - 2- I Industrial plant per hour 73 75
pun `I�" u� t i 1 `t t I A °'s ".= . ; :r ! Y KK+ F : 7
CCB Lic.: 3c °v. < t ..:3
��G1 � 4 Electrical Lic.: fit.(, z L Su Lie.: Op 3
� f _ Subtotal . / / K �
Suprv. Electrician signature, required: .rti �� (8% Plan review (25% of permit fee) Y
Print name: Yr Date: _ z�� State surcharge (8 of permit fee) 5 y
TOTAL PERMIT FEE 7 2r , /
Authorized signature:
This permit application expires if a permit is n ot obtained within 180
Print name: Date: d ays a It h as b een a ccep ted as complete
Fe me set by Tti County Building industry' Service Board
'" Number of inspections per permit allowed.
i:\ Building \Permitst5LC- PermitApp.doe 12)03 440- 4613T(10)02ICOMfWEB
-.
CITY OF TIGARD
BUILDING DIVISION , • , - PERMIT #: ELC2005"00633
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/29/2005
Phone: (503) 639 -4171 /rudtlidi
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/15/2005 TIME: 7:03Am PAGE: 74
SITE ADDRESS: 10250 SW GREENBURG RD 212 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER /LINCOLN BLDG LOT #: 001 TYPE OF USE:
PROJECT NAME: S PEC SPACE
DESCRIPTION: ( branch circuits.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #: 503-412-4800
CONTRACTOR: VALLAME I I E ELECTRIC INC PHONE #: 503.624 -3631
Inspection Request Scheduled For: Date: 9/15/7005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 \j Electrical final 015764 -02 503- 624 -3631 N •
Corrections /Comments /Instructions:
,l► PASS I I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
ll III FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: D ate ' /,) ' (( Phone #: (503) 718-
..,