Permit . CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
Aro , , , . ,1 DEVELOPMENT SERVICES PERMIT #: ELR2005 -00415
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13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/17/2005
PARCEL: 1 S 135AB -03400
SITE ADDRESS: 10260 SW GREENBURG RD 160 ZONING: C -P
SUBDIVISION: LINCOLN CENTER /LINCOLN TOWER LOT: 014 JURISDICTION: TIG
Project Description: Data /Cabling. Job #15055.
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:
EQUITY OFFICE PROPERTIES TRUST COMMWORLD OF PORTLAND
ONE SW COLUMBIA ST #300 5711 SW ARCTIC DRIVE
PORTLAND, OR 97258 PO BOX 3675
BEAVERTON, OR 97005
Phone: Phone: 503 -520 -1220
Reg #: LIC 103916
ELE 26- 890CLE
FEES SUP 3541LEP
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 11/16/200E $75.00
[TAX] 8% State Surcha 11/16/200`. $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 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 rates adopted by he Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OA; • _- 001 -0101 ' . may obtain copids of these
rules or direct questions to OUNC at 503 - 246 -6699.
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Issued By: - 7 /) � Permittee Signature: -1!
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 `; , .' ' -- •
Received City of Tigard ® Date/By:/ ,
ar i 7 �✓ l/ �- Permit No.: _ yi
13125 SW Hall Blvd., Tigard, OR 97223 y
g Plan Review
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Phone: 503.639.4171 Fax: 503.598.1960 ry Date
Inspection Line: 503.639 -4175 NUV 1 l 2005 ..,...161-41! ® ( B Other Permit:
Date ReadyBy• E See Page 2 for
Interne[ www.ci.tigard.or.us Notified/Method • Supplemental Information
CITY OF TI(tARD
, 1: , M ,5 ..r:..?. _ -P ykl°.. � . r uil. uc l s . ..., -. " " " ", ", , : z PLAN , REVIEW U -
❑ New construction /Addition/alteration/replacement Addition/alteration /replacement Please check all that apply
❑ Demolition I ❑ Other: Service over 225 amps, comm'l Hazardous location
Service over 320 amps — rating ['Bulldog over 10,000 sq. ft.,
.�l g . Z WA k' CATEG O F•$CONST R UCTION` '? -. of I- and 2- family dwellings 4 or more new residential
�u ors � � s..- � a .. � °� � �, �� �_,.�,,�» , �..� �_ ..,; ..��,�m ._ , > .� , e. �- wri.�.�.7
❑ 1- and 2- family dwelling X Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi family ❑Master builder ❑ Other: ['Building over three stones ['Feeders, 400 amps or more
r r:.., ° ,< ,r,, -emu >,z.._ PE I persons red structures or
['Occupant load over 99 e ['Manufactured
� r�= JOB'.1SPN 'FORMATION = ANDk L OGA'I' I ON ` - ❑E ess /li htin Ian RV park
. s. .:.:3.� -.,� S.��.� d.e: v_ ,,:.� ,t��.ts- xr�,,, , s 6, _ _k- �.��, ..�4s,a �. � �,�� . _ a ,z�,. _�_ e i'� g g p
Job no.: 15055 Job site address:1 0 2 6 0 SW Greenburg Rd . ❑Health -care ofp ay ['Other:
g Submit 2 sets of plans with any of the above.
City/State /ZIP: Ti •ard OR 9 7.2 3 3 The above are not applicable to temporary construction service. •
Suite/bldg./apt. .s .:1 60 , . O Projectname:Kelly Services `f,> i``° ,; , : .= a�'�yFEE* _S`e itiliP E_`V I'..' `' -
Description w Qty. Fee. Total
Cross street/direc ins to job site: Lincoln Towers New residential single- or multi - family dwelling unit.
Includes attached garage.
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 75.00 2
Limited energy, non - residential 75.00 2
4 4 : i -vim" ? "i "r S
ECR OF WO R KS Is 3 sr �tl `" ' i , s P^ " 3 Each manufactured or modular
w %�a.tq,'11 _.� :.fi t . " , ", -. : _A �_ - � .te.�n. .,,. , a :oa.r,.
dwelling, service and /or feeder 90.90 2
Data Network Cabling Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
p " PRDEEItTY OWNE12 l t y W a ®TE AI VT ° °° 'g, 201 amps to 400 amps 106.85 2
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
relocation
Phone: ( ) 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 600 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
e ,,.�, r,.: a: l : ;f . x, -11 Sc ; .a'.� =t' l - r . r ..,.. :Tal >. , - i r
'"� � � r � � t �a ®"CONTAC,T;'PE'rRSOhC � A Fee for circuits with b
I� ❑ APPLICANT :" ..
�' t4. ` r �a z, m wM .�.�. ;s" ° ru:. :. .y
service or feeder fee, each 6 -65 2
Business name: CommWorld of Portland branch circuit
B. Fee for branch circuits
Contact name: Bob Olsen without service or feeder fee, 46.85 2
each branch circuit
Address: 5711 SW Arctic Drive Each add'I branch circuit 6.65 2
City /State /ZIP: Beaverton, OR 97005 Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( 503) 520-1220 Fax: : (503 ) 646-0235 Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited -
> DItl'a r.. ; `tat _ . _ l.: ktiNtT;RACTO$' . ,_." 14„ :. ," t .:i... t' i}r .. ...g-'x energy panel, alteration, or
extension. Describe: Page 2 2
Business name: CommWorld of Portland
Address: 5711 SW Arctic Drive Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State /ZIP: Beaverton, OR 97005 Metro: 5276 Investigation per hour (l 62.50
Phone: (503)520-1220 Fax: (503 ) , -12 .0 Industrial plant per hour 73.75
b ;7,: l ' ",'`' ELECTRICAL -FEES* - j _
CCB Lic.: 103916 Electrical Lic - , 89 I, I . V. Lic.: ;/-91 1476 Subtotal 7 C
Suprv. Electrician signature, required: A Plan review (25% of permit fee)
� �� 44 State surcharge (8% of permit fee)
l—J 6
Print name: i 2 ��/1i't . -. 6. -. I j 7/() i a.
T OTAL PERMIT FEE �) 60
Authorized signature: This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete
Print name: Bob Olsen - Date: 11/17/05 ' Fee methodology set by Tri- County Building Industry Service Board
" Number of inspections per permit allowed.
i:\ Building \Permits\ELC- PemtitApp doc 12/03 440- 4615T(10 /02 /CODI/WEB
Electrical Permit Application - City of Tigard -
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL RWROntiq. '. ltai ;gp, :
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
n Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
Fee for each commercial system $75.00
(SEE OAR 918 -260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
•
❑ Boiler Controls
❑ Clock Systems
X .
Data Telecommunication Installation
❑ Fire Alarm Installation
(l HVAC .
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
n Outdoor Landscape Lighting*
❑ Protective Signaling
Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I \ Budding \Perrtuts\ELC- PenmitApp.doc 04/03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005 -00415
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/17/2005
Phone: (503) 639- 4171H
Inspection Requests (24 Hrs.): (503) 639 -4175 `�f L..
INSPECTION WORKSHEET FOR DATE: 11/22/2005 TIME: 7:02AM PAGE: 97
SITE ADDRESS: 10260 SW GREENBURG RD CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER /LINCOLN TOWER LOT #: 014 TYPE OF USE:
PROJECT NAME: _ELLY
DESCRIPTION: D "'abIing. #15055.
OWNER: EQUITY OFFICE ROPERTIES TRUST, PHONE #:
CONTRACTOR: COMMWORLD OF 1TRTLAND PHONE #: 50:520.1220
Inspection Request Scheduled For: Date: 11/22/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Lb. _a+0 022164 -01 503-520-1220 N
. rrections / Comments/ In uctions:
•
\\\
K PASS ❑ PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �' 146 611 1 Date: I `//i or Phone #: (503) 718- VIA
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