Permit 1 CITY OF TIGARD ELECTRICAL PERMIT
• q PERMIT #: ELC2007 - 00058
COMMUNITY DEVELOPMENT DATE ISSUED: 1/25/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 15135AB -03400
SITE ADDRESS: 10260 SW GREENBURG RD 200 ZONING: C -P
SUBDIVISION: LINCOLN CENTER /LINCOLN TOWER LOT : 014 JURISDICTION: TIG
Project Description: (3) branch circuits to split HVAC system. Job # 80.1838.
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: 2 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 TICE ELECTRIC
ONE SW COLUMBIA ST #300 PO BOX 15009
PORTLAND, OR 97258 PORTLAND, OR 97293 -5009
Phone: Contact #: FAX 503 - 872 -8290
PRI 503 - 233 -8801
FEES
Description Date Amount Reg #: ELE 26 -126C
[ELPRMT] ELC Permit 1/25/2007 $60.15 LIC 166
[TAX] 8% State Surcharge 1/25/2007 $4.81 SUP 2586S
Total $64.96 REQUIRED ITEMS AND REPORTS
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: // �� Permittee Signature: S
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.
,... c7e r p p, ,.,...L.- ) . .
Permit A A at4:Onp ' . -- - FOR OFFICE USE ONLY
Electrical Pexlr�z pU
City
R eceived � Per Ito•
of Tigard t Date/B : /� 7 �V l .0
g JAN 2 4 200 Review
Phone: 503.639.4171 Fax: 503- 598.1964
13125 SW Hall Blvd., Tigard, OR 97223 Plan Re ether Permit:
1''' ?-1. �` `ts DatC%�Y:
� ruris• l3 See Pa e 2 for
Inspection Line: 503.639.4175 ^ � g �i .:,e � ' „o Aaee R cady/ t1 o S
Internet www.ci.tigard,or,us
c� > J� NotiSe Supplemental Information
1' I O 'WO1tK' PLAN REVIEW
❑ New construction (] Addition/alteration/replacemen Please check over that apply:
❑Service over 225 amps, comm'1 ['Hazardous location
❑ Demolition ❑ Other: ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of i- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling ® Commercial/industrial El Accessory building ❑System over 600 volts nominal units in one stxueture
❑Building over three stories ❑Feeders, 400 amps or more
❑ Multi - family ❑ Master builder ❑ Other: ['Occupant load over 99 persons ❑Mattufacmrcd structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
'' 01dcalth -care facility ❑Other
Job noM 0 . 1 838 1 Job site address: 10260 SW Greenburg R d Submit 2 sets of plans with any of the above.
City/ State/ZIP: Tigard, OR 972 2 3 Ste 200 The above are not applicable to temporary construction service.
ASC2ntiulri FEE* SCHEDULE
Suite bldg. /apt. no.: )'reject name: Damnation ""
I Q ty. I p T otal
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
_ Includes attached garage.
• 1,000 sq. ft. or less 145.15 r 4
Subdivision: Lot no.: Ea. add'1500 sq. ft. or portion 33,40 1
. - Limited energy, residential 75.00 2
Tax map /parcel no.: - Limited energy, non - residential 75.00 2 I
DESCRIPTION OF WORK • Each manufactured or modular
dwelling, service and/or feeder 90.90 2
circuit to split HV.AC system Services or fet:ilt■s installation, alteration, and/or relocation
200 amps or less 80.30 2
201 amps to 400 amps 106.85 2
11 PROPERTY OWNER TENANT 401 amps to 600 amps 160.60 2
Name: Ascel2tiuln _ 601 amps to 1,000 amps 240.60 2
•
Address:10260 SW Greenburg Rd Ste 200 Over 1,000 amps or volts 454.65 2
Reconnect only 66.$5 2
City /State /ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( 503) 281 6 Fax: ( ) 200 amps or less - 66.85 s 1
Owner installation: 'I his installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for salt, lease, rent, or exchange, according to ORS 447, 449, 670, and 701_ 401 amps to 600 auras 133.75 2
Owner signature: Date: _ Branch circuits - new, alteration, or extension, per panel
❑ APPLICANT ❑ CONTACT PERSON A, Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, 1 46.85 46 • 85 2
each branch circuit
Address: , •
Each add'1 branch circuit ..2 6.65 13_10 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53,40 2
Phone: ( ) Fax: ( ) Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
- - extension. Describe: Page 2 2
Business name: Tice Electric . Co,
Address: 5405 N Lagoon Avenue Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State/ZIP: Portland, Oregon 97217 Investigation per hour (lhr 62.50
Phone: ( 503) 233 - 8801 a Fax: (503 ) 872 - 8290 Industrial plant per hour 73.75
. _ — ELECTRICAL PERMIT FEES* ___
CCB Lie.: 166 Electrical Lie.: 26 - 1260 Suprv. i ie.: 2586S Subtotal 60.1 5
Suprv. Electrician signature, required: 4 Plan review (25% of pe fee)
Print name: John J. Maloney Date: 1/2 / 0 7 State surcharge (8% of permit fee) 4 , 81
°--- TOTAL PERMIT FEE 64. 9 6
Authorized signature: • This Permit application expires if a permit is not obtained within 180
• ' — days after tt has been accepted as complete
Print name: Date: • pee methodology se t by Tri- County Building Industry Service Board
–._.' •• Number of inspections per permit allowed.
i;tauildintw4rsnft2 C- Pcrn+dt.App.doc 12/03 440- 4615T(10/02 /COM/VEB
~—
CITY OF
�pnm m ��n TIGARD ~
BUILDING DIVISION PERMIT #: ELC2007-00058
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/25/2007
Phone: (503) 639-4171 \
Inspection Requests (24 Hrs.): (503) 630'4175
INSPECTION WORKSHEET FOR DATE: 1/29/2007 TIME: 7:05AM PAGE: 5
SITE ADDRESS: 10260 GWGREENBURGRC>200 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/LINCOLN TOWER LOT #: 014 TYPE OF USE:
PROJECT NAME: ASCENTIUM
DESCRIPTION: (3) branch circuits to split HVAC stem. Job #0Q.1838.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: TICE ELECTRIC PHONE #: 503-233-88O1
Inspection Request Scheduled For: Date: 1/2E/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 042653-01 503-341-7322 • N
Corrections/Comments/Instructions:
G | I PARTIAL APPROVAL CANCEL | I NO ACCESS
FAIL I | CALL FOR INSPECTION EI ADDITIONAL FEES ASSESSED
Inspector: q& hJ«(?) LC Date: 11211 b Phone #: (503) 718- 2-1-11t'