Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00636
I
DEVELOPMENT SERVICES DATE ISSUED: 10/4/2004
i 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S135AB-03400
SITE ADDRESS: 10260 SW GREENBURG RD 1060
SUBDIVISION: LINCOLN TOWER -TOWN OF METZGER ZONING: C -P
BLOCK: LOT : 014 JURISDICTION: TIG
Project Description: (6) branch circuits for TI.
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: 5 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: Phone: 503 - 624 - 3631
Reg #: LIC 75059
SUP 1965S
FEES ELE 34 -283C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 10/4/2004 $80.10
[TAX] 8% State Surcharge 10/4/2004 $6.41 Rough -
Elect'I Final
Total $86.51
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 7 •rth -QA_R 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -6s•9 or 1 -800 -332 -2 •4. ,
/ Iss ed By: /, !�,�' � ! Permit Signatu ' jam/
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: / = 4! 1 = DATE:
LICENSE NO:
96 ST3
Call 639 -4175 by 7:00pm for an inspection the next business day
SEP 27 2004 9: 30FIM HP LFISERJET 3200 P, 2
� Electric ..41. I rmit Ap e Xl.' \I E® - FOR OFFICE USE 0NL1'
City of T igard ry 1 Received ff�- C � D 4/
1
13125 SW
2 7 [O Dot p IO Permit No.: G Hall Blvd., Tigard, OR 97223 [ Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 S / °a'^�'"i' Date/B : Other Permit:
Inspection Line: 503 639.4175 p� T 1 a& "4 Date Ready/By: •
Internet: www.ci.ti ard.or.us T r �"" - " -' El l for CITY : pp Notified/Method: / Supplemental Information
' i $' y4' � �� t'l�i 3Ip ti r v35"'�- x'n�.L�,I�S Z'1 `'".,: d L �t..t`0t�¢� �y ��y,�i - rk k Y! :'enre wYt a l�lrJ { Y }� ° r, y :
I r 2i, , L r, N' a '. l t, si( i d -� �,llii ,•° {i t jol V?a 1 fo t , "ri „ .. trt': s '11
. %L... ti � J: ' 8iut.0::41 'iiil iG' r < 1� }, ,' a t ; S, p ` .1 i, t,; �er 4.2. -= ,';' t 7 7�.,i�
- ... iP. lipt :b,::F111W[Ui..� - 1. +.s : r:� litilitM ..�>3, I lai�wF�4,i �f i.Y;• l. . 'e ° .';�"F�UICF' - .�` ,
❑ New construction Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑Other: ['Service over 225 amps, comm'l ❑ Hazardous location
+t t N � : I' l u Y r+ �t� ii5 T>n>> ° ,. ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
`.,ii It gi !i_ 1 {E 5? „lic . t, ih` aril� aiihiilfr r;7. . 11 , II% r i ¢; of I- and 2- family dwellings 4 or more new residential
❑ 1 - and 2 family dwelling 0 Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders, 400 amps or more
❑ Multi family El Master builder ❑Other:
a'? Illlulb 0 �� �Il �I,�w + Dui �, rs y ❑Occupant load over 99 persons El Manufactured structures or
, niw ig ril ii t4 t` ; f�� till ,L ° ° a : t , a iii y ivowil t 1 t 4 E �` i mt i I( i . RV. ark
) afi I L - {� ❑Egress/lightingplan P
J ob site address: ❑Health -care facility ['Other: Job no.:
7 _ 102 ScJ C
�� Submit 2 sets of plans with any of the above.
City /State/ZIP: fa Q CI? 2.2-T The above are not applicable to temporary construction service.
Suite/bldg./apt. no.: Project name: zI i' - AF 1(�1i,2 , � i.Y Ti P lit. t ;°:,; : : : -•' ..;'
����/ 7 S'CC/'i�Pler j l ijv�lws Description Qty. Fee, Total •:
Cross street/directions to job site: ( New residential single- or multi - family dwelling unit.
/q Includes attached garage.
i & ia.tlero.ari ..._ - 1"1.0.4....c..... 1,000 sq. ft. or less 145.15 4
Subdivision: 1 Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00' 2
l ' 11�IJIIi 1 7 t i ki'�liftll� C' sa lam ` °!lwa °' ' n $ } LtiG�l6 Limited energy, non- residential 75.00 • 2
1 a ei i + '�': I rt ; t. : EM1111 414.0 )`.! ali ill.ii 2 MERO r r 45 Each manufactured or modular
' dwelling, service and/or feeder 90.90 2
Z e.4. . -- A 1 j i" l�'(j Services or feeders installation, alteration, and/or relocation
t 200 amps or less 80.30 2 _
Al ,1. t egtt 4A . ° "` fin 11"11 by a " c 1 iT rrf i7t°Si i R 8t nil i t 1' , 11 . ' l k :t , 201 amps t°4°° amps 106.85 2
,ilk S l ,W11.��L, . al., ,.. ...,i- AI �, h, �= 401 amps to 600 amps 160.60 2
Name: q-ts 0 601 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: (s-n ) I(t L_ `t oc) 1 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 1 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
d:� ':�,i '( �, PS �exen i t.Ij i � i7 i H r Ia i t i i t '
u : " 1" q r•+ : r 1 ' r sl l° t + u1 ,, Ei,. l� :, 1 � , ,,,,,I.i i t s`,,,„, k.14 .. .....p i ..., i . A. Fee for or circuits with
i ce ` service or feeder fee, each
Business name: _ branch circuit 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee, i 46.85 y(,i� 2
Address: each branch circuit �
Each add'] branch circuit S 6.65 T 2
City / State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax:: ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E - mail: t� „W Signal circuit(s) or limited -
I. itt J! 4 i 43.1111211E: iffi � s `m e iiA !`t a ti`? ItDllt . 1 i i t i a 1 • a . 1 ", energy Panel, alteration, co extension.. Describe: Page 2 2
Business name: k) r i (ii r ..e• 1612 Vie, rit le_ 4v e
Address: 4 � }, Each additional inspection over allowable in any of the above
Per inspection 62.50
City / State/ZIP: .` C 6 , _ C3 )- z- f Investigation per hour (1 hr min) 62.50
Phone: ( ) 6244 _ cg, C ( I Fax: (6-p; ) - 213' Industrial plant per hour ;^ 73 75
." �����ilS�x' �. w2�1. �. �' m ,c.,'�°;,�O�d���.n,GT,Z�i�� t��j °,.u•�ea"`:i "•'�- `'m''N. ;`;t` "`l� } v .t
CCB Lic.: 7 Electrical Lie.: �.. g C_ Suprv. Lic.: ��� `
'+� Subtotal A:14/0
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print name: dV jr ! e Date: /' Z� . -!t y State surcharge (8% ofpermit fee) �, t
• TOTAL PERMIT FEE g
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as comptete
Print name: Date: * Fee methodology set by Tri- County Building Industry Service Hoard
* * Number of inspections per permit allowed.
i:\ Butldiag\PemuS\BLC- PemiitApp.doa 12/03 440- 4615r(IO/02/COM/WEB
CITY OF TIGARD 24 -Hour
BUILDING Inspection -Lines ,(503) 639 -4175 MST
INSPECTION DIVISION' Business Lille: (503) 639 - 4171
BUP
Received Date Requested / Q — - ' AM PM BUP
Location // c; -(O—O a -4 g/j'f . / 49 Suite Suite leCo 6 MEC
Contact. Person Ph (V ) PLM
Contractor / Ph ( ) 2-- -36 3/ SWR 1
BUILDING Tenant/Owner (� -P �n ELC °�b6 ! 7 - 'd 6 6,3)
Footing ( /
ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT 7
•
Post & Beam
Shear Anchors
Ext Sheath /Shear l
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall P/468 � l Fire Sprinkler ' , `�
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING v' .e-
_ 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
UG /Slab
Low Voltage
Fire Alarm
PART FAIL
El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
S . Please call for reinspection RE: Ei Unable to inspect — no access
Fire ADASupply Line D J - 0 16/1/1 teem? Approach /Sidewalk Date Inspecto , I f� I Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL