Permit * CITY OF TIGARD, ELECTRICAL PERMIT
PERMIT #: ELC2004 -00643
DEVELOPMENT I e d 97 (503) 639 -4171 DATE ISSUED: 10/6/2004
PARCEL: 1S135AB-03400
SITE ADDRESS: 10260 SW GREENBURG RD 1160
SUBDIVISION: LINCOLN TOWER -TOWN OF METZGER ZONING. C -P
BLOCK: LOT : 014 JURISDICTION: TIG
Project Description: Tenant improvement.
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: 10 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 10/6/2004 $113.35
[TAX] 8% State Surcharge 10/6/2004 $9.07 Rough -
Elect'I Final
Total $122.42
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: Permit Signature: 0.(f ff 7,0"
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 639 -4175 by 7:00pm for an inspection the next business day
OCT '05 2004 7:41RM HP LRSERJET 3200 p.2
Electrical Permit Application, r FOR OFF rc>E USE ON �-
City of Tigard � �� Received tBy. Permit No : EteeeZ00a ...3
] 3125 SW Hall Blvd., Tigard, OR 97223 - Plan Review r (
Phone: 503.639,4171 Fax: 503.598.1960 OCT %t ^< 4 'y � l� "l � ', Other Permit:
i i 1 Date Date/By: ' !' _
Inspection Line: 503.639.4175 C+ ' Ready/By: Jaris: Ea See Page 2 for
Internet: www.ci.tigard.or.us .1T e TIGARD Notified/method: .i(6- Supplemental information
Pc r t: i -- ,r. k t Gt r. 4L" xl : f,:1 c .� Y4 v� - 7 6. 'y S_'... 7 Y. t ,45�*F° - lint 5 -1,-:,-V•' ' r.. '� 1 t :',
4
1t? i I 1i t t f 1 IF �m r ra w 3 , A
� r r u c� i i i t s f . 4 y x r
..i: �! r5; ��, 3 si; �e` ��'' kP lF1( � - 'e.�� 3:"' :r u�iL' t1i�,. o�t�" iJ�ii=`:. 1' t' ��t5�n.. l+. u�� .n�i�,:�,1��.�r Pi3��"�' a�i .. �S'�+ ,>'�rti. ,. � �a w .� es � 0, ■ -
❑ New construction Addition/alteration/replacement PIease check all that apply:
z -s.
['Service over 225 amps, comm'l ❑Hazardous location
El Demolition ❑ Other ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
R , � tr � i f�" P x^ �� @1 r d�vt u i "�r �.. N
; nP�r ngag r � a i ilr ��, r' a ru u s, .t 11t k 7 s it ., . sw..., t. ;1 4k c of 1- and 2- family dwellings 4 or more new res identiai
❑ 1 - and 2 family dwelling [l Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders, 400 amps or more
❑ Multi family 0 Master builder ❑ Other: Manufactured structures or
1 w i i at ,32/ t4.6�r , ie�t1'r ,fr r sa T: ❑Occupant load over 99 persons ❑
1; r 1. ._ a il 1 'E i ii; !,,t � ; L- l a�sfg' .ay 'L" 1,6 ,, TM; , ��!' t , ,:�4 , , Y4 � , '} ❑E gress/lightingplan RV park
Job no.: 7. f Job site address: I C)2.100 c ,Ly ❑Health care facility ❑Other:
t°'r- E'7 Submit 2 sets of plans with any of the above.
City / State/ZIP: 1. -, ,� 'op ?, . Li The above are not applicable to temporary construction service.
'! w ! r B �1 'si15:a ' ::' :. '
Suite/bldg. /apt no,: iii, 0 I Project name: A. , p.t7. vl,; � Y' °�, �.G:.I.tl +i• ;jrnw "fr1 4'�i W : ..
Description Qty. Fee. Total
Cross street/directions to ob site: CO t New residential single -or multi - family dwelling unit.
3 L c °`� �d 6j Includes attached garage.
1,000 sq. ft. or less 145.15 4 t
Subdivision: I Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 l
Limited energy, residential 75.00 2
Tax map /parcel no.:
;atria `i - J 6�t
`, � '1x.111 a9,t y r, ¢ ,- m sli :1� M iMl'"t t c �,�s Limitedenergy,non- residential 75.00 2
u i k I l 1. t i it fi, r',3 F mn iri' (t l�G l''6� p 7 4 g�,, s� E igi4 t 0
S. .a LAI,at .t„..t?. ,1._lr%t.,.,.. a.sf�,,,.r...3,,a.o,,, . 1atb.�r_it.1 1,. � ,, :4 ;x3V.t,.kai,..t� >,. Mt Each maxnifacturedormodular
• /- dwelling, service and/or feeder 90.90 2
( -1 e/t^ -mo t Services or feeders installation, alteration, and/or relocation
1 200 amps or less 80.30 2
t' E 1 v ' 1 ,� j 11 i ' : to l t " i e ` �V;11. i `'; RP 3 , ,s u a 201 amps to 400 amps 106.85 2
i'1 2/L:', f :ifi*1 -m: 1f. - 144 lll'le.;,j >11 tiri 6.. �Lk:. _• immaku��I.. -`:. , .,,,, t. 401 amps to 600 amps 160.60 2
Name: T 6 l 601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
- Address: S �'` S v r/jlj Reconnect only 66 -85 2
City/State /ZIP: a -v, 4 C.4.-- of ) Z. S'�C 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 an 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
'y ri :tk.� �. �,3 i 1 $ 1 S 7tV '� k�I' ,' 1E '•te "pi t 'w t , 5 � 't1 4it" ills I IR} D . 4 7 .1, . r . i u118P pi A. Fee far branch circuits with
i�r �, ia, „a . is .. a.., r,:x, 3• tsa�l] i iii ti t 3.1 =.s ,. ' ih. t uL .. , .� h.z., ,1tc�'''''' " ' " ' service or feeder fee. each
Business name: : branch circuit 6.65 2
B. Fee for branch circuits i-+
Contact name: without service or feeder fee, l
each branch circuit ( 46.65 ! SQ 2
Address: Each add'i branch circuit /d) 6.65 G 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: Signal circuit(s) or limited -
� # , t 1 d i�ts, h 2a O�I 1 P� aK tt ryhl ,fit '�.,. �- 1 I fL' - energy panel' a
•�, s �° t � m(��r; �iEt §��t ° � I �tt�. ��'� r' +i ���� � ° ::. Q����. e � � �� .�: �'.��..._i'r'. '�" r . ener a"c"tion' or
L,,.1ti� i wLui t " n u` `' a" ° ] '' extension. Describe: Page 2 2
Business name: , i ( 0.,,,,,k e. t Ye ;'.' t 4, -
Address: � � Each additional inspection over allowable in any of the above
d t �1t 2. -? Per inspection 62.50
City/ State/ZIP: il 7 0,4,Ax G i g
9.- Investigation per hour (Ihr min) 62.50
Phone: ( .fj/3 ) 6 2 q - 3 -s t I Fax: (jb3 ) 4 z_e( - Lcf s 4' Industnalplazrtper hour 73.75
_ ;,-�,t':; attar; � ?•w���;��;�si7t`5�,, t i vs i�uap;���, ; �� f ^
CCB Lic.: Electrical Lic.: ? C Suprv. Lic.: iy 5`
� Elt J 2� up �f'G 5 - Subtotal �(
Suprv. Electrician signature, required: /'
A. : Plan review (25% of permit fee) c
y� Date:
State surcharge (5% of permit fee) /,, (/ ,/
Print /11111��d�
N �� // i O 5` TOTAL PERMIT FEE 1 22 m L4 L
Authorized signature: • This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: ° Fee methodology set by Tri - County Building Industry Service Board
- ** Number of inspections per permit allowed.
i? Building \Pemmits1ELC- PemmitApf.doa 12/03 440 4615T(5010VCOMt4 E5
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business "Line: +(503j`639 -4171 MST
BUP
Received Date Requ ) (— 1 _ AM PM BUP
Location /6 D-(p -O -- 4--)1.Qo/'L Suite / / (0 MEC
Contact Person P ( ) PLM
Contractor Ph ( )6.,a4— : 3 63/ SWR
BUILDING Tenant/Owner ELC ROD 4
Footing
ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing r R l /�
Insulation
C
4 �,p it e 1 <, � OQ- ; J$ '' l f )
Drywall Nailing °�M
Firewall , b. - Fire Sprinkler
Fire Alarm Cam) L\ N (, 11) \ f p\ CA l L \ r c/
Susp'd Ceiling `� Et- 1 � �/ �y
Roof To �1� � 1 I `7 �� 1^(
Other:
Anal ta \� 1Cl � ‘,`VVM I
PASS PART FAIL
PLUMBING ` r '
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
°ug -
UG a.
Low Voltage
Fire Alarm
`' PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE `,. Please call for reinspection RE: LI Unable to inspect — no access
Fire Supply Line
Approach /Sidewalk Date\ I V l Inspector v l 1 Ext
Other:
Final DO NOT REMOVE this inspection record fr m the ob site.
PASS PART FAIL