Permit 4 CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2006 - 00221
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/14/2006
PARCEL: 1 S135AB -03400
SITE ADDRESS: 10260 SW GREENBURG RD 1165 ZONING: C -P
SUBDIVISION: LINCOLN CENTER /LINCOLN TOWER LOT: 014 JURISDICTION: TIG
Project Description: Data /Telecommunications.
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 HI -TECH SYSTEMS
ONE SW COLUMBIA ST #300 512 NW CARTY RD
PORTLAND, OR 97258 RIDGEFIELD, WA 98642
Phone: Contact #: FAX 360 - 887 -7065
PRI 360 - 887 -7062
Reg #: ELE 37955CLE
FEES LIC 124360
Description Date Amount SUP 3117LEA
[ELPRMT] ELR Permit 9/14/2006 $75.00
[TAX] 8% State Surcha 9/14/2006 $6.00 REQUIRED ITEMS AND REPORTS
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 require ou to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 -001. -0010 through OAR -00 0100. You may obtain copies of these
rules or direct questions to OUNC at 503 - 246 -6699.
Issued By: `% Permittee Signature:
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 _ 1 - 1 FOR OFFICE USE ONLY
\- A. Received ���
!City of Tigard t ' 7 1 Date/By: No.:6 4 .
13125 SW Hall Blvd., Tigard, OR 97212. G Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 OQU Other Permit:
2
Inspection Line: 503.639.4175 C��Q ! �. D ae _ Date Ready/By: lu s: El See Page 2 for
Internet: www.ci.tigard.or.us 1 \GA Notified/Method: Supplemental Information
TYS,�;;�pi Ott PLAN REVIEW
❑ New construction 1ddt'tion/alteration /replacement Please check all that apply:
❑Demolition III Other: ['Service over 225 amps, comm'l ['Hazardous location
['Service over 320 amps – rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ 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 stories ['Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
JOB _ SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park
❑
Job no.: Job site address: O ( tA/ 6sle� 1)4" Submit f t 2 sets of f plans
J ians with ❑Otov
th any of the abovee
.
City/State /ZIP: .Q 9 (■ T k 0 (A 9 7 a a 3 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: k , (08 Project name: rt 0...e., 43 tickl r cftwry.ter FEE* SCHEDULE
Description I Qty. I Fee. I Total
Cross street/directions to job site: t.$) h1 ao L-.A.1 O + t�./�r New residential single- or multi - family dwelling unit.
1 Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'I 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
DESCRIPTION OF WORK Each manufactured or modular
T ,p dwelling, service and/or feeder 90.90 2
1'N 5' - A L . 1. �l�(� v _� + 5? '1 4 Q ft 8L- 44 P P P Services or feeders installation, alteration, and /or relocation
9401.4`e.., st 0 'Ilk . 200 amps or less 80.30 2
.. ❑ PROPERTY OWNER ja TENANT 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
❑ 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, 46.85 2
Address: first branch circuit
Each add'I branch circuit 6.65 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-
.
CONTRACTOR energy panel, alteration, or
t extension. Describe: Page 2 2
Business name: H. I 1 ' C3 5y S i eirn. 3
Address: S , a N Q'` -‘. RD Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State /ZIP: 'Q ; o r e LD t (.0 A • Investigation per hour (1 hr min) 62.50
Phone: a()) 6.7,- ) U & a_ Fax: ('6;,v) $ H ' 1 - " (g, 5 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: 04 -36, Electrical Li ‘ Suprv. Lic.: (31 1 '7Le* Subtotal
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print name: D I _ G J Date: State surcharge (8% of permit fee)
De:"/ J TOTAL PERMIT FEE
Authorized signature: Thi p application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: 0 NI f e' � Date: * Fee methodology set by Tri -County Building Industry Service Board
J ** Number of inspections per permit allowed.
i:\Building\Permits\ELC- PermitApp.doc 12/03 440 -4615T( I 0 /02 /COM /WEB
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CITY OF ��U��������
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BUILDING DIVISION �- '
~~�,��""�~° �"°"=.~~.~ PERMIT #: BR2006-00221 •
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/14/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 ^��W�
INSPECTION WORKSHEET FOR DATE: 9M8y2006 TIME: 7:OiAm PAGE: 45 ,
SITE ADDRESS: 10260 SW GREENBURG RD 1165 CLASS OF WORK . .,
SUBDIVISION: LINCOLN CENTER/LINCOLN TOWER LOT #: 014 TYPE OF USE:
PROJECT NAME: ERIK BUCHER & PARTNER
DESCRIPTION: Qato/Tm!enmmnrnunicatiwnn.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: H-TECH SYSTEMS PHONE #: 36O'887-7062
Inspection Request Scheduled For: Date: 9118/2O06 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 030687'01 380-887'7062 N
mI
Corrections/Comments/Instructions:
�,,
N.
`
N ., i ,, \ )
.
pM PARTIAL �� AL APPROVAL CANCEL pi NO ACCESS
` J --
I-' ` CALL FOR INSPECTION I 1 ADDITIONAL FEES ASSESSED
Inspector: "--* N (S6 LE Oota:V.R 1 ak) Phone #: (503) 718-
'' .