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Permit CITY T I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT l 8 l DEVELOPMENT SERVICES PERMIT #: ELR2005 - 00166 ��'l 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/23/2005 PARCEL: 1 S135AB -03400 SITE ADDRESS: 10260 SW GREENBURG RD 1200 ZONING: C -P SUBDIVISION: LINCOLN TOWER -TOWN OF METZGER LOT: 014 JURISDICTION: TIG Project Description: Low voltage. • 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 COLUMBIA TELEPHONE CO. INC. ONE SW COLUMBIA ST #300 9860 SE EMPIRE CT PORTLAND, OR 97258 CLACKAMAS, OR 97015 Phone: Phone: 503- 230 -8899 Reg #: LIC 99500 ELE 26- 940CLE FEES SUP 1812LEB Description Date Amount REQUIRED ITEMS AND REPORTS [ELPRMT] ELR Permit 6/23/2005 $75.00 [TAX] 8% State Surcha 6/23/2005 $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 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. Issued By: ,X 4 Permittee Signature: 9, \f; 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. • 06/22/2005 15:35 5032395516 COLUMBIA TELEPHONE PAGE 03 El ermit A . Jcation® FOR 01:11(:1•'. USE )M,\ • �U V,� City of Tigard n ` ` , !05 �41 Penult No.: - 0 O /6 6 13125 SW 11a11 Blvd., Tigard, OR 97223 Moue; 503.639.4171 Fax: 503.598;1 2 1�5 rrP x 'c, D t Insp Line: 503.639.4175 .1 U IL 2005 ; '�;/ I G 'i See Page 2 tnr t � ` ww.ci .0r CITY OF TIGARD -�� s t PP tem n 4l luimrntatlon Q Hew cotilttrtictiou ❑ A ddition/albotatiol�/replacement Please check that apply: - 0 Demolition Q3ervice over 225 snips, comm'l Dliaeardous location ® Other: CATS O1W OF ' ONSTiY CTION '. . Q �1 and d 2-ff� y igs 4or mo e new r ,. estidential .' .Q 1- and 2- family dwelling [] Co�i mercia1findustri�.l 0 Accessor building °System over 600 volts nominal units in one structure Q Multi-family Q Master builder 0 Other: ❑13nilaithg ova- three stories ❑Feeders 400 amps or more ❑occupant toed over 99 poa ❑ ersoManufactured arueuuoa or „ J Cl fi'l'> ,i1!1.V*ATIOl!1: LO ClEgress/lighting RV park Job no -: Job site address: .. Q S� J b bk.", ©health -cat facility JD other: Submit&, seta of plans with any of the above. City /State/ZIP: T i &I /r• RD . ® R . 9 --I 1 The above are not applicable to temporary cent uctaotl service. Suite/bidglapt. no.: t, r, 0 Q Project chicle: l E AL1J €.1- 1 .1 v E-G.TM.+-►� ' ` �' A $; • . , - • ; Cross street/directions to job site: New residential stack.- or multi- fanmlly dwelling molt. Includes ottRehea prep. - 1,000 sti. R. or less 145.15 4 Subdivision; Lot X10.: Ea. adds 500 sq. ft. or p -33.40 1 Tax map/parcel no.: Limited energy, reeidvntial 75.00 2 3 meted energy, ace -residential 75.00 2 ' ' JDF�CRIPTION.:. WOR I( ' - F.acli manufactured or modular p�T C�3 4 t dwelliah service and/or feeder 90.90 2 services or feeders idtatatlatton, alteration, end/or relocation 200 amps or less - . 80.30 2 rl 'l1ts '1<'kr' Cil" iNE1i' . . • , `' f ' 2 • 01. at to 400 amps 146.85 2 • ' . • . • 441 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 City/State/ZIP: Reamed only _ 66.85 2 Temporary services or feeders installation, alteration, and/or Phone: ( ) Fax: ( ) relotsteiou - 200 amps or less 66 -$5 f 1 Owner installation: This installation is being made on lnvrperty that 1 own which is not 201 s to 400 an 100.30 2 intended for sale, tease, rent, or exchange, according to ORS 447, 449, 670, and 701. Owner t _ 133.75 . _ alteration, a .... _ p ate .75 2 . - -- .... 0.::Al't'TI Q.,CONTT 'd'.'1t RSON t$ Branch el Y'eet its -� new, akerakl n or a tension, per panel _. � . . A. Fee for branch circuits with 7 tlSirtess name: service or feeder fee. each 6.65 a. 2 branch circuit Contact name; B. Fee for %munch circuits _ without service or feeder f ee, 46.85 2 Address: *sob branch oitt nit • - Each add'i branch circuit 6,65 2 City/State/ZIP: Miscellaneous (service or feeder not lnclnded) ih Phone: ( ) Fax:: ( uttp or irrigation clrtle 53.40 2 1~rm711: - - Sign or outline lighti :. MN 53.40 111.. 2 Sigaai .CU1V PitAC l�lft' pane t(s) or limited- eturgy panel, a[teratioo, or extension. Describe: 70e95 at., (� fi j90 e�i E _-t7 N C._ Page 2 2 13t1Si MPi1 Arldre33 E$ 12 GY m µ Each additional inspection over allowable lea any of the above Per inspection 62.50 City/St'iWZIP: IN p mt". A S ® l� R O G t a Investigation per hour (t to min) 62.50 P h t x h a : ( 503 ) 4-Z O - 25 & 9 9 - Fax: (5p y) �. i - 5 5 1 { y Industrial plant per hour 73.75 GCP Lie,: ♦ • c n Electrical Lie.: ♦ } {} "- ',11?>�t*.:'I► :.nt, * :: , . .. . `)J 40 cie S uprv, Lac.: 1 Z �+ Subtota ) Suprv. Elee irician signature, required: / _, -.- = - • Plan review (25% of permit fee) Print name: M ‘ (`1 Date Stale surcharge (8% of permit fee) Fit Authorized signature: TOTAL l'ERMi 1 FEE / This permit apptication expires ifs permit is not otrtplhed within 180 Print name: clays after It hex been accepted Aa complete Date: s Fee methodology set by Tri- County Building Industry Service Board 11s. kp tmshAriL -P itAp c WO - •,* Number of impecticea pa penult ' 1owcd 440-46 t 5T(i e o2rcoMwVBg leITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2005- 00166 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/23/2005 Phone: (503) 639- 4171re- i�lm�i�Pl'�I�� Inspection Requests (24 Hrs.): (503) 639 -4175 :_.. INSPECTION WORKSHEET FOR DATE: 6/29/2005 TIME: 7 :08AM PAGE: 68 SITE ADDRESS: 10260 SW GREENBURG RD 1200 CLASS OF WORK: SUBDIVISION: LINCOLN TOWER -TOWN OF METZGER LOT #: 014 TYPE OF USE: PROJECT NAME: REAL NET DESCRIPTION: Low voltage. OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #: CONTRACTOR: COLUMBIA TELEPHONE CO. INC. PHONE #: 503 - 230 -8899 Inspection Request Scheduled For: Date: 6/29/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 6 Low volta • 010418 -01 503 - 230 -8899 N ` bL_) Corrections /Comments /Instructio' s: era , .�. \ � 4 v 1 PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS l FAIL n CA FOR INSP - -CTI 'J N ❑ ADDITIONAL FEES ASSESSED bb i Inspector: / � Date: 6 ` l' � Phone #: (503) 718 - Z 1