Permit i� ' , i CITY O F TIGARD ELECTRICAL PERMIT
�:a ~'' PERMIT #: ELC2004 -00761
10:140 DEVELOPMENT SERVICES DATE ISSUED: 12/1/2004
III
-�-' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S135AB-03400
SITE ADDRESS: 10260 SW GREENBURG RD 1180
SUBDIVISION: LINCOLN TOWER -TOWN OF METZGER ZONING: C -P
BLOCK: LOT : 014 JURISDICTION: TIG
Project Description: Install (8) branch circuits.
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: 7 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: 503 - 412 -4800 Phone: 503 - 624 -3631
Reg #: LIC 75059
SUP 19655
FEES ELE 34 -283C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 12/1/2004 $93.40
[TAX] 8% State Surcharge 12/1/2004 $7,47 Rough -in
Elect'I Final
Total $100.87
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:
OWNER INSTALLATION ONLY \ i
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
DEC 01 2004 10:25RM HP LRSERJET 3200 p.
• Elec 5rir; Permit A Ii FOR OFFICE USE ONLY
City of Tigard E'VE , / Received Date/Sy: l ' / D 7 6/ Permit No.: i../v' Q y 7 �j
f
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 ' = ^ 1 qy (` Date/By: Other Permit.
Inspection Line: 503.639.4175 DECO 1 2 � � l ,Yom ' ;,,' I i Date Ready/By: Sons: 0 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: T (I Supplemental Information
; �r:, �i; v:�`ll r r, t � � ,; �i ,• ,�,s .�v � . , "' ���' rl,��l„ ,��n It �, ,. r,�11 .,..�. n�i�!! ?" . � . is '�, : w , l;���„ � � • s,w
i i 4° 14 11 t l .s k }'+�! I S dy d }! ' 4 10- r. i� r id i ;i : 1 114 N [i• • . Y' . de .. • } S'•t' =�: �Ey: :" 0 f y. f- ... '; -'
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❑ New construction ELAdditio : teration/replacement Please check all that apply:
❑ Demolition ❑ Other ❑Service over 225 amps, comtn'l ' DHazardous location
t r, i� f !r g( r ' s;�! r t tlq+ nu ^ `� a e„ s - , OService over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
r ' d, k ti }! �i h(I: Y il s, t'� °l 0, ( �1 '�iry - i`. 0 1.11, P , , ,kk'r iP
t s o•.z77r,.
$:1:?slle..:.) .1 - , +ry a'.T.,.,: ikner n! atit �ii.ter?y.t iiwsnai rah -_;-, , _ �?:? .:.: ■ i �°' of 1- a td 2- family dwellings 4 or more new residential
❑ 1 - and 2- family dwelling ..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
r It , a t+ ❑occupant load over 99 persons ❑ Manufactured structures or
y g t�luw si I i ,rm urr 1 e � e�, ? plall�, Ct �t ;, ilkl lr s
- *flu , 1 p1 1 �1 r . ) 1 E ess /ii htin plan RV park
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1 if' l i nT .ti: rn, , N „, Y ❑ gr S g P
Job no.: 4 c„ 1/44 Job site address: ioa S- , ti IV � J _i( ❑Health -care facility ❑Other.
. n Submit 2 sets of plans with any of the above. •
•
Qty/State/ZIP: / /l 4 40 LE w• co..IQ,I,,-. 7`O7t9e.�s.,__ The above are not applicable to temporary construction service.
24 The
W.,_ r� hr�"t9` fi t,J 1 1 eA,0l �! Y s
Suite/bldg. /apt. no.: // �d I Project name: g f' x° ...,... :
f1►C M- Al Description
Imp t• Qty. Fee_ Total
Cross street/directions to job site: . New residential single- or multi - family dwelling unit.
G Includes attached garage.
w �/ 14 tot)e/`_ S�/ / ( `f O 1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.: Ea. add'I 500 sq, ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no
`` t it## I* {{ FI f� 4`` UKt�Yrll " 1 ' , v I li a st M ��4 y I i i , - . I' Limited energy, non - residential 75.00 2
I .i ,; i "i l l t'ii l l it m l° l g1 1 "4 arA r l �. .au tr rte! c1 w7 I 11 1 1 R ''' , ;, � . rN '! .1 ' -- gf ilp t. Each manufactured or modular
,.� dwelling, service and/or feeder _ 90.90 2
/ -.Pei, �tti t ltd ®4.0 /tP.v
s, ,/ �n I Services or feeders Installation, alteration, and/or relocation
. ( 200 amps or less 80.30 2
C;! 201 amps to 400 amps 106.85 2
I , 'it;l i i t , i t1 s , t I r't 1 I 'Hilo' t 0 i�gI'� 1. 4 I s ,• ,, =' ligl 401 amps to 600 amps 160.60 2
.?. 413 , , 1? ..,,Ft _ .mrar 1=.6. iattim it samth l #1111 eu i , . 1 sW ,m - heeled tit a ., ..,
Name: f.0 e 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: ( ) I F ax: ( ) relocation
200 amps or less 66.85 1
Owner Installation: This installation is being made on property that 1 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
�V , h a ! �' ' `�' ' 1 rri 1 i l ` ° ; ttj , r tai 4 etu� m nn, WMii...3 I- i : A. Fee for branch circuits with
.14 g,r. to a, l i f `+.: oistdo, „ii rr •. :it,a:, t ri�ina. v1gvivr =.1a "rlaniv.414.a, v..9: 4Bitf �,� ilr. service or feeder fee, each
Business name: . branch circuit 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee, /
each branch circuit ( 46.85 7 , �� 2
Address: ' .1 % c ' -
Bach add'l branch circuit 6.65 ( 2
•
City / State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) I Fax:: ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E-mail: Signal circuit(s) or i limited -
Ffi t { ;ter9�9,1�p/ N' 8i37�� r { r, rZ I yp��s'1r��y�� £ lt �u�l lli3bt3'���N,]jr� 3 1(.1..]' ,..rh;�• -`�} 1 . w "', -i, anl, ali
t�;" IkiINSM�3�iLL�il. �l�' �I. Nti w. f.! NAss�.. �t- M liti 'li.lu.;.°- ,aT4:�R�l'•'• �A. \ 2
extension. gyP Deescribe: terat on, or
Page 2
Business name: (, J , i ( a is.uv f-_ el iff.critt t_, x e__
Address: Each additional inspection over allowable In any of the above
�G 13c Per inspection 62.50
City / State/ZIP: 7/5 l - 4A,_ c Zed' / Investigation per hour (1 hr min) 62.50
�}p ) � 3 Fax g am; ( ) Z 7 y re
Industrial plant hour 73.75
Phone: (
.JZ3 424 - 3 fy� 1 I S" 'i tt! - i iittTvu, i 1t t lfl-''i;.: iJ 3 i�) yl'±S I `3' " "�` Je ', {r °,.is;t•, s- ' i ' . •'
CCB Lic.: Asg I Electrical Lic.: .3 (t, z 0 C. I Suprv. Lie.: (94 %s Subtotal 9, . y Q
Suprv. Electrician signature, required: Date:
A Plan review (25% of permit fee) 3
�.... /�c 1
Print name: / /� 9/
State surcharge (8% of permit fee)
4) N � � 't �' fZ� r- TOTAL PERMIT FEE /) (j, '1(-
Authorized signature: This permit application expires if a permit Is not obtained within 180
days Biter it has been accepted as complete
Print name: Date: * Fee methodology set by Tri County Building Industry Service Board
44 Number of inspections per permit allowed.
1 \ BeildiegkPermitt .LC- PermitApp.doc 12103 440 - 461 ST(10 /01,COM/WEB
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line:-,1503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested / — / ( AM PM BUP
Location 4 d -' -��1� _ Suite 7 /CS o 0 MEC
Contact Person Ph ( ) PLM
Contractor Ph (_ ) 6 a S' -3 c. 3/ SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: . SIT
•
Post & Beam
Shear Anchors
Ext Sheath/Shear _
Int Sheath/Shear
Framing
Insulation
Drywall Nailing n Firewall
,�^G( f /j,6- 6 /SL q l
Fire Sprinkler �� / 1 /Y
Fire Alarm
Susp'd Ceiling
Other: r:
Final
PASS PART FAIL r
1.7
P LUMBING
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/Slab
Low Voltage
Fire Alarm
ZOO Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
S - Please call for reinspection RE: Unable to i — no access
Fire Supply Line ✓ &-- ° itiftn 706 4 nspect 3 ADA ] 'J � J
Approach/Sidewalk Date ` �✓ / I nspector / Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
•