Permit CITY OF TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
l DEVELOPMENT SERVICES PERMIT #: ELR2005 -00078
`�' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 4/5/2005
PARCEL: 1S135AB-01003
SITE ADDRESS: 10300 SW GREENBURG RD 200 ZONING: C -P
SUBDIVISION: LINCOLN ONE /RED LOBSTER /CASA L LOT: JURISDICTION: TIG
Project Description: Limited energy for 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 COMMNET SERVICES
ONE SW COLUMBIA ST #300 MICHAEL F KERN
PORTLAND, OR 97258 7075 SW ARMITAGE CT
WILSONVILLE, OR 97070
Phone: Phone: 503 - 539 - 1851
Reg #: LIC 97334
ELE 1714LEA
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 4/5/2005 $75.00
[TAX] 8% State Surchari 4/5/2005 $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 C you t ow ru e - dopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
thr gh OAR 952 -00 • • i. ' .0 may obtain copies of these rules or direct questions st to OU 3- 246 -6699.
M 4Zi..— Is ued By: ` ' �t �i AIL -� 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 . ) ' - FOR OFFICE USE ONLY' ' . ' ' : ' fiV',.
i-•
City tt Tigard RDeactee/iBved �E /�/�� Permit No.: e 05' - 0007
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date /By: t' I Other Permit:
� q,•
Inspection Line: 503.639.4175 ...... ' -� , Date Ready /By: Inns. ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: / 0. Supplemental Information
TYPE OF WORK PLAN REVIEW
New construction ❑ Addition/alteration /replacement Please check all that apply:
['Service over 225 amps, comm'I ['Hazardous location
❑ Demolition ❑ Other:
❑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 ' Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
El Building over three stories ❑Feeders, 400 amps or more
❑ Multi- family ❑Master builder ❑Other:
['Occupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND LOCATION /J ['Egress/lighting plan RV park
Job no.: Job site address: + //�� // �� /U ❑Health -care facility ❑Other:
`!/ 300 -5 4/r G to /4�" Submit 2 sets of plans with any of the above.
City /State /ZIP:. 7, ' " The above arc not applicable to temporary construction service.
Suite /bldg. /apt. no.: Ta
p Project name: /veic/9 ��-� -�j7 s FEE* SCHEDULE
Description Qty. Fee. Total
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
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 I
Limited energy. residential 75.00 2
Tax map /parcel no.:
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
/ 1� 6?-'//e-/ ` dwelling, service and /or feeder 90.90 2
777/f _ , 7` i l G.t� .t�� /'-mot ' Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
201 amps to 400 amps 106.85 2
CI PROPERTY OWNER .8 TENANT
401 amps to 600 amps 160.60 2
Name:
viiax /- '/, 6., 5 /L' 6 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
�? / a/ 9 Reconnect only 66.85 2
City /State /ZIP: J ' / (/ t Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 I
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
��g� SvC s B. Fee for branch circuits
Contact name: / L i / , ' 2 /L6 without service or feeder fee.
46.85
Address: 79 7,S',/ 4,,,,,,,,,,7---65,<-- c--77-- each branch circuit
Each add'I branch circuit 6.65 2
City /State /ZIP: Miscellaneous (service or feeder not included)
3 S � Pump or irrigation circle 53.40
Phone: ) / �/ Fax:: ( )
Sign or outline lighting 53.40
E -mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: / Page 2 2
Business name: — 77/4 , n9 -
Address: Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State /ZIP: Investigation per hour (I hr (1un) 62.50
Phone: ( ) Fax:( )
Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lie.: Electrical Lie.: Suprv. Lic.: Subtotal -75- 75
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print name: Date:
State surcharge (8% of permit fee) (y • O v
TOTAL PERMIT FEE g i f pt,
Authorized signature: Iry • This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: ��, 2/6 .---- /Zee/ Date: e o • Fee methodology set by Tri- County Building Industry Service Board
** Number of inspections per permit allowed.
is iRuilding \Prnnits\ELC- PermitApp day 12,53 440- 2515T(10l02 /COM /WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
n Audio and Stereo Systems*
n Burglar Alarm
n Garage Door Opener* •
n Heating, Ventilation and Air Conditioning
System*
Vacuum Systems*
Other:
COMMERCIAL WORK ONLY:
Fee for each commercial system $75.00
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
Audio and Stereo Systems
n Boiler Controls
n Clock Systems
n Data Telecommunication Installation
n Fire Alarm Installation
HVAC
n Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control*
Ti Medical
n Nurse Calls •
n Outdoor Landscape Lighting*
n Protective Signaling
n Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
i.A Building APennus1ELC- PemntApp.doc 04)03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005 00078
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/6/2006
Phone: (503) 639 -4171 /���r • ���� ' lll
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/14/2005 TIME: 7:10AM PAGE: 55
SITE ADDRESS: 10300 SW GREENBURG RD 200 CLASS OF WORK:
SUBDIVISION: LINCOLN ONE/RED LOBSTER /CASA L LOT #: TYPE OF USE:
PROJECT NAME: HOME LOAN
DESCRIPTION: Limited energy for data telecommunications.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: COMMNET SERVICES PHONE #: 503 -539 -1851
Inspection Request Scheduled For: Date: 4/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 004613-01 503- 539 -18661 Y
Corrections /Comments /Instructions:
f0
a s L :v Go O. 1 cat1 6 tyi . GN tL� N v,c 0 b �\ p
K PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: "-<- l/ . Date: 7 7, Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005- 00076 t_
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/6/2005
Phone: (503) 639 -4171 :P
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/13/2005 TIME: 7:10AM PAGE: 83
SITE ADDRESS: 10300 SW GREENBURG RD 200 CLASS OF WORK:
SUBDIVISION: LINCOLN ONE/RED LOBSTER /CASA L LOT #: TYPE OF USE:
PROJECT NAME: HOME LOAN
DESCRIPTION: Limited energy for data telecommunications.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: COMMNET SERVICES PHONE #: 503 - 539 -1861
Inspection Request Scheduled For: Date: 4/13/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
136 Low voltage 004362-01 503 -539 -1851 N
Corrections /Comments/ Instructions:
cs 2,1c iu r e
`fart, - i\e- by used.. 01-0 oci2
❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
/
Inspector: • Date: r ` / 3 - ON Phone #: (503) 718-