Permit v ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00207
,r� DEVELOPMENT SERVICES DATE ISSUED: 3/31/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
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: 7 branch circuits for TI
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: 6 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
FEES Reg #: LIC 75059
SUP 1965S
Description Date Amount 34 --2828
ELE 33C
[ELPRMT] ELC Permit 3/31/2005 $86.75
[TAX] 8% State Surcharge 3/31/2005 $6.94 REQUIRED ITEMS AND REPORTS
Total $93.69
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 4c1- 332 -2344.
Issued By: • � Permittee Signature: 77 ✓,/ ` •
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 a1 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.
. , MFIIF 31 .f: 15 7:41 AM HP LASERJET 3200 p. 2
1
Electrical ermit Application r., FOR OFFICE USE ONLY
\ U `1 = L Received s, Q
1 Hall Blvd., Tigard, OR 97223 D : 3 1 / -, l.J p, Permit No. , i S 0 ()
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960
2 ^ 2 � �� ?lyt' +� l''� DaraB Other Permit: Inspection Line: 503.639.4175 IPIK - rts"i' .. Date ReadyBy: ® See Page 2 for
Internet www.ci.tigard.or.us r rr TIGARD Notified/Method: Supplemental Information
:lll-lip y fl ,��. �t t �.rf(f+ " l ;¢YR p. -r rsl <- fiT;, "• ^� "l!il; �.rr�t x y ! a• Y,; yy. .•7m: +•M
�..`Si''r'„ '�
(, +��+ J3 � , ' ( � j, � } �y 7,(� 1 '� 11' t 7 it �'I.fI 1 17 ➢g }y;4 IL t r ' gl YintitA ,Ir ,:t.7:74'
t ? 3 i w . :;i i`'. #qty �.. a'
AL_IA' ..1 iil!le.._ .. lllu.t. ..e mtzieb ::' &1:,1ibi Wiiiirtt� �e. 1'Iil:E 3. t., N :cD . a .1 i4. :' ,1 'r./t'. sV1 1r, o.a_ar:1a �! 'K A- 'l ` ! `
❑ New construction [ , Addition /alteration/r'eplacement Please check all that apply:
❑ Demolition ❑Other, ❑Service over 225 amps, comm'I ❑Hazardous location
'41'°'' , ii v t �, „, 4a u y � 7 , Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
t . ' , " r l(t g 1 i= 14 � P Ail Yv r r i E t„ .:.kilie ` . . p ,r , + 3fv of 1- and 2- fancily dwellings 4 or more clew residential
❑ I- and 2 family dwelling a CommercialJindustrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
['Building over three stories ['Feeders, 400 amps or more
❑ Mulct family 0 Master builder ❑Other
r , ,„ , s !mu €t� L 1a c r1!14 e n ['Occupant load over 99 persons ❑Manufactured structures or
1d --. . ' � i `� 4 illWINki:LJ 4,1 :& .In' nTy�rti!1 AT...i m ' i i1 '�',rtlIrli AMU gl, ,c,;f* ,„ ' ❑Egressllighting plan RV.park
Job no.: g ❑Health -care facility ['Other: � Job site address: ,,1'` ?2
4 d �� S �' Submit 2 sets of plans with any of the above.
City /State/ZIP: T. . 0 + L N � C The above are not applicable to temporary construction service.
1149 1 $i1 s i ` x nisi , �( 0 111 J , PA Tc i ;
Suite/bldg. /apt. no.: ac>,J I Project name: Hoe., t Lc s,. { n•ral ; LL ., , . .
piton Qty. Fee. TWA ''" '
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached ga rage.
1,000 sq. ft. or less 145.15 4
Subdivision: 1 Lot no.: Ea. add'1500 sq. ft. or portion 33.40 I
Tax / /parcel no.: Limited energy, residential 75.00 2
map p Limited energy, non - residential 75.00 2
Al s«�� .a �'n " { , C !ns 1 t »ur» �x e; ¢ � r�xr� I y G'4 1;g' �:1' a+I's 8Y
,;r..t!!]i l:llif{l�il�l�h 111 kiiii3111i{ ; :• t :4l t 'r ' . ` 1 �nEm'mm ih 1 , L �n i( iEl?�k Mil + <: Each manufactured or modular
dwelling, service and /or feeder . 90.90 2
.1-20-‘1....a`"..2k 1 s' �-C.- Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
r iliWn 1 1[ rn a rc , .�• ' a at l M e s l `,I Zu a x, 201 amps to 400 a 2
s 106.85
< ti' =e J1 T 11, ( li h Y' JT tF �,
�2zi�Itl� !' lCl�y_�, ,!,F xnt t� € 3 �y r .t1r�� 6u," >c.�1�����d „�,�,E��a� � ,,� �r? l „ �� ; r 401 amps to 600 amps 160.60 2
Name: Gds 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 Fax: ( ) relocation
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
11'i ! , 1 '1 '/ I i Y1'4151. c ,:,F, I , r•' ;' 11 c1i , u1 a i 7e�ifi�XVI 1 ",'. : a r' A. Pee for branch circuits with
,sic 3 .d : EU k�.) ..., , ,:43gra. t ,:;. ra idak � .II. j , ,11 „t�r : ,,r... rn" a,l! r :ur.i., ."gas ,,! to ' • service or feeder fee, each
Business name: branch circuit 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee, ( 46.85 "Jf.� 2
Address: • each branch circuit G
Each add 'I branch circuit if 6.65 '`!r 2
City / State/ZIP: Miscellaneous (service or feeder not included)
-
Pump ar irrigation circle 53.40 2
Phone:
( ) l Fax:: ( )
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited- •
1 l g"nfiRf lli ally Aek t 11171. z 't�
' mos..s.l .: mains lt, 111 !_t. i?1 t ii w swrr ' ` ... ;i-ics Nigiell , s s l -, ` ,, , ? " energy Panel, alteration, or
extension. Describe: Page 2 2
Business name: ,
II e t l a ., 2 ke, r ytie tit, c--
Address: P O 4 23G Each additional inspection over allowable in any of the above
k Per inspection 62.50
City /State/ZIP: T t 51 0 A 9 ( Investigation per hour (1 hr min) 62.50
Phone: (OK ) l�2 - Fax: ( 3) ( Z4 - Z - 1 3 Industrial plant per hour 73.75
CCB Lie.: '7 - 1 Electrical Lic.: ( 3 _L----... q - /43 d Suprv. Lie.: /f6 5 -- r Subtotal S-4 9. 5 --
Suprv. Electrician signature, required: j \ Plan review (25% of permit fee)
•
Print name: �� � Date: 7.-. y(/ -ri j State surcharge (8% of p ermit'fee) C t 9 ti t N t TOTAL PERMIT FEE at 5 . 6, G
Authorized signature: This permit application expires if a permit is not obtained within 180
days after tt 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\ BuildinglPemriul6LC-PermitApp.dac 12/03 440 4615T(10/02JCOM/WmB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 -0Q207
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/31/2005
Phone: (503) 639 -4171 i r //4NPp��j�hl
Inspection Requests (24 Hrs.): (503) 639 -4175 J
INSPECTION WORKSHEET FOR DATE: 4/26/2005 TIME: 7 :10AM PAGE: 17
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 FUNDING
DESCRIPTION: 7 branch circuits for TI
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: WILLAMETTE ELECTRIC INC PHONE #: 503- 624 -3631
Inspection Request Scheduled For: Date: 4/26/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 005373 -01 503-624-3631 Y
•
Corrections /Comments / Instructions:
•
•
•
SS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I I FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: `` � Date: 'f-2.6 `04 Phone #: (503) 718-