Permit ._.. ` CITY OF TIGARD ELECTRICAL PERMIT
? t PERMIT #: ELC2004 -00514
!VIII. DEVELOPMENT SERVICES DATE ISSUED: 8/16/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S135AB
SITE ADDRESS: 10300 SW GREENBURG RD 271 ZONING: C-P
SUBDIVISION: LINCOLN ONE /RED LOBSTER/CASA L
BLOCK: LOT : JURISDICTION: TIG
Project Description: 4 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: 3 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
10260 SW GREENBURG RD #100 PO BOX 230547
TIGARD, OR 97223 TIGARD, OR 97281
Phone: Phone: 503 - 624 - 3631
Reg #: LIC 75059
SUP 1965S
FEES. ELE 34 -283C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 8/16/2004 $66.80
[TAX] 8% State Surcharge 8/16/2004 $5.34 Rough -in
Elect'l Final
Total $72.14
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 -33 -2344.
Issued By: Permit Signature: 6 Ce�fQ�j l s
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 639 -4175 by 7:00pm for an inspection the next business day
',RUG l6 2004 9:55AM HP LASERJET 3200 p.2
1'" - • a
( cdric'al Permit_ Ap llication FOR OFFICE USE ONLY
City of Tigard ���'��® Received / _ / w ,
13125 SW Hall Blvd., Tigard, OR 97 p atA•Rene', /b J •
Phone: 503.639.4171 Fax: 503.598.1960 • - �'t "i"'9i• 4iti,' Date/13 : Other Permit:
Inspection Line: 503.639.4175 1 (; 200 ( r Dat Ready/By: Jam: El See Page 2 for
1
Internet: www.ci.tigard.or.us AUG v T Notified/Method: Supplemental Information
c 7 4 .. ll n I 1il 1 1 l P! i !Ill p y, a. r %. ,. :,t . n ' -• - ''''W ∎lil F 'rlg':.4 ;i .::rx 4:-: :. ..
/ i.
I `f{ tt ,b 1, -.. 1 l. 1, t i ,, !ekj •q, .w't 311..l,�� ;e" @I t- , 1;11 i3'CII•' I' Ll0;' 'y 'a � 1IS:j1 A g t I.
/ '31a. "i���� 'T i ull � -� u 1 � S .s :,R. �' �.+ `i., � .v? L�....a .�.n !1 ..'' ":�� �S:T%..,�.�,rt, .1 _ - • i. � � keS511 {I naN x�;� ,�a.� -Q ..:. ffir � if nw . � - I ;'� �,? r.. : •r::, Mk�._,� ..,•si•.. ,•. 6 ;;. .,•.
❑ New construction 14 43'' : tiktFUiVItilement Please check all that apply:
El Demolition 1=1 Other: OService over 225 amps, cornrn'l ❑ Hazardous location
li n" " 5 "> # sjf�' i�'"� "k"9 " a . ° � �" , t � 't "' . t ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
sa
1, 1 , tP, - h{ ifi i, l a w iiii a 2 ��{{ I ta31, ,1,, 1 1,,V'i.'- -P. k , ri ., ;1; of 1- and 2- family dwellings 4 or more new residential
t n inin tflni 'i nn . O.... �.a.: - - train it�l t41...linlat nairi a + b.,i .Bondi .an x. v , i :••
Y ❑ 1- and 2- family dwelling IIR Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Multi- family ID Master builder ❑ Other:
ID Building over three stories ['Feeders, 400 amps or more
- , n Multi-family t n 114 .t'u 5 t yi7�, builder , M ad` . 1 tb ,g1 n ❑Occupant load aver 99 persons ❑ Many factured structures or
- � " r i "li q� �� 1Zr t -Y6tiy e } M� y ' 7 i ,y ,t `tD N ii -,, � { I l ; l �tll �ti l ,on t l V t� i ! RV.
� : 614 n � 1 aiihd,"ni,,,iiiti , lur .. I I t 2.c'1c. � ;ru i o. , ❑ park
Egress/lighting plan p
❑Health -care facility El Other:
Job no.: 6 ( i Job site address: 1 43 c 7 Z ,-
5 Submit 2 sets of plans with any of the above
City/State/ZIP: l t 5 pRp J The above are not applicable to temporary construction service.
Suite/bldg. /apt no.: Z.,?- ( I Project name: 5 a N Ex IVG Description Qty. Fee. T°tel
Cross street/directions to job site: New residential single- or multi - family dwelling unit. •
Includes attached garage.
1 L i ry (c-�� v Z-7?' ( L,000 sq. ft. or less 145.15 4 -
Subdivision: I Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map/parcel no.: Limited energy, non - residential 75.00 2
`1,19 . g dl ( A14°$� ��$ '� � �,� } S ��up �. Y. rl�l II l ) 011l WY 4 " (I 1 .1� Y i , gy
'ilitti l ` t � "s , �'.1 ,,, f r;�� K" z .. .1d thila l�a a u w�lk.� N .. .. t4Lna, 1.a , L, - , ,, Each manufactured of modular
• I+c n n. 1
a .,1. . _ dwelling, service and/or feeder 90.90 2
I : ,. I i. f n u ut - . _ Services or feeders Installation, alteration, and/or relocation .
/ 200 amps or less 80.30 2
,(ral f !t ixan°v,In i try 1.rl - 4:: { t if u ,b`y ' i4v4f g ?IN' i , ' ;> , 1, g. 201 amps to 400 amp 106.85 2
� ,rot' .a '�i ia to f t 9i _ 11 - 4;: unn i A , nr,t,I.L n. 11 WI."' ' ?,. C[F -' l+ ii -nth LI
40l amps to 600 amps 1 60.6 0 2
Name: Fe P Li A, 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: („ ) g tbs 0 4 -s 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
jil 1girlbil l g R It ILA �n,� �� t 't �` I 1� I l l 4 rlRrP 3" llj `•fp t Mtt t i f f( rr
l Cl3 fpp,m� l dl A. Fee for branch circuits with
,tiurt�IlufC:..c.�..,..�..a �:i• li. +fir„ +.,1'�L,,.> b+a,:.l .l .�INiI �li'li.r. :Ili' i .v+}. `?q 1., SuFi9 #iJS,.A;lIR4[FR? t
s or feeder fee, each 6.65 2
Business name: , branch circuit
B. Fee for branch circuits / ,
without service or feeder fee, E Yy
Contact name: fr
each branch circuit 46.85 2
• Address: Each add 'I branch circuit 6 .65 : 2
City/State /ZIP: Miscellaneous (service or feeder not Included)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax:: ( )
Sign or outline lighting • 53.40 2
E -mail: Signal circuit(s) or limited -
, 1 ,, , ulat )'" #.. 1 1 Icy s r° , li "1 �yy,, - ; °' w ;t r ,03 r ul 7 d 8 , 7, energy panel, alteration, or
3lr "if'�lt!l � i.tti2a+.. 1 iSit. t +i _'i d T t.a..KH'Ld 1 , , ��.
�, rte � � .�:����� � � .��.�s,�f> #� •� , � , , , t., . ,= �.,..,�
extension. Describe: Page 2 2
Business name: W j et [ L"lGt i „.G h.,(..._
L
Address: �� �� 236 y Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State/ZIP: 7 S igt t i 0 K ` 9 i ( Investigation per hour (1 hr min) 62.50
/
Industrial plant per hour • 73.75
b
Phone: ( o?) Z 31.3 l I Fax ( -3 G ZY - z4 , ) �, '� � yliilfitiil n l�. > *�.iYi�u�4ti'i t cal � °. w iN _'; r . a r.: )'` - r „ •.g: ... ^�:
r. �.-,�t,[_I
CCB Lic.: y...5- i Electrical Lic.:3 4 - z.3-3 C. I Suprv. Lic.: /965 Subtotal C ( -O '
• Suprv. Electrician signature, required: /4 4,........, __ Plan review (25% of permit fee)
I
State surcharge (8% of permit fee) 5
Print name:. Fc , Date: g_ i b , _ 0 . 3 ti
\ �' TOTAL PERMIT FEE j 1. Z i Li
e
Authorized signature: This permit application expires if a permit is not obtained within lg0
days after it has been accepted as complete
Print name: Date: ' Fee methodology set by Tri- County Building Industry Service Board
.` Number of inspections per ?emrit allowed.
i\Building\PeemitiBLC-PertnitApp .doe 17/03 440 4615r(10/02.'COM/WEB
CITY OF TIGARD 24 -Hour , -
BUILDING Inspection Liner (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested � /C AM PM BUP
' Location / U 3O c.. L t .0—.24 <baiter Suite c- ( MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) 6J- 3 ( SWR / /
BUILDING Tenant/Owner ELC ! 7 7L T �� - " °
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors 4t
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation ` , { 4 S /) Ft&I
Drywall Nailing V
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
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
Rough -In
UG /Slab
Low Voltage
Fir- larm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
ASS PART FAIL
SITE 111 Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line 4-efc-/%* ADA Da t e � ® Ins actor . t?
Approach /Sidewalk Ext
P
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL