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Permit CITY OF TIGARD ELECTRICAL PERMIT - RESTRICTED ENERGY 1)c_'l DEV w SW Hall Tigard, RR9 SERVICES (503) 639 -4171 DATE ISSUED: 12/22/2004 0383 0 — 13125 SITE ADDRESS: 10300 SW GREENBURG RD 375 PARCEL: 1S135AB-01003 SUBDIVISION: LINCOLN ONE /RED LOBSTER /CASA L ZONING: C -P BLOCK: LOT: JURISDICTION: TIG Project Description: Low Voltage /data telecommunication. 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 JUNIPER TELECOM ONE SW COLUMBIA ST #300 2147 N EMERSON ST. PORTLAND, OR 97258 PORTLAND, OR 97217 Phone: Phone: 203 - 285 - 0002 Reg #: LIC 67762 ELE 26- 590CCLE SUP 1019LEA FEES Required Inspections Description Date Amount Low Voltage Inspection [ELPRMT] ELR Permit 12/22/2004 $75.00 Elect'l Final [TAX] 8% State Surchart 12/22/2004 $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 a, ,Z a �A Permittee Signature /fi ar 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 7:00 P.M. for an inspection needed the next business day Dec 21 04 03:19p Eric Goranson 503 - 285 -3219 p.1 ' 12/21/2004 «:,0':00 FAX 50 CITY OF TIGAR'D I?' 001 ` Electrical Permit'laifn ® FOR OFFICE USE ONLY City of Tigard °P C 2 j 2004 Received I I. )1 D 8/ L /W� e9O3'3 D eive Permit No,: 13125 5W Hal] Blvd., Tigard, OR 97223— Plan Review Phone: 503.639.4171 Fax; 503.5`811f6t0 ►1 1l( p ® aA "l.'•ti} : ", 0. Date/By: Other Permit: Inspection Line: 503_r 9.4175 p��q /�j r`^ �„. Date Ready/By: iur j f See 1'5Re 2 for e. w Interneww.ei.tigold.or.us BUILDING DIVISIO' Notified/Method: / �G Supplemental Information . 3:'Y t E'OF: 'WORK ... . • :.g : .: .: _ PLAI\: RE1ViEVir "� : : . : `. . . _ ❑ New construction ddition/alteration / replacement Please check all that apply: • ❑ Demolition ❑ Other: ❑ Service over 225 amps, comm'l ❑Hazardous location — Suvrce over 320 amps tali Btlildrt ove 10,000 sq. ft. , .. % C .AlEOORY OF••.CQ�1Ogir.CTIO' 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 Stricture El Multi-family ❑ Master builder El Other: ❑ Building over three stories ❑Feeders, 400 amps or more ID Occupant load over 99 persons ❑Manufactured structures or ' ..: JOB: SITE INFORMATION A1tiD' LOCATION ' • .' ' ' i ❑Cgressilightin RN/ park Job no.: l Job site address: , C 5 G'r'eftkbu ❑Health -care facility ❑Other: Submit 2 sets :Anions with any of the above. City /State /ZIP: 1 L( - p 1") The above are not applicable to ternporaary construction service. • Suite/bldg. /apt.no.: 7 5 1 Project name: r r V ' •.: F EE* SC buLE ..• •:.:' Description 1 Qty. l Pte I Total i Cross streer/directio:ls to job site: New residential single- or multi - family dwelling unit. •• Includes attached enrage.. 1,000 sq. ft. or less ' 145.15 4 SubdiviSior1: Lot no.; Ea. add'l500 sq. R or portion 33,40 1 Limited energy, residential 75.00 2 Tax map /parcel no.: Limited energy, non - residential I 75.00 2 • :..:•:.: • • ..1 ' DESCRIPTIOTd•'OF :wORIZ; ; . ; ": ; •. ;• ': '' •. Each manufactured ar modular Na t Gr ' ` i{i t ' v n r dwelling, service and/or feeder 90.90 2 � Services or feeders installation, alteration, and /or relocation 200 amps or lass 80 _30 2 201 amps 11) 400 amps 106.85 2 ❑ 'FRQFEItTY 'OWNER . : ; CI : i�N4NT ' " . 401 amps to 600 amps 160.60 2 Name: .601 amps to 1.000 amps 240.60 I 2 Address: Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 i 2 City/Statc/ZIP: Temporary services or feeders Installation, alteration, and /o r Phone. ( ) F ax: ( ) relocation 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 Y Owner signature: .Date: Brunch circuits new alteration, or extension, per panel • . ❑ APPLICANT • E' CONTACT' PERSON •:: A F cc f or branch circuits with service or feeder fee, each Business name: branch circuit 6.65 2 E. Fee for branch circuits Contact name: wi/hout service or feeder fee, each branch circuit 4G.85 2 Address: Each add') branch circuit 6.65 2 City /State /ZIP: Miscellaneous (service or feeder not Included) Pump or irrigation circle l 53.40 2 < ) Fax::( ) Phone: Sign or outline lighting 53.40 2 E-mail: Signal circuit(s) or limited- • ' • - " ` ; ' ' ` energy panel, alteration, or • ... :.• .. ..: COIv TRACTOR• . � :: .. Business name: JUNIPER TELECOM extension. Describe: Page 2 2 , Address: 2141 N. EMEHSON S 1 . Each additional Inspection over owoble in any of the above Per inspection 62.50 -3808 City /State/ZIP: PORTIANDTGR--9-7-21-7 Investigation per hour (I hr min) 62.50 7 n 7 industrial plant per hour 7335 �') Phone: (�p � 'O � - Fax::( ) — ` )L) � EtEct:EiW;4L. k'E mrr .VEFS' - :..i:' ' .. i CCB Lie.: W �7 t�' Z Electrical Lie. p - D -t Suprv. Lie.: ( p�q,L- Subtotal '7 S - �j �? r O t © $spec'. Siectrician signature, requ I C) � Plan review (25% of permit fee) Print name: eZ\C„, A 0R■._ Date: 2- 2,i-of _of- State surcharge (8% of permit fcc) (p — TOT AL h''P;RM1T FEE W 1 Authorized signature: This permit application expires if a permit Is not oblalned within 180 day. after it has been accepted as complete Print name: Date: - FCC methodology set by Tri- County Building Industry Sender Board "• Number of inspections per permit allowed. i:\BuldinglPermiti\EGGComilA 00, /ac 1310: 4.4045152(1 alo2ICCONWRn CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business, Line: - (503) 639 -4471 MST BUP Received Date Requested �-- AM J PM BUP Location / U 3 C) C Suite 3 7s MEC Contact Person C Jl t r pW( 2 y 5- 000 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Ftg Drain Access: ELR � 00 38.E Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final P ASS PART FAIL PLUMBING Post & Beam Under Slab r Rough -In \10/'/‘ 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 Fire Alarm ',1■ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. '' • RT FAIL SITE - El Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA \ Inspector Ext Approach/Sidewalk Date �' p PP/444(y Other: Final DO NOT REMOVE this inspection record from the b site. PASS PART FAIL