Permit •
CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00139
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/15/2007
PARCEL: 1 S 135AB -01003
SITE ADDRESS: 10300 SW GREENBURG RD 390 ZONING: C - P
SUBDIVISION: LINCOLN CENTER /ONE LINCOLN LOT: JURISDICTION: TIG
PROJECT: RELIANCE
Project Description: Low voltage for data.
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 PROGRESSIVE TELEPHONE SYSTEMS
ONE SW COLUMBIA ST #300 710 NE CLEVELAND # 120
PORTLAND, OR 97258 GRESHAM, OR 97030
Phone: Contact #: PRI 503 665 - 4900
FAX 503- 655 -4830
FEES Reg #: ELE 26- 1117CLE
LIC 150175
Description Date Amount
[ELPRMT] ELR Permit 5/15/2007 $75.00
[TAX] 8% State Surcha 5/15/2007 $6.00 REQUIRED ITEMS AND REPORTS
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 Not' ' 'a` enter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules direct questions to ouNC at 503.246.6699 or 1.800.332.2344. 417
Is ued By: �, // Permittee Signature: �l
OWNER INSTALLATION :!
The installation is being made on property I own which is not intend-d 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
1114 City of Tigard
Date/B f b ' 7 Permit No.: sz. Q , /39
- 4 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit
TIGAR Inspection Line: 503.639.4175 Date Ready/By: kris Vi See Page 2 for
Internet: www.tigard - or.gov Notified/Method: i e Supplemental Information
TYPE OF WORK PLANK REVIEW..
• El New construction Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
. ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinasand boatyards.
CATEGORY OF CONSTRUCTION - exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE. INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "1 -3 ",
Job no.: Job site address: /63c0 5w 4 fvynl Six or or more residential units. ❑ Recreational L� ❑ or al vehicle parks.
o--P-__ � c 7- V ❑ Health -care facilities. ❑ Supply voltage for more than
a ❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: 343 Project name: 1 i � p - ❑ Service or feeder,600 amps or more.
FEE SCHEDULE'
Cross street/directions to job site: g 1' A - Q,., -(� Description I Qty. Fee. I Total I •
7 �' ` V� New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. f -)
f ` Limited energy, multi - family
Les V
'r jL 8- i �� VQ t C - N A eQ. f \ Co I.1 residential (with above sq. ft.) 75.00 2
� Services or feeders installation, alteratlor, and/or relocs'5n
200 amps or less 80.30 2
❑. PROPERTY OWNERNANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
� 601 amps to 1,000 amps 240.60 2
Address: c5 hi C y,- rd . Over 1,000 amps or volts 454.65 2
City/State /ZIP: W /` Q7973 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (' ) Fax: ( ) 200 ampi 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 599 amps 133.75 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: • A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: B: Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Each add'I branch,circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling; service and/or feeder 90.90 2
Phone: ( ) Fax:: ( ) • Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR . Sign or outline lighting 53.40 2
\ - ��" Signal circuit(s) or limited -
Business name: U , ress` � �Jy� ..s sle v 1 r C$JYr` energy panel, alteration, or .A
extension. Describe:
Address: ( Page 2 7 2
7 O 6 6 - 0 1£VC A -'(V�
City/State /ZIP: g� (yQ Q *1' , CS Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (` 7 33) 66 ^ 'gOs9 Fax: ( 3) 6r^ ? Investigation per hour (1 hr min) 62.50
CCB Lic.:r 5O - Ih 7S ---- Electrical Lie.: aG °it f7c.c,€ Suprv. Lie.: a267C613 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: _75-:°-(1.
Print name: Date: Q7
Plan review (25% of permit fee):
State surcharge (8% of permit fee): 6 . 0
Authorized signatur / TOTAL PERMIT FEE: 87,00
This permit application expires if a permit is not obtained within 180
Print name: /��f
Date: ( (O days after it has been accepted as complete.
• Number of inspections allowed per permit.
I'\ Bwlding 'Permits\ELC- PermitApp.doc 05/23/06 440- 4615T( l l /05 /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..ONLYi: ,
Fee for each commercial $75.00
system
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
n Clock Systems
V Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
n Instrumentation
n Intercom and Paging Systems
❑ Landscape Irrigation Control*
n 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. \ Budding \Permits\ELC- PermitApp.doc 03/23/06
CITY OF TIGARD •
`" DIVISION PERMIT #: ELR2007 -00139
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5115/2017
Phone: (503) 639 -4171 V Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/16/2007 TIME: 7:00AM PAGE: 1
SITE ADDRESS: 10300 SW GREENBURG RD 390 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER /ONE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: RELIANCE
DESCRIPTION: Low voltage for data.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: PROGRESSIVE TELEPHONE SYSTEMS PHONE #: 503 - 665.4900
Inspection Request Scheduled For: Date: 5/16/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
1- € - r ti • e 048 11 01 N 503- 969 -4091 " Y
Corrections /Comments /I uctions:
c • 11,c'1( “Li 110 %41 04
k: I l_ Ur100 c Q, i 5 0• (� .
ooieg
0•ASS n PARTIA PPROVAL ❑ CANCEL n NO ACCESS
L FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: N 66 Date: 61 6`0 Phone #: (503) 718 - Z 1.4
_ .