Permit •
.
CITY TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
l DEVELOPMENT SERVICES PERMIT #: ELR2006 - 00202
'�I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/28/2006
PARCEL: 1S135AB-01003
SITE ADDRESS: 10300 SW GREENBURG RD 470 ZONING: C -
SUBDIVISION: LINCOLN CENTER /ONE LINCOLN LOT: JURISDICTION: TIG
Project Description: 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 AZIMUTH COMMUNICATIONS INC
ONE SW COLUMBIA ST #300 P.O. BOX 508
PORTLAND, OR 97258 WILSONVILLE, OR 97070
Phone: Contact #: FAX 503 - 639 -0115
PRI 503- 639 -0110
Reg #: ELE 36 -94CLE
FEES LIC 145828
Description Date Amount SUP 2312LEA
[ELPRMT] ELR Permit 8/28/2006 $75.00
[TAX] 8% State Surcha 8/28/2006 $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 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.
J 1
t
Issued By: Y Z / Permittee Signature: t � ,
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
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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.
f
Electrical Permit Apphl j >n V _ ... - - - - F012 'USE ONLY - - --
! 1 " fw Received A ?
City of Tigard Date /B . � .- Permit No.: _ , _
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review �` �'
Phone: 503.639.4171 Fax: 503.598.1960 AUG 2 (; 201, :"t/ /it i , ?fl l �> Date/By.. Other Permit:
Inspection Line: 503.639.4175 ! .. Date Ready/By: 1211. ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
tJ1 I is r PLAN REVIEW
`' 1 ia T�TO-.
' r " "� " ig ' ` . ,
Please check all that apply:
❑New construction [�; Addition /alteration /replacement PP Y:
❑ Demolition El Other: ❑Service over 225 amps, comm'l ❑Hazardous location
['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 IF Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi family ❑Master builder ❑Other: ❑Building over three stories ['Feeders, 400 amps or more
❑Occupant load over 99 persons OManufactured structures or
JO &.SITE INFORMATION AND LOCATION` - ❑Egress/lightingplan RV park
0 Job no.: Job site address: (03 00 Sul Ge �6Ca_ ❑Healt2 -care facility ❑Ot
Submit 2 sets of plans with any of the above.
e.
City / State/ZIP: ( 06 Y_t. `eci" / Oa- The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: 47 0 Project name: f) 0/1 7E Z,dAk� FEE* SCHEDULE
Description I Qty. I Fee. I Total I "•
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 1
Tax map /parcel no.: Limited energy, residential 75.00 2 •
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK, Each manufactured or modular
V A ^� / � � dwelling, service and/or feeder 90.90 2
V [J C l Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER .. - I,. TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: /UI 7MfJ(.0 /0 E -741/c a 601 amps to 1,000 amps 240.60 2
Address: /0 360 SoJ ar-,-gxigccd-4 6) Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State/ZIP: ?oiTiiiiro J (5 61-. Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( )
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
' ❑ APPLICANT 17 CONTACT PERSON A: Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name:
(v4 LAT1._1 CoriAM ulOtcAT,Oft3 s branch circuit
B. Fee for branch circuits
Contact name: LLL&e L without service or feeder fee,
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each branch circuit 46.85 2
Address: (' Bo\& 5(J h C•1c/ Each add'l branch circuit 6.65 2
City /State /ZIP: kj (L SNJ 0 ,0_,e-- o R. c j � t ') b Miscellaneous (service or feeder not included)
7 Pump or irrigation circle 53.40 2
Phone: ( 503 ) 7g3 Zc-,/S1 Fax: : (52)5 )C 9
Sign or outline lighting 53.40 2
• E - mail: Signal circuit(s) or limited-
n . CONTRACTOR ' ti energy panel, alteration, or ���
Business name: ft Z((uea ` -1 ' KM µ „ta Ai, 6 4 2 S extension Describe: Page 2 75(.1(.) 2
Address: P. V , e k 508- Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State /ZIP: (Jl Ls O 0 J. LLE) c w . _ q7 0 Investigation per hour (1 hr min) 62.50
Industrial plant per hour 73.75
Phone: (5020 a _ 01/ U Fax: ( 3 ) 6 f - 0 ) (c ELECTRICAL PERMIT FEES*
CCB Lic.: (L5 2 Electrical Lic.: 36,14 cLE Suprv. Lic.: 23 /Z ' LE Subtotal
Suprv. Electrician signature, required: ,� ..t S/ Plan review (25% of permit fee)
Print name: t 1I ' u LA e C Date: g 2...0 OL State surcharge (8% of permit fee) �w�l
TOTAL PERMIT FEE ? i vv
Authorized signature: This permit application expires if a permit is not obtained within 180
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 permit allowed.
i:\ Building \Permits\ELC- PermitApp.doc 12/03 440- 4615T(10 /02/COM/WEB
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Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENT,aiTii ORK ONLY:: `" s
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
El Audio and Stereo Systems*
❑ Burglar Alarm
El Garage Door Opener*
El Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
CONIlVIERCIAL WORK ONLY: .
Fee for each commercial system $75.00
(SEE OAR 918- 260 -260)
Check Type of Work Involved: .
•
El Audio and Stereo Systems
•
❑ Boiler Controls
❑ Clock Systems
F, Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
El Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
El Outdoor Landscape Lighting*
❑ Protective Signaling
• ❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
i:\ Building \Permits\ELC- PennitApp.doc 04/03
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CITY �����7N�������% ' ~
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. BUILDING DIVISION
PERMIT #: ELR2006-00202
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/28M7000
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 -
INSPECTION WORKSHEET FOR DATE: 9/8/2008 TIME: 7 PAGE: 68
SITE ADDRESS: 10300 SW GREENBURG RD 470 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/ONE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: NATIONWIDE
DESCRIPTION: DmtarFa|enomnnunivahonn
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: AZ.|hHUTH COMMUNICATIONS INC PHONE #: 503-639-0110
Inspection Request Scheduled For: Date: 9/8/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
036202-01 503-793-2906 N
Corrections/Comments/Ins uc1iono:
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•
);1DASS •
I PARTIAL APPROVAL CANCEL 0 NO ACCESS
|| .A|L CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
G---t »����& �� �� • ��1.
Inspector: n`w ~°�� u~�s Date: -»` oo^ ~~�� Phone #: (503) 718- ?Mb