Permit i CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT #: ELR2004 -00224
'-" 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/23/2004
SITE ADDRESS: 10300 SW GREENBURG RD 525 PARCEL: 1S135AB-01003
SUBDIVISION: LINCOLN ONE /RED LOBSTER /CASA L ZONING: C -P
BLOCK: LOT: JURISDICTION: TIG
Project Description: Limited energy, phone & data moves.
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:
Owner: Contractor:
EQUITY OFFICE PROPERTIES TRUST C3 COMMUNICATIONS INC
10260 SW GREENBURG RD #100 10950 SW 5TH
TIGARD, OR 97223 SUITE 110
BEAVERTON, OR 97005
Phone: 503- 892 -2500 Phone: 503- 643 -1922
Reg #: MET 00004740
LIC 117658
ELE 24- 373CLE
FEES SUP l$gad Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 7/23/2004 $75.00 Elect'l Final
[TAX] 8% State Surchaq 7/23/2004 $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 .mot OK_ Permittee Signature S� � p .e
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
FROM ;MUNICRTIONS 503 - 643 - 1203 (THU)JUL 22 2004 14:16 /ST.14:12 /No, 6807695320 P 1
07/22/ 2:50 FAX .5005941960 CITY OF TIGARD 21001
Electri Permit Apiil ca n PUlR mulct USE ONLY
\I tie.— R tccevcd /��/ [ n( t�
City of Tigard V i '�,00'‘ tlard - 7 -- 7 Permit No.: l_.�— p 7 J 011i •., /
. 13125 SW Han Blvd, Tigned, OR 97223, ` Plane ocher Pamir
Phone: 503.639.4171 Fax: 503.598.1960 Q •"_,' ` ' I -
Dat _
inspection Line: 503,639.4175 , - ( \GA ■ , i), Dare ReodY(BYt jam In SoePage2 for
Internet: www•ei-tigard•or.us C, \IY O \V\ s 1C r NotitleNMete J -
od: 1T' ( - 9upplcnlcIDlNInformation
ttVG --•r- . -
� .I OF Bi WO ' !',; : - I; '! , r '!, :: •:` PLAN, I V}t' • • • • i • i
0 New construction ❑ Additionisl cration/seplaeer act Please chick all that apply:
❑Service over 225 amps, control ❑Hazerdoualocation
[] Demolition ❑ Other. ['Service over 320 amps — rating ❑ Buildng over 10,000 sq, ft,
' 1 ::c.ATEGQRY op i eiNSXBUCTIOIW . ..:. :, ;.• • • .:,,,•,. ;;.' of 1- and 2-family dwclling6 4 or more new residential
p I- and 2- family dwelling C i Coat nercial/inclustrial 0 Accessory building ❑system over 600 volts nominal unite in one structure
ng over
❑ Multi -famil ❑ Master builder ❑ Other; ❑Buildi three atone [Weeders, 00 amps or more
[]Occupant load over 99 persons ❑ManofacNrcd »ru nnei or
e w• r r a a °Egressii h6mg plan RV park
QHealth -care haiku/ Other:
Submit 2 of plans with any of die City/Slate/ZIP: _ The above me mot applicable to temporary construction service,
: i i'' "FMS s ' SC1I DULE .
e. ,. at o raer d ug Q4- ors rotas : .
sheet/directions Cross job site: Ncw residential ;Ingle or multi- family dwelling unit-
InCtadea misdeed garage. _
1,000 sq. a• lass 145.15 • 4
Subdivision: Lot no.: EL add'I 500 sq. It or portion 33.40 I
• Limited energy, residential 73.00 2
Tax map /parcel no.: Limited energy, nonoreeldondal 75 2 •
• ;i , '. E'$ R ' '. PTION. OF WORK . . ,; ''' : . • Each mantsttiotutedormodUlar
f
. dwelling. service and/or feeder 90 2
Ph 011.0._ 't Thr7 n k/48Ye$ Services or feeders rartaltaoioo, alteration, and/v relocedon
•
200 crap; or less 80.30 2
a 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 434.65 2
- Reconnect only 66 - 85 2
City /State/ZIP: Temporary services or feeder, installatieo, alteration, and /or
relocation _
Pbonc: ( ) Fax: ( ) 200 am. s or less 66.8$ I
Owner installation: This installation is being made on property that I own which is nor 201 amps to 4430 amps 100,30 2
intended for sale, lease, rent, or exchange, according to OILS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: _ Date: Branch circuits— newt1 aleeratlob, or extension, pe r panel
A Fee for branch citcafa wish
[] AP1iLICAN' ' , ' fl . GO1tI I`AC - C' pFON service or feeder fee, each 6.65 2
Business name: brunch t rciit ,
-- B. Pee for branch circuits
Contact name: wt'WJto service or feeder fee,
each branch circuit 46.85 2
Address: each add'l bench circuit 6,65 2
City /State/ZIP: M hultaeetus (service or feeder not included)
Phone: ( ) F X: ; { Pump or irrigation circle , 53.40 2
a )
Sign or outline lighting S3.40 2 _
5 - mail: Signal circuits) or limited-
' . .C ON ' P1�Al;T dxt ' " , ' • extension. D of
" . _ i ; ' en panel, alteration, or
ext cribs: / Page2 75 2
Business na1110:
01111
Address: 10950. SW 5th Street, Suite #110
Rath additional inspection aver allowable in an of the above
For inspection 62,50 • City /State /ZIP: Beaverton Oregon 97005 Investigation per hour (1 br min) 62.50
Phone: (O ) 643 -1922 Fax; ( • ) e , _ ]ndu trialpl�fp 73
. ... :)8LE. 'KIC1iL • IV
PER *- ES* -
CCB Lie.: 1176 ,58 Electrical Lic.: 24'173 f.EP Suprv. Lie.:' es, L subtotal — 7,5
Suprv. Electrician sii nature, required; („- (Zr ,Lt,.k._._ Plan review (25% of permit foe)
• Print name: . State surcharge (814 ofpernilt li:e) A
Jerr L; Koch pa te '
_ TOTAL PERMIT FEE 'y A GO
Authorized signature: Tai, permit application explra if a por b not •brained w,tbin 180
day' after it has been accepted al complete
Print name: Dare: • Fee madtodolory .ct by Td- County Building Industry Service board
'• Number of inspection' per permit allowed,
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION : 131 - -`,-. (503) 639 -4171
BUP
Received Date Res ested AM PM BUP
Location / 0 306 i Suite Sa MEC
Contact Person Ph ( PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access: �/ d�Z Z
Ftg Drain ELR /
Crawl Drain
Slab Inspection Notes: (3J 57 9 °'�'��a SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear 6
Int Sheath /Shear 7 //)2
Framing
Insulation
Drywall Nailing
Fi rewal I
Fire Sprinkler
Fire Alarm ! pgriv6L f ii(lLL
Susp'd Ceiling ��
Roof
Other: n
Final C P l'. ./1git r o C/ - L /v r Pp5rE w -d o g>
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
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
E l Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line ADA /(.tM P .�i l � i Ext
Approach/Sidewalk Date _ Inspector
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL