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Permit
p, CITY TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT im DEVELOPMENT SERVICES PERMIT #: ELR2005 -00060 6�'II DATE ISSUED: 3/18/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S135AB-01003 SITE ADDRESS: 10300 SW GREENBURG RD 500 ZONING: C -P SUBDIVISION: LINCOLN ONE /RED LOBSTER /CASA L LOT: JURISDICTION: TIG Project Description: Data lines 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 HARDLINE CONSTRUCTION ONE SW COLUMBIA ST #300 PO BOX 1334 PORTLAND, OR 97258 SHERWOOD, OR 97140 Phone: Phone: 503 - 502 - 9461 Reg #: ELE 34- 557CLE LIC 146186 FEES SUP 3552LEA Description Date Amount REQUIRED ITEMS AND REPORTS [ELPRMT] ELR Permit 3/18/2005 $75.00 [TAX] 8% State Surchar€ 3/18/2005 $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 -101 -0100. You may obtain copies of these rules or direct questio J t OUNC at 503, -6699. Issued By: — '�/�si/ Permittee Signature:X ,tf)Gt, 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 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 P � ' 1 a li ,. T 'FOR'OFFICE'USE'ONLY ' City of Tigard Received Date/ : ! ff PermitNo.: / BO ) O 13125 SW Hall Blvd., Tigard, OR 97223 MAR 1 (`), 2005 / ' Plan Revie MAR / ��, Iy�� f Other Permit: Phone: 503.639.4171 Fax: 503 jl I Date/By: Inspection Line: 503.639.4175 ' I Date ReadyBy: Saris: a See Page 2 for Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: Supplemental Information T l pLM iTpoirM ISION PLAN REVIEW ❑ New construction ❑ Addition /alteration /replacement Please check all that apply: ❑ Demolition ❑ Other: 11 Service over 225 amps, comm'l CI 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 lie Commercial /industrial ❑ Accessory building ID System over 600 volts nominal units in one structure [1] Multi family ❑ Master builder ❑ Other: ❑Building over three stories ❑Feeders, 400 amps or more ❑Occupant load over 99 persons ['Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑ Egress /lighting plan RV park Job no.: O n;4 Job site address: 103 00 s� 6Ir � Jf 0 ❑Health - care facility ❑ Other: 00 v ^`f Submit 2 sets of plans with any of the above. City /State /ZIP: � ewfX • V `' . 9 "7 D-3,-- / The above are not applicable to temporary construction service. / Suite/bldg. /apt. no.: 5 6 0 Project lam' jectname: pr\,J I„-t`' \ . FEE* SCHEDULE ** �--' Descri tion Qty. Fee. Total Cross street /directions to job site: ,,1 L. Gclvs G v1n t/" o 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'l 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 C C1 -- 1 i vA,e,5 E.64...kt, 5e.-_) dwelling, service and /or feeder 90.90 2 Services, or feeders installation, alteration, and /or relocation 1 8" -f -k 200 amps or less 80.30 2 ❑ PROPERTY OWNER CI TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 • Name: 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 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 ❑ CONTACT PERSON . A. Fee for branch circuits with ` service or feeder fee, each 6.65 2 / Business name: 'Cxf'M, nQ ,-• r‘s4-L branch circuit B. Fee for branch circuits Contact name: J 6,-E__" Q. F,E0d without service or feeder fee, 46.85 2 � 2 J each branch circuit Address: I/JOx ).3 3 _I Each add'l branch circuit 6.65 2 City/State /ZIP: S I] .e t..L)o00 () `._ C1 / - 2/ 4 0 Miscellaneous (service or feeder not included) / V / Pump or irrigation- circle 53.40 2 Phone: ( 50`3) .ry .)— -- 9 V6 f Fax: : ( ) Sign or outline lighting 53.40 2 E- mail: (C�� Signal circuit(s) or limited - CONTRACTOR energy panel, alteration, or extension. Describe: i Page 2 1 2 Business name: 1—I- 14 AC ® „S C) I Vin Address: p V eV )( i 3 (.a Each additional inspection over allowable in any of the above 1 ! O 7 L � Per inspection 62.50 City/State /ZIP: 5 esr�J o r� J"� Investitigation tion per hour (1 hr mm) 62.50 Phone: (St ) �d)- 927 6 / I Fax: ( ) Industrial plant per hour 73.75 . ELECTRICAL PERMIT FEES* CCB Lie.: ( 16 ig 6 I Electrical Lic.: 3y_ 5 7 I Suprv. Lic.: 55J-Ge&. Subtotal Suprv. Electrician signature, required: , Plan review (25% of permit fee) \ p ri640` Date: 0 c{ 03 State surcharge (8% of permit fee) Print name: `� J / TOTAL PERMIT FEE I 00 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 \Pemits\ELC- Pe,mitApp.doc 12/03 440- 46t5T(10 /02 /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 ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* Vacuum Systems* Other: COMMERCIAL WORK ONLY: Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: I Audio and Stereo Systems I 1 Boiler Controls 1 Clock Systems Data Telecommunication Installation Fire Alarm Installation ❑ HVAC ❑ Instrumentation 1 I Intercom and Paging Systems ❑ Landscape Irrigation Control* I Medical U Nurse Calls U Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations is\ Building \Permits\ELC - PermitApp.doc 04/03 / CITY OF TIGARD BUILDING DIVISION PERMIT #: ELR2005.00060 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/18/2006 Phone: (503) 639 -4171 Jai l f l Inspection Requests (24 Hrs.): (503) 639 -4175 __.. INSPECTION WORKSHEET FOR DATE: 3/29/2006 TIME: 7 :11AM PAGE: 92 SITE ADDRESS: 10300 SW GREENBURG RD 58 �g) CLASS OF WORK: SUBDIVISION: LINCOLN ONE/RED LOBSTER /CASA L LOT #: TYPE OF USE: PROJECT NAME: OWNIT MORTGAGE DESCRIPTION: Data lines OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #: CONTRACTOR: HARDLINE CONSTRUCTION PHONE #: 503.602 -9461 Inspection Request Scheduled For: Date: 3!29/2005 Pour Time: Code '# Inspection Description Confirm # Contact # Message 135 Low voltage 003062 -01 503- 502 -9461 Y • Corrections /Comments /Instructions: got. NI' / ( Vi ■ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS I I FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: gc/,,,,,, �""`- Cy Date: J -- - 5 7 Phone #: (503) 718 -