Permit CITY OF TIGARD VHK RD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00905
DEVELOPMENT SERVICES DATE ISSUED: 11/18/2005
• "ff 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S135AB-01003
SITE ADDRESS: 10330 SW GREENBURG RD RED LOBSTER ZONING: C -P
SUBDIVISION: LINCOLN CENTER/ONE LINCOLN LOT : JURISDICTION: TIG
Project Description: Disconnect/reconnect rooftop HVAC equip. Job #05 - 913.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: 8 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
EQUITY OFFICE PROPERTIES TRUST BOB'S ACTION ELECTRIC INC
ONE SW COLUMBIA ST #300 2700 NE BURTON ROAD
PORTLAND, OR 97258 STE A
VANCOUVER, WA 98662
Phone: Phone: 360- 254 -7200
FEES Reg #: SUP 4322S
53136
Description Date Amount LIE 37-43
ELE 37 -431C
[ELPRMT] ELC Permit 11/18/200' $133.50
[TAX] 8% State Surcharge 11/18/200` $10.68 REQUIRED ITEMS AND REPORTS
Total $144.18
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 or
1- 800 - 332 -2344.
Issued By: Permittee Signature:
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 Permit Applicatto n EGL i \ r ¢! _• . ` ` • ` FOR.OFFICEUSE ONLY
City of Tigard Received , /j �� permit No. °� / �/ `
13125 SW Hall Blvd., Tigard, OR 97223 y ; r, Date/B // / i QU YL/ �1. f
Phon 503.639.4171 Fax: 503.598.1960 "u
NOV 1 O Plan Review
/ / Hi lrn r t Other Permit:
ryIV Date/B :
Inspection Line: 503.639.4175 y / _ .• a Date Ready/By 1E1 See Page 2 for
Internet: www.ci.tigard.or.us C11 Y o '' , L. , Notified/Method: Supplemental information
tW.. ;`}�44 -.. a..w'u,. =€" < "11' �2 �;�:;er, n���i Nr;' y'��.ibr E'�t.�xx:.am:.��i a� nv� M:' �.h" .�°. ^i;'�u' > "F;.'�' {;"�' �
FJ� <i ,
x", N ,M1r�'F-'r : r-ry N'4 + , n;«�' ':l ' `„ l.. = 'Ys v.i s . �,`: 4�ti ' ;:L:•.�I 'YY
�t�. sy ,: �PLAN?RE�'IE.
w.'�J�li',��e' fir 3nm' bi��3�`'' er�„:`>.». ceY`, � +:s#'.�.�un��:'s.�N �e��nw� !? ri�.��i;f.:.Yn ,+�.:z�:i: ��e..^a . _, .� ... •!- ...
❑ New construction ❑ Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑Other: ❑Service over 225 amps, comm'l ❑Hazardous location
, s . .., : ,: - Y, , a:� = - �: sR�:a,' « .c - .. . .; Y � : ° '' ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
n;. ' �C VP- T6gSt i . ICT a et'.7 a Vinn w Y g i
. m.; .- . �'. i., s.a. ; 4 e: 4 of I- and 2-family dwellings 4 or more new residential
❑ 1 - and 2. family dwelling ® Commercial/industrial ❑ Accessory building Cl System over 600 volts nominal, units in one structure
❑ Multi - family ❑Master builder ❑Other: ['Building over three stories ❑Feeders, 400 amps or more
•,,, r< f ,� y ., F _ „ ,rte ., s , $. ❑Occupant load over 99 persons 1=I Manufactured structures or
` fjl3 IiI a O121VIATION- D ¢ � Oq �z ;r.x ❑Egress/lighting plan RV park
❑Health -care facility ['Other:
Job no 05 - 913 Job site address: 10330 SW Greenburg Rd . Submit 2 sets of plans with any of the above.
City /State /ZIP: The above are not applicable to temporary construction service.
Ti gard OR 97223
Suite/bldg. /apt. no.: Project name: s"s ' ` E.. „HEDCILE„ ,.
Red Lobster Description Qty. l Fee. < - Total
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'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.:
Limited energy, non - residential 75.00 2
y{ " y4 y " x« «Y
a 4 'tfi fii. " 'do-'. Ser�s{;s s` 9. ` or modular
• w ,�� �_ ��' �; ' E^SCRI °����'� � "'� "'�` � r �r � ; „ta Each manufactured _-?�.LL n't�. <�t��' r'^.e" -.L- .''r,'.m:- aa��p.,x,�v.. .��<,'l^��- .;:ssy,,.� ��', .� 1�;i�», _`S? "a,ee`i'��:i .. .�'4: �'�nY`,�;A3a+x`� f 0
dwelling, service and /or feeder 90.90 2
Disconnect & reconnect rooftop HVAC equipment Services or feeders installation, alteration, and /or relocation
• 200 amps or less 1 80.30 80.30 2
.� ±7 1 . „ arc ,,.> -.:.,u .;,�.- �i s; iixr = itct F" ,aE ° &n .,., Ny x t '., € �r 201 am s to 400 amps 106.85 2
ill e - tPRO�ER ' O WN R t.. ° ' 7"°r , , , , P P
ei 2x n rr:r.;,'n•` sc� ° .e Y =..e'''P�A+ §'� 1+ < cev.- , s:rho:.z'.: *aw -
401 amps to 600 amps 160.60 2
Name: Red Lobster Restaurant 601 amps to 1,000 amps 240.60 2
Address: 10330 SW Greenburg Rd. Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State /ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and /or
) Fax:( ) relocation
Phone: (
50 624 - 0499 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
" ' a � " "' '' ""vi '"''''' " "'°"'"' ' " "' .' " A. Fee for branch circuits with
O A t� .1 " CA T « t - is t t' C ON' m r 3
ION arrx��' cu. -�.�C* s �¢,osi -�1� �3 ��..`'�i. ,�il"'_,N,�ae�t' <;x�J���`#."� � � � .. - .. 15 `,
service or feeder fee, each
Business name: branch circuit 8 6.65 53.20 2
B. Fee for branch circuits
Contact name: without service or feeder fee,
each branch circuit 46.85 2
Address: Each add'l branch circuit 6.65 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax:: ( )
Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or Panel, altera limited -
p � � , �,. »= �x.+µ,; € ,`',�T�. s,'. -s' Ei � .z�:ao� ".:, „��ma:>`c ene
�c
;;`aft a k(9( 7 � { TR TiOR , ^t - -,A 'AMR RR +k• r ti on , or
',`�t"%v;t�amz�s` a ,..i '° ` " :c- '>:��„,'r."d .� 3."�;:r'.:vv";. ».'c,
extension. Describe: Page 2 2
Business name: Bob's Action Electric
Address: , �� Each additional inspection over allowable in any of the above
2700 NE Burton Rd. "A" Per inspection 62.50
City /State /ZIP: Investigation per hour (1 hr nun) 62.50
Vancouver, WA 98662
Phone: ( 360) Fax: ( ) Industrial plant per hour 73.75
360 254 -7200 360 254 -8219 Wirt - VRTIERICAL'wYE,RMIT�35N'EEW, ,. . .. . ... -
CCB Lic .: 53136 Electrical Lic.: 7_ 1C Suprv. Lic.: 4322S Subtotal 133.50
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print name: Date: State surcharge (8% of permit fee) 10.68
Kev B rose ll e 11/16/05
TOTAL PERMIT FEE 144.18
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 doe 12/03 440- 46I5T(10/02/COM /WEB
, • _ .
CITY OF TIGARD
BUILDING DIVISION
PERMIT #: ELC2005-00905
D ATE 13125 SW Hall Blvd., Tigard, OR 97223 E ISSUED: 11/1012005
Phone: (503) 639-4171 ahre
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 12/13/2005 TIME: 7:02AM PAGE: 62
SITE ADDRESS: 10330 SW GREENBURG RD RED LOBSTER CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/ONE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: RED LOBSTER
DESCRIPTION: Disconnect/reconnect rooftop HVAC equip. Job #05-913.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: BOB'S ACTION ELECTRIC INC PHONE #: 360254-7200
Inspection Request Scheduled For: Date: 12/13/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
1991 Electrical final 023370-01 360-254-7200 N
Corrections/Comments/Instructions:
•
c
/ - - -
PASS PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
FAIL fl CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector z</ Date: / Phone #: (503) 718-
.
. , • •