Permit a- P.
•
CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
, DEVELOPMENT SERVICES PERMIT #: ELR2006 - 00249
s' '�I I� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/1312006
PARCEL: 1 S135AB -03400
SITE ADDRESS: 10260 SW GREENBURG RD 400 ZONING: C -
SUBDIVISION: LINCOLN CENTER/LINCOLN TOWER LOT: 014 JURISDICTION: TIG
Project Description: Low voltage for HVAC wiring.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: X PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
EQUITY OFFICE PROPERTIES TRUST AMERICAN HEATING
ONE SW COLUMBIA ST #300 1339 SW GIDEON ST
PORTLAND, OR 97258 PORTLAND, OR 97202
Phone: Contact #: PRI 503- 239 -4600
FAX 503- 239 -7038
FEES Reg #: ELE 26- 993CRE
LIC 33135
Description Date Amount
[ELPRMT] ELR Permit 101131200E $75.00
[TAX] 8% State Surcha 101131200E $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 - • rec qu- • '•ns t. OUNC at 503-246-6699. "ICJ
Is ed By: ' 044 Permittee Signature: GGr
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 Application FOR OFFICE USE ONLY
City of Tigard Received /�, Q ab i0 O-
`.7 g Date/By: /J eh PennitNo.:
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 /i� , ,: t .
Date/By:
Inspection Line: .503.639.4175 . ■_ `'J M Date Ready/By: ra' • H See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: la Supplemental information
� 41P -. a ','-.' �-,, 11 -gam - ::tR _' � -Z " »Pgre:, t 77 � ty h N • - a 'r (_ ∎ - p;
; . > y ,�. `r a ..� , '7. - �3 "^rn" Oi l f'� _ - '.tea,:: R a• • '•y' 3 6 "/"''''.i'� ! -.P a� %. • Z ';. _c ;c tj 7 I kr r� ' 3 ��:�� � k Ej(1 � = y'rr�i4 w�:�'= ... �Ci r� �.s��ys`:` &xlC�ti _ ,.,, -• `'� '�- '� ', xu... . _
❑ New construction ■ddition/alteration/replacement Please check all that apply:
El Demolition ❑Other: OService over 225 amps, comm'l ['Hazardous location
T - `_ x � _. y .� b i -z ,��� ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
r . > •a�.t enta *(e a e J = e o . AV yh- ;_ 14 .A of 1- and 2- family dwellings 4 or more new residential
❑ 1 - and 2 - family dwelling ['System over 600 volts nominal units in one structure
Commercial industrial 0 building
❑Building over three stories ❑ Feeders, 400 amps or more
❑ Multi family ❑ Master builder ❑ Other: ❑Occupant load over 99 persons ❑Manufactured structures or
e.i" i i e 3 o voe user€ e BPr LF r park
N' a - f Y ' -. -
; `- .. . -.-W.1_,-; t _ � °�` a r ❑Egress/ plan RV
�4 > - , .. r4„ =Ln4 t ❑Other:
Job no.: 58 , I b Job site address: \0 940 0 arum. b (24I ❑Health -care facility
Submit 2 sets of plans with any of the above.
City/State/ZIP: - 1 - (01 ii�rt 0 (Z--- The above are not applicable to temporary construction service.
i �
Suite/bldg fc;, . � �� 1' •°� fir- r. .. J:yiy:-
. /apt no.: (* ) I Project name: ` . 0 �, es <.i.otal •*
c Deserlptioa Qty. 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: I Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 I
Limited energy, residential 75.00 2
Tax map /parcel no _ Limited ener gy, non - residential 75.00 2
` /`47T ' c n1 W.
' x T t r fr �, f l� u�"� n O i ,,,t ..y -1 1 , _..�. Each manufactured or modular
.:3;;� . ^- Y . �.�. r-_ .h � ..:. � ' ^ � ' 3: . 4 '
, � , csaL � .:�.' 4- y ��.u.1M1'F s. !,y L�,_ -
1 \ f - Lb tN \ b , ` - , , I " S _ dwelling, service and/or feeder _ 90.90 2
Services or feeders Installation, alteration, and/or relocation
200 amps or less 80.30 2
1iT 6 H� e ` 1 � u . eg M 1 2 r '� : e SFr . . t rvi 201 amps to 400 amps 106.85 2
_, ' ___Yi.L..,_ -� , f f . [ 1 ,fMzes9�J,sL-E.^� ?'.- :I.- . 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
Phone: ( ) I F ax: ( ) relocation
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
11 t r s± �' �W = P h q., frE o ' „ A. Fee for branch circuits with
? �6<a. � . - 220.1. .' - .f4 f'1�2� l � 1!e:A 12* service or feeder fee, each
Business name: [ � , branch circuit 6.65 2
1 �� (�'� n �rl 1 t B. Fee for branch circuits
T �
Contact name: . 1)66 without service or feeder fee,
G each branch circuit 46.85 2
Address: 1.-C1 6:k �� E ach add'l branch circuit 6.65 2
City/State/ZIP: 'U Y4 OA d Q rz "1 a 6 a Mlscellaneous or feeder not included)
t
) a - bo o I ( )a. c � 63g Pump or irrigation circle 53.40 2
Phone: Fax:
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
' 'z., i i t f� ttt - o . , �o Ss'�', aZ iii f .a � , p energy panel, alteration, or
'r�=" °, " ' n"N-�� extension. Describe: Page 2 2
Business name: AIfl2 i CGS • ,4- nn _DAC ,
Address: 1 5e �i ra S- r Each additional inspection over allowable in any of the above
Per inspection 62.50
City/ State/ZIP: "--PU y` lc f C � E q---) 'DO? Investigation per hour (1 hr min) 62.50
Phone: (3) Q l-y (p O U I Fax: ( ) a _7123 ¢ I ndustrial plant per hour 73.75
'7, . ;5 w'.:s�:
• -
CCB Lic.: 331 3 5 Electrical Lic.: 96gc3 � Cie Sup Lic.: aid-101E8, Subtotal ( ✓J _ * I
l/ / �
Suprv. Electrician signature, required: J /' ' ' Plan review (25% of permit fee) ,
0 State surcharge (8% of permit fee) v
Print name: Y y (, Date: �, Q,, - TOTAL PERMIT FEE ( . 0 v
Authorized signature: (Q� 1 ( Q� This permit application expires if a permit Is not obtained within ISO
1 ///����)) r t vvv - -_ ,' days after It has been accepted as complete
Print name: . iryl (y' a S , (_o o ,V Date: 10 __ I (-Q • Fee methodology set by Tri -County Building Industry Service Board
•• Number of inspections per permit allowed.
i:\ BuildingTermits \ELC- PermitApp.doc 12/03 440.46 15T( IO/02/COM/WEB
- OCT. 19. 2006 1:48PM 5032397038 NO. 0220 P. 1
Building Division / ) (' )
r j. I Request for Permit Action or Refund
City of Tigard RD
TO: CITY OF TIGARD
Permit System Administrator U C T 1 9 2006
13125 SW Hall Blvd., Tigard, OR 97223 C ITY of TI G
Phone: 503.718.2430 Fax: 503.598.1960 BUI D1 V Igl�
FROM: ❑ Owner ® Applicant ❑ Contractor ❑ City Staff
(check one)
Name: American Heating, Inc.
(Business or Individual)
V 0 1 ® Mailing Address: 1339 SE Gideon Street
City /State /Zip: Portland, Oregon 97202
4/23As 4 74#4--
Phone No.: 503 - 239
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1):
►� CANCEL PERMIT APPLICATION.
LI REFUND PERMIT FEES.
❑ REMOVE CONTRACTOR FROM PERMIT (do not cancel permit).
Permit #: ELR2006 -00249
Site Address or Parcel #: 10260 SW Greenbur Rd, #400
Project Name: Suite 400 @ Lincoln Ctr /' G
Subdivision Name: Lincoln Clx/Lincoln Tower Lot #:
EXPLANATION: Pnematic Controls - Electrical not required
Signature: i deDe ( ■ Date: 10 -19 -06
rntxla �. G on
Print Name:
Iteimd Policy
1. The Building Official may authorize the rtfimd of
a) any fee which was erroneously paid or collected.
b) not more than 80 percent of the permit Ice for issued permits prior to any inspection requests.
o) not more than $0 percent of plan review fee when an application is canceled before any plan review efibrt has been expended.
2. Refunds will be returned to the original Payer in the same method hi which payment was received.
FOR Ol• I l Si 0 \1 \
Rte to S s Admin: Da i ' • -/ B Rte to Bl. Admin: Date /B r• al
Refund Processed: Date ; ' D - B ,Z,'J Invoice Processed: Date B
Permit Canceled: Date 2..„3 , B #( Parcel T:: Added: Date ['
Date f. .e O - Method 4 _ Amount $
l : \Buildir g\Forms\RegPermitAction : Ids. • on Rev 10/17/05