10250 SW GREENBURG ROAD STE 112-1 C)
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10250 SW GREENBURG RD 112
CITY O F T I GA R D _ ELECTRICAL PERMIT _
PERMIT#: ELC2004-00140
DEVELOPMENT SERVICES DATE ISSUED: 3/22/04
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 1S135AB-04500
SITE ADDRESS: 10250 SW GREENBURC RD 112
SUBDIVISION: LINCOLN BUILDING PP1991-055 ZONING: -P
BLOCK: LOT : 001 JURISDICTION: TIG
Project Description: Electrical TI, (4)branch circuits.
Job No.4698
_ RESIDENTIAL UNIT _— T VIP SRVC/FEEDERS MISCELLANEOUS.
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'I. 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HMI SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER —BRANCH CIRCUITS ADD'L INSPECTIONS
0 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W,O SRVC OR FDR: 1 PER HOUR:
4C^. - 600 amp: :-:A ADD'L BRNCH CIRC: 3 IN PLANT:
601 - 1000 amp: _ PLAN :tEVIEW SECTION
1000+ amp/volt. -4 RES UNITS: >600 VOLT NOMINAL:
Reconnect only: — SVC/FDR—225 AMPS: —`_ CLASS AREAISPEC OCC: _
Owner: Contractor:
EOP LINCOLN,LLC WILLAMETTE ELECTRIC INC
10260 SW GREENBURG RD PO BOX 230547
SUITE 100 TIGARD,OR 97281
PORTLAND,OR 97223
Phone: Phone: 503-624-3631
Reg #: LIC 75059
-- —�
FEES SUP CLC 344-28-28
3t
Description Date Aiiourit
Required Inspections
[ELPRMT] EL('Permit "u 1 $66.80 — — --
[TAX]8%State Surcharge 2-1 na $5.34 Rough-in
Elect'I Final
Total $72.14
This Permit is issued subject to the regulations eont.iined in the Tigard Municipal Code,State of OR.Specialty Codes and all other applicablia 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 th.,duAffl-o ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rulers are get
fort ' R952-001,_-D& through OAR 001-0100. You may obtain copies of these rules or direct questions to OUNC at(503)246-6699 or
1 0-332-2344.
Issued By: Permit Signature:
\ OWNER INSTALLATION ONLY
The installation is being made or, property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: _ DATE:
COtiTRACTOR INSTALL TION ONLY
SIGNATURE OF SUPR. ELECV. _ DATE:
LICENSE NO:
Call 639-4175 by 7:00pm for an inspection the next business day
'FOR OFFICE ILISE
Electrical illermit Application K .civeu 1 Electrwal ONLY,
Date./Ry: PcmUtNo.:
(,It of Tigard Planning Approvai - --- Sign
g Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard,Oregon 97223 Date/By: Permit No.:
Phone: 503-639.4171 Fax: 503-598-1960 Post-Review Land Use
Date/By: Case No.:
Internet: WWW.C1.tlgard.or.llS CuntactJutis.: See Page 2 for
24-hour Inspection Request: 503-639-4175 Name/P.4ethod: Su lemental Information.
;Addition/alteration/replacement
,:k- ew construction Demolition Service over 225 amps- Health-care facility Other: commercial C3 Hazardous location
Service over 320 amps-rating of Building over 10,000 square feet,
EO $s • U'CIi 1&2 family dwellings four or more residential units in
2-FamilLliH elling _L Commercial/Industria! G System over 600 volts nominal one strucurce
Accessor•dui din Multi-Family ❑Building over three stories ❑Feedero,400 amps or more
��_ am _ ❑Occupant load over 99 persons ❑Nianufactured structures or RV park
Master Builder Other: []F.gress/lightingplan ❑Other:
&'i'td�I I, �44t 1iiWAW. Submit_sets of pians with vny of the above.
The above are not licable to tem orary construction service.
Job site address I V: � Sl-t- C.�i.,�.'6,c - ' -�.R . T.
Suite#: (I Z Bldg./Apt.#: C, ,r — _ Nurnbcr of ie
ins actions tr crmit allowed
Project Name: C k e,,e Qty Fee(ea.) Total
Cross street/Directions t Ob site: New residential single multi-fantil per
l dwelling unit.Includes attached garage.
Service Included:
1000 sq.ft.or less 145.15 4
Each additional 500 sq.ft.or portion thereof 33.40 _ I
SUbdIVISIOri: LOt#: Limited energy,residential 75.00 2
Limited energy,non residential 75.00 2
Tax map a�reel#: Each manufactured home or modular dwelling
T' DESCC .—-ON OI+_ (JRIt' t service and/or feeder 90.90 2
----- Services or feeders-installation,
j �,Y _ alteration or relocation:
__ / -- -
�. r T ;;0o amps or less 80.30 2
-- ------- ------ 2U 1 amps to 400 ams 106.85 _ 2
401 amps to 600 amps 160.60 2
PROP TX OWNEI2z;_ N-T�"i 18T -- 1." 601 am to 1000 ams 240.60 � 2
Over 1000 amps or volts 454.652
Name: Reconnect only 66.85 2
Address: Temporary services or feeders-installation,
- alteration,or relocation:
Cil /State/Zi 200 amps nr less 66.85 1
201 ams to 400 ams 100.30 2
Phone: Fax: --
--- —i.----- ut l to 600 ams 133.75 2
APPLIC. Branch circuits-new,alteration,or
Name: extension per panel:
—- -------_ - --- A.Fee for branch circuits with purchase of
Address: _ service of fe^.der fee,each branch circuit 6.65 2
City/State/Zip: B.Fee for branch circuits without purchase of b
-- - --- - - service or feeder fee first branch circuit 46.85
Phone- Each additional branch circuit 6.65 2
E-mail: Misc.(Service or feeder not included):
+ -DC7 .I2 : t.t Each pump or irrigation circle 53.40 2
- --' -- - -- Each sign or outline lighting 53.40 2
Job No: ti u,�' Signal circuit(s)or a limited energy panel,
�- — — - alteration or extension Pae 2 2
Business Name: (,�, if a wt rf/,r 5'(e r7,,,, i_� c - Description:
Address: (,J Avu 2-30 S ti
City/State/Zip:/State/ZI t �— Each additional Ins ectlon over the allowable In an of the above:
/l U� 1 a) Per in!pection per hour min. 1 hour 62.50 1 _
Phone tS` b 14 •-_?f FaX S'6-61 q - 2 y Investigation fee: _ _ —
CCB L_c. #: s Lic. : ?y y is T c Mer:
Supers ising electrician / subtotal a U `
5i ature required: � et. Plan Review(25%of Pertnit Fee) $
Print Name_�/�N t• _ - 3 . #.- I y State Surcharge(8°/6 of Permit F:^l
TOTAL PERMIT FEE a
Authorized Notice: This permit application expires if a permit Is not obtained within
Signature __- Date:— 190 days.rter it has been accepted as complete.
'Fee methodology set by Trl-County Building Industry Service Board.
(Please print natne)
i
i I)sts Pe+Tmi Forms E1cPemntApp doc 01103
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Feefor all systems............................................................ $75.00
ChecK Type of Work Involved:
Audio and Stereo Systems*
Burglar Alarm
Garage Door Opener*
Heating,Ventilation and Air Conditioning System*
ElVacuum Systems*
Other _
COMMERCIAL WORK ONLY: _
Fee for each system.......................................................... $75.00
(SEF.OAR 918-260-260)
Check Type of Work Involved:
7 Audio and Stereo Systems
Boiler Controls
Clock Systems
Data Telecommunication Installation
Fire Alarm Installation
HVAC
Instrumentation
Intercom and Paging Systems
Landscape Irrigation Control*
Medical
Nurse Calls
Outdoor Landscape Lighting*
Protective Signaling
Other --
_Number of Systems
* No licenses are required. Licenses are required for all
other Installations
i:\Dsts\Permit Fonms\ElcPermitAppPg2 doc 01/03
ELECTRICAL
CITY OF TIGARD RESTRICTED ENERGY
DEVE L.OPMIL. 1T SERVICES PERMIT#: ELR2004-00069
13 i25 SW Hall Blvd.. Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 3/18/04
SI1 E ADDRESS: 10250 SW GREENBURG RD 112 PARCEL: 1S135AB-04500
SUBDIVISION: LINCOLN BUILDING PP199'1-055 ZONING: C-P
3LOCK: LOT: 001 JURISDICTION: TIG
Proiect Description: Limited energy for data/telecommunications system,
Job No. 004:1.'
A.RESIDENTIAL., __ _ B.COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BUR61-AR ALARM: BOILER: LANDSCAPE/IRRIGA T:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR L.ANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL.:
INSTRUMENTATION: OTHER:
TOTAL #OF SYSTEMS: 1
Owner: Contractor:
EOP LINCOLN , LLC ESP TECHNOLOGIES
10260 SW GREENBURG RD 7929 SW BURNS WAY STE. F
SUITE 100 WILSONVILLE, OR 97070
PORTLAND, OR 97223
Phone: Phone: 503-628-4195
Reg #: LIC 73872
ELF. 34-269CLE
FEES Required Inspections
_Description Date _ Amount Low Voltage Inspection
LLI'tMTJ ELIC Permit 3/18/04 $7500 Elect'I Final
(TAXI R"S,State Smclmrt 3/18/04 $6.00
Total $81.00
This Pen-nit 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 folio esa ed by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 throuc
Is h
sus by � Permittee Signature
OWNER INSTALLATION ONLY
The im-tallation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
_CONTRACTOR INSTALLATION ONLY
SIGNATURE Or SUPR. ELEC'N DATE:__ _
LICENSE NO
Call 6394175 by 7:00 P.M. for an inspection needed the next business day
Y
7-L
Electrical Permit Application FOKOONLY
City of Tigard p;,�;�ed p�f Pemtit No f Q
13125 SW Hall Blvd.,Tir,:rd,OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/B ; Other Pemtit:
Inspection Line: SOJ.639.4175 Date Ready/By: Juni, ® 56a Page z fur
Internet: www.ct.tigard.onus Notified/Method: SufptementalInformauon
TYPE OF WORK PLAN REVIEW
❑New construction ❑Addition/alteration/replacement Please check all that apply
❑Demolition ❑Other: ❑Service over 225 amps,comm'I ❑Hazardous location
--- -- - — ❑Service over 320 amps-rating ❑Buildng over 10,000 sq.11.
CATEGORY OF CONSTRUCTION of I-and 2-family dwellings 4 or more new residential
❑ I-and 2-family dwelling ommercial/industrial ❑Accessory building ❑System over 600 volts nominal units in one structure
❑Multi-family Ll Master builder ❑Other: ❑P gilding over three stories ❑Feeder^,400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures o,
JOB SITE INFORMATION AND LOCATION ' ❑Egress/lighting plan RV park
I�'} O J Gt1 QQv�bt�.�.. 01 -care facility ❑Other:
fob no.: Job site address: L � --
Submit 2 sets of plans with any of the above.
City/State/ZIP: �( 7.1The above are not applicable to temporary construction service.
Suite/bldg./apt.no.: Project name: jA$ FEE* SCHEDULE
DuerlpUanI Qty. pee. I Total
Cross street/directions to job site: , QI New residential single-or multi-family dwelling unit.
Includes attached garage.
1,000 sq.ft.or less 145 15 a
Subdivision: Lot no.: Ea.add'I 500 sq.ft.or portion 33.40 1
- Limited energy,residential 75.00 _
Tex rnap/parcel no.: Limited energy,non-residential 75,00 2
DESCRIPTION OF WORK Each manufactured or modular
U O , ^ ( ,n dwellio ,service an�1/or feeder 90.90 2
LP
Jc.r r(� Services or feeders Installation,alteration,and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to ,0 amps 160.60
1
Name: A 11AA 601 amps to 1,000 amps 240.60 2
Address: 10'Z - S�v 1 S Z Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: Z _j Temporary services or feeders Installation,alteration,and/or
relocation
Phone:( ) Fax:( ) 200 amps or less I 66.85 1
Owner Installation:This installation is being made on property that I own which is not 201 amps to 400 amps 1 100.30 12
intended for sale,lease,rent,or exchange,according to ORS 447,449, 10,and 701. 401 amps to 600 amps 1 1133.75 1z
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: branch circuit
B.Fee for branch circuits
Contact name: without service or feeder fee,
Address: each branch circuit 46.85 2
Each add'1 branch circuit 6.65 2
City/State/ZIP: Miscellaneous(service or feeder not Included)
Pump or irrigation circle 5340 2
Phone:( ) Fax: :( ) Sign or outline lighting 53.40 2
E-mail: Signal circuit(s)or limited-
CONTRACTOR energy panel,alteration,or
e extension.Describe: Page 2 /J 2
Business name: F.,!5?P C` L('1 O 1 S
1 Z .7 LJ �LI( N S �/�� Each additional Inspection over allowable in any of the above
Address: —
Per inspection 62.50
City/State/ZIP: l I S U h V1 U 9 01 0 Investigation per hour(l hr rein) 62.50
Phone:(SD3)6; g Z-Lj ,9 S Fax:(50:3 G$Z- Z�1$ Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: -7 Z Electrical Lic.:3+20cl Suprv.Lic.:M I LEA Subtotal 60
,
Suprv. Electrician signature,required: Plan review(25%of permit fee)
Print name: �-i F Fn J Date: 3 - I( -U •i State surcharge(8%of permit fee) (fJ
�) n n4.♦-
— TOTAL PERMIT FEE
t
Authorized signature: This permit application expires Its permit Is not obtained"'.thin Iso
days after It hos been accepted as complete
Print name: Date: • Fee methodolog)set by Tri-County Building Industry Service Board
-- ••Number of inspections per permit allowed
i t8uildingVemuts .LC•PennitApp doe 11101 440.4611T(I01021COM WEB
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175
NIST _
INSPECTION DIVISION Business Line: (503) 639-4171 .�---
I P _ __
Received __- Date Requested ___!_ �Z"__ AM_� P _ _
BUP --- ---- ---
Location --- --- Suite - --
�D _ MEr. - -- - ---
Contact Person —. -- 1 -___ ._. _-_ (- ,�) ? " .__. a1 SPLM
Contractor_,_E'er -- -- Ph( ) --. -- -- -- SWR
BUILDING Tenant/Owner --
Footing ELC
Foundation Access:
Fig Drain !R 00 0-1
Crawl Drain — —
Slab Inspection Notes: SIT
I lost&Beam — -
Shear Anchors _
Ext Sheath/Shear __—
Int Sheath/Shear
Framing - - -- -- - ---.. ---
Insulation
Drywall Nailing -- - - -- ----- -... ----
Firewall
Fire Sprinkler - --- —
Fire Alarm
Susp'd Ceiling - --- _ - -- —
Root
Other: -- -
Final
_PASS_ PART FAIL - ---- -- --- --
PLUMBING
Post&Beam
Under Slab -_s— _ ---
Rough-In
Water Service --- --- - — — -
Sanitary Sewer
Rain Drains - -- .......
Catch Basin/Manholp
Storm Drain - ---- - - _- - --
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL --
Post&Beam
Rough-In -
Ras Line
Smoke Dampers ----- -----___ _-- --�--
Final
PASS PART FAIL - --ELECTRICAL
Service
Service — -
Rough-In(,tj,
ow Volta e
Fire HTarm
Fin PART FAIL Rsinspection fee of$— required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd.
Please call for reinspectign RE: _ Unable to inspect-no access
Fire Supply Line
ADA Daae %),�1✓ _— Inspector
Approach/Sidewalk
Other:
DON T REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171
BUP — --- -
Received �. ��P Date R,eqested�� __- AM PM__— BLIP —�
Location ��1G� /.:. __ Suite ,l Z MEC
Contact Person _ Ph( )/V ZV— 3 3 / PLM
Contractor_ _� _._-__—.___. Ph( ) _— SWR
BUILDING Tenant/Owner (! LC —
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Ins pe ion Notes: ... _ ' / SIT
Post&Beam """s —�
Shear Anchors V --
Ext Sheath/Shear
Int Sheath/Shear
Framing - ----- -- -
Insulation
Drywall Nailing -- - - ---- -- ------
Firewall
Fire Sprinkler - --- - -—
Fire Alarm '
Susp'd Ceiling _- -- -
Roof
Other:
Final
PASS PART FAIL _ ---- -- - -
PLUMBING _
Post&Beam
Under Slab
Rough-In
Water Service — ---------- - --
Sanitary Sewer
Rain Drains --- - -- ------
Catch Basin/Manhole
Storm Drain --- - --�- -
Shower Pan
Other: - _ — -- - ---
Final -�
_PASS PART FAIL
MECHANICAL
Post&Beam
Rough-In _ --- - —
Gas Line
Smoke Dampers -
Final
_PASS PART FAIL -
ELECTRICAL
Service ------
Rough-In -
UQ/Slab
Low Voltage
AS PART FAIL L-1 Reinspection fee of$ required before nest Inspection. Pay at City Hall, 13125 SW Hell Blvd.
S [] Please call for reinspection RE:__ _ Unable to inspect-no access
Fire Supply Line
ADA D d — Ietap�aRO �� —txt
Approach/Sidewalk
Other:
Final DO NOT REMOVE this Inspection record t m the fob s
PASS PART FAIL