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Permit
CI TY - O F TIGARD ELECTRICAL PERMIT PERMIT #: ELC2007 -00032 COMMUNITY DEVELOPMENT DATE ISSUED: 1/12/2007 'TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S126DC-03300 SITE ADDRESS: 09900 SW GREENBURG RD 290 ZONING: C - P SUBDIVISION: LEHMANN ACRE TRACT LOT : 005 JURISDICTION: TIG Project Description: COLUMBIA BUSINESS CENTER. (1) branch circuit. Job #5063. 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: W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 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: ATHERTON REALTY PARTNERSHIP HILLSBORO ELECTRIC MARTHA ATHERTON 21185 NW EVERGREEN PKWY #110 2100 S WOLF HILLSBORO, OR 97124 DES PLAINES, IL 60018 Phone: 847 - 298 -8600 Contact #: PRI 503- 439 -9666 FAX 503 -601 -3680 FEES Description Date Amount Reg #: ELE 34 -4399C [ELPRMT] ELC Permit 1/12/2007 $46.85 1 1C 134481 [TAX] 8% State Surcharge 1/12/2007 $3.75 SUP 4941 S Total $50.60 REQUIRED ITEMS AND REPORTS 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. x,51 12 - ' 07 11:48 FROM- Hillsboro Electric 503 -601 -3680 T -499 P002/002 F -181 w'.ect,rcai .rermit A location City of Tigard E l x Received _ n Date /Bv: A LT 7 �>�/1 Permit No.' , O , 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review `� Phone: 503.639.4171 Fax: 503.598.1960 t'srt. tl iil'h Date /Bv: Other Permit: • Inspection Line. 503.639.4175 ' • RM 1 0 zt3� Date Ready /By: P1 See Page 2 for Internet: www.ci,tigard.or.us JYxIY .L ... L - . Notified/Method: $upplcment9llnforp, • T�P�O c t I' P LAN REVIEW W A c onstruction Q � t/ aa/i Please check all that apply: • Q Demolition ❑ ll �S ❑Service over 225 amps, comm'I ❑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 dwellin Comiriereial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure Q Multi-family [] Master builder ❑Other. ❑Building over three stories ❑Feeders, 400 amps or more JOB SITE INFORMATION AND LOCATION • - ❑Occupant load over 99 persons ❑Manufactured structures or ❑ Egress /lighting plan RV park Job no.: so E Job site address: 0# 6t,k) :Health-care facility ❑Other: • .8 •• Submit a sets of plans with any of the above. • City/State/ZiP: .4 r P • The above are not applicable to temporary construction service. gimp FEE *. SCHEDtJT )r, bldg. /apt. no.: jp Project name Co • id ' r �Sf & .� �( ej lkscAntion Qty. Fee, Toraf 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'1500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 . .: DESCRIPTION OF WORK • •..; ' 75.00 2 Limited energy, non-residential - Each manufactured ormodular MA rec l_ _ /� ; Ae Y 9 � /' W A et - NkA dwelling, service and/or feeder 90,90 2 y w ` 1,{ / I Services or feeders installation, alteration, and /or relocation 200 amps or less I 80.30 1 2 ,. ❑ PROPERTY OWNER. ' ' . ,' . ', ❑ 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 I 66.85 2 City/State/ZIP. Temporary services or feeders installation, alteration, and /or Phone; ( ) Fax: ( ) relocation 200 amps or less 66.85 I 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 Business name: service or feeder fee, each 6.65 2 branch circuit ^ " v B. Fee for branch circuits Contact name: wirhr,ul service or feeder fee, )�r each branch circuit 46.85 `�(� 2 Address: +"►►» Each add'l branch circuit 6.65 2 City /Stale/ZIP: Miscellaneous (service or feeder not included) • Pump or irrigation circle 53.40 2 Phone: ( ) I FaX: : ( ) _ Sign or outline lighting 53.40 2 • E -mail: Signal circuit(s) or limited- ., ,......... ,..,.: ;: CONTRACTOR . . .. ,. , energy panel, alteration, or extension. Describe: Page 2 2 Busirless name:Hillsboro Electric L.L.C. Add ress; 2 Each additional inspection over allowable in any of the above 1185 NW Evergreen PKWY Ste #110 Per inspection 62.50 _ City/State/ZIP: Hi 11 sboro, OR. 97124 Investigation per hour (I hr min) 62.50 T Phone: (5 0 3) 439-9666 Fax: (503 )6 01 - 3 6 8 0 Industrial plant per hour 73.75 : • •• . ELECTRICAL, PERMIT FEES* ' CCB Lic. :1 3 4 4 81 Electrical Lic.:3 4 - 4 9 9 0 Suprv. Lie,: 4941 S Subtotal (p„ Suprv, Electrician signature, required: Plan review (25 %ofpennit fee) .r-- Print name: Joey Vjt / Date: .,_ 12 -0-7— State surcharge (8 %ofpennit fee) _ f �,- TOTAL PERMIT FEE c -0/ (d) Authorized signature: Mil permit application expires ifa permit is not obtained within 180 days after it has been accepted as complete Print name: Date: • Fee methodology set by Tri- Coonry Building Industry Service Board "" Number of inspections per permit allowed. iaBuiidingtPcrmiistELC- Pcnni,App.doc 12)03 4404515Tt10roJCOMAWEB - - CITY OF TIOARD BUILDING DIVISION PERMIT #: ELC2007-00032 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/12/2007 Phone: (503) 639-4171 " Inspection Requests (24 Hrs.): (503) 639-4175 „Jai- IL INSPECTION WORKSHEET FOR DATE: 1/18/2007 TIME: 7:06AM PAGE: 17 SITE ADDRESS: 09900 SW GREENBURG RD 290 CLASS OF WORK: SUBDIVISION: LEHMANN ACRE TRACT LOT #: 005 TYPE OF USE: PROJECT NAME: COLUMBIA BUSINESS CENTER DESCRIPTION: COLUMBIA BUSINESS CENTER. (1) branch circuit. Job #5063. OWNER: ATHERTON REALTY PARTNERSHIP, PHONE #: 847 CONTRACTOR: HILLSBORO ELECTRIC PHONE #: 503-439-9666 Inspection Request Scheduled For: Date: 1/18/2007 Pour Time: . Code # Inspection Description Confirm # Contact # Message 199 Electrical final 042252-01 503-439-9666 Corrections/Comments/Instructions: '0 wL 7d ce• C l • 1) - CZ:a 6/. PASS El PARTIAL APPROVAL I I CANCEL fl NO ACCESS FAIL j CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: . l ) 3 Phone #: (503) 718-