Permit CITY TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
I DEVELOPMENT SERVICES PERMIT #: ELR2005 -00430
6JII DATE ISSUED: 12/1/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1 S 135AB -01004
SITE ADDRESS: 10220 SW GREENBURG RD 100 ZONING: C -P
SUBDIVISION: LINCOLN CENTER /TWO LINCOLN LOT: JURISDICTION: TIG
Project Description: Data cable.
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 L J MATTISON COMMUNICATIONS
ONE SW COLUMBIA #300 7021 SE 31ST
PORTLAND, OR 97258 PORTLAND, OR 97202
Phone: Phone: 503 771 - 5708
Reg #: ELE 26- 849CLE
LIC 95742
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 12/1/2005 $75.00
[TAX] 8% State Surchart 12/1/2005 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, ale of OR. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. T. 's permit will expire if work is not
started within 180 days of issuance, or if work is suspended for more tha :0 day AT 'ENTION: Oregon law requires
you to follow rules adopted by the Oregon Utility Notification Center. Tho.e rule- ar- :-t forth in OAR 952 - 001 -0010
through OAR 952 - 001 -0100. You may obtain copies of these rules or direr .i• -s 'ons to OUNC at 503 - 246 -6699.
Issued By:" ^ Permittee Signatyfe•
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 ApaliiRicaEl V FOR OF ICE USE ONLY
.City of Tigard Received ,-----) Permit No.
13125 SW Hall Blvd., Tigard, OR 97223 DEC ( } p Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 0 1 0 03 "'*741 1 `s V D : Other Permit:
Inspection Line: 503.639.4175 CITY o OF T1 GA `. e y y: g
Date Rea B kris 0 S ee Page 2 for
Internet: www.ci.tigard.or.us 8 G� LJ Notified/Method: Supplemental Information
UILDIIVI 011 f et
TYPE OF WORK PLAN REVIEW
❑ New construction , Addition/alteration/replacement Please check all that apply:
12 Demolition El Other: ['Service over 225 amps, comm'l ['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 Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders, 400 amps or more
El Multi - family ❑Master builder 0 Other
['Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
Job no.: l Job site address: .2 O S.ki s/4� � ❑Health - care facility ['Other:
Submit 2 sets of plans with any of the above.
City /State /ZIP: ' ��. 7.7 r,) .� 0 7" C- 2 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: /00 I Project name _/� � D i • � L �_ FEE* SCHEDULE
/ ' Description l Qty. I Fee. I 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'I 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
dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ .PROPERTY OWNER I ❑ 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: ( ) I 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: branch circuit
Contact name: B. Fee for branch circuits
without service or feeder fee, 46.85 2
Address: first branch circuit
Each add'I 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 limited-
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: 4, 441- niSat4/ e ex , u dldi � a(/f
Address: T.57ic, S e '<) O p. S ..._ vii? . Each additional inspection over llowable in any of the above
Per inspection 62.50
City/State/ZIP: D _ / 7.3 Investigation per hour (I hr min) 62.50
Phone: 663) - 77 a/ 6 off Fax: 4 •)) '77 / 6 4L4 r Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: 757 5(t�. Electrical Lic.: -.- �9 Suprv. Lie.:�6t92 L€.a Subtotal
Suprv. Electrician signature, requir-d:/ Plan review (25% of permit fee)
Print name: e I /�� , , c d Date: ti, . d / —0 State surcharge (8% of permit fee)
/ TOTAL PERMIT FEE
Authorized signature-/ This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: g� ter �, Date: Jz .. r 0 * Fee methodology set by Tri- County Building Industry Service Board
• "" Number of inspections per permit allowed.
i : \Building\Permits■ELC- PermitAp . o 12/03 440- 4615T(10/02/COM/WEB
.
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
L RESIDENTIAL. WORK ONLY: " ,
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ 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:
❑ 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
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
i:\ Building \Permits\ELC - PennitApp.doc 04/03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005-00430
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/1/2005
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 1/9/2006 TIME: 7:01A1Vi PAGE: 17
SITE ADDRESS: 10220 SW GREENBUR i'.1D 100 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/TWO ,NCOLN LOT #: TYPE OF USE:
PROJECT NAME: TRANSNATION
DESCRIPTION: Data cable.
OWNER: EQUITY OFFICE PROPERTIES RUST, PHONE #:
CONTRACTOR: L J MATTISON COMMUNICATIO PHONE #: 503-171-5708
Inspection Request Scheduled For: Date: \ :1/w2006 Pour Time:
Code # -. - • • I - cription Confirm #\ Contact # Message
199 Electrical final 024581101 N 503-120-M25 N
Correction - al l• • ctions:
A PASS L PARTIAL APPROVAL fl CANCEL fl NO ACCESS
FAIL El CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: Ni Date: t 0•6 Phone #: (503) 718- 2.4 q
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005•00430
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/1/200fi
Phone: (503) 639-4171 /A
terg2/App11/ I
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 12/30/2005 TIME: 6:59AM PAGE: 72
SITE ADDRESS: 10220 SW GREENBURG RD 100 • CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/TWO LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: TRANSNATION
DESCRIPTION: Data cable.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: 1, J MATTISON COMMUNICATIONS PHONE #: 503-771-5708
Inspection Request Scheduled For: 'Date: 12130/2005 Pour Time:
I
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 024187-01 503-720-3425
Cei / Li j
Corrections/Comments/Instructions:
• ( 1 ,
j<-1
fl PARTIAL APPROVAL CANCEL E NO ACCESS
FAIL I I CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
#2441 Inspector: Date: /2—. 3 0 — .1° Phone #: (503) 718-