Permit C ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
'' I DEVELOPMENT SERVICES PERMIT #: ELR2005 -00449
''' II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 12/29/2005
PARCEL: 1S135AB-01004
SITE ADDRESS: 10220 SW GREENBURG RD 100 ZONING: C -P
SUBDIVISION: LINCOLN CENTER /TWO LINCOLN LOT: JURISDICTION: TIG
Project Description: Fire Alarm.
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: X OUTDOOR LANDSC LITE:
OTHER: • HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
EQUITY OFFICE PROPERTIES TRUST T & L COMMUNICATIONS INC
ONE SW COLUMBIA #300 PO BOX 87387
PORTLAND, OR 97258 VANCOUVER, WA 98687 -7387
Phone: Contact #: PRI 360 - 737 - 9725
FAX 360 - 737 -9648
FEES Reg #: LIC 67787
ELE 37- 428CLE
Description Date Amount
[ELPRMT] ELR Permit 12/29/200: $75.00
[TAX] 8% State Surcharl 12/29/200: $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 for in OAR 952001 -0010
through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions 'o 0,%t - 03- 246 -6699.
Issued By: 11J , ]' Permittee Signature: d
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 Permi p 'ica 11 J . • FOR OFFICE USE O\ Ll'
` :••,.
l.` City of Tigard nor 2 9 2005 Received Date/By j� ' q ' U PermitNo I ay r
1'3 SW Hall Blvd., Tigard, OR 97223) Plan Review
• Ph 503.639.4171 Fax: 503.5 8 ection Line: 503.639.4175 I 1 1 960�F TIGARD j L t �'4- ' i I �'`• Date/B Other Permit:
Inspection ■ _ • 1 � Date Ready/By: ® See Page 2 for
G DIVISION Internet: www.ci.tigard.or.us �UILD Notified/Method: Supplemental Information
c w 1:� f .', 5 s rt ., �.�: � - r V-t. "- , - tif0M ' fit#. a_,,'a r • G `.. , t .. , . .. .. ' TY R OF x WORK I } ' ...4 Ty xg at :� PLAN REVIEW .''' .:.
❑ New construction ❑ Addition/alteration/replacement Please check all that apply:
ID Demolition ❑ Other: ❑Service over 225 amps, comm'l 0 Hazardous location
. „;,.,. v , �,,,,� , ,, n a ['Service over 320 amps - rating ['Bulldog over 10,000 sq. ft.,
4" GATEGORX OF CONSTRUCT10Np `' L'4---,t11 " *, r ' „A"--4- of 1 -and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building OSystem over 600 volts nominal units in one structure
❑Building over three stories 0 Feeders, 400 amps or more
1:1 Multi - family ❑Master builder 0 Other:
;t ['Occupant load over 99 persons ❑Manufactured structures or
' : v JOB INFORMATIO A LO ; 1 R te . �,4 g r ss/li htin plan RV park
Job no.: Job site address: ( 0 22.0 S(,) 67(6245,a.t4 I CJ ❑He 2 -care o p l a y ❑mar
Submit 2 sets of plans with any of the above.
City / State/ZIP: .1701 0 ore .--. The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: 100 Project name: iv- s f -(-- � A �� FEE* SCHEDUi E 1 : c '
Description I Qty. I Fee. I Total I
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
-... ;,,i tDESCRIPTION OF WORK d z �.
+� - �x =� � � � � r,� f � :��.,�,��' ;� � Each manufactured or modular
dwelling, service and/or feeder 90.90 2
e- 'kk O✓ N"5 -S Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
..t ,;. � s ..._ iiii :. ��:. o= •w.;- r;;..� 4 - r Y :.v : 201 s to 400 amps 106.85 2
�-.� ®YROPERTl' OWNER � 1 t ®� TENANT �� P P
z ., _v� . � ., u_ :. - - � : � .. ; ._ . � d ,, .. - ... .� - 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: ( ) 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
' ®., :* , ® CON PERSON `' � ` A Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name:
1--C, 6 - co YN ti (4. „I t C 1^� branch circuit
Contact name: S c B--,S � C.....) B. Fee for service circuits
es
without service or feeder fee, 46.85 2
each branch circuit
Address: r 0 6 c)- G '
,, � 6 1 Each add'I branch circuit 6.65 2
City / State/ZIP: ti /'� / t ' c_ f f/t �- T eg e ` 1 Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( p ) ')3 )? 2 2 s— Fax: : ()) )3 7 9 6 y 8 Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
�„r . - r / �` _` W ONTRACTOR`� 4 '� :- ” , ,,' energy panel, alteration, or
ate,
Business name: �j extension. Describe: I Page 2 2
GoPt.4 /2/ a At / C °°S
Each additional inspection over allowable in any of the above
Address: -
�� � � ,, � � -2.3-4C--) Per inspection 62.50
C
City / State/ZIP: /71 -- ./ G` t,..> Itek Investigation per hour (1 hr min) 62.50
Phone: ( 3 6z ) D 3 ) 9 S'"— Fax: (( b) )j17 q‘ yeK Industrial plant per hour 73.75
tm' tEte'RIGA PERMIT` FEES*'*
CCB Lie.: 6777 g" Electrical Lie.: 32 t jQFd J Suprv. Lie.: ('S yG ffr Subtotal
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print name: L . r 1 � 3 - s---- State surcharge (8% of permit fee)
�.- /-0 l J Date: 1 2_ — TOTAL PERMIT FEE
Authorized signature: 1✓ This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: 1 -.SS 8 4S A a(A) Date: / .2
2 23 — b S — • Fee methodology set by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed.
is\ Building \Permits\ELC- PermitApp.doc 12/03 440- 4615T(10 /02/COM/WEH
CITY OF TIGARD
BUILDING DIVISION \ A A PERMIT #: ELR2005-00M9
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1209/2005
\ Phone: (503) 639-4171 4W1
Inspection Requests (24 Hrs.): (503) 639-417 5k, •
INSPECTION WORKSHEET FOR DATE:\ 1/12/2006 TIME: 7:02A1v1 PAGE: 68
SITE ADDRESS: 10220 SW GREENBURG R 1100 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/TWO LIN IIPO LN LOT #: TYPE OF USE:
PROJECT NAME , _ c 'kLATION
DESCRIPTIiN: Fire Alarm.
OWNER: E w" - FICE PROPERTIES TR PHONE #:
CONTRACTOR: T & L COMMUNICATIONS INC PHONE #:360-737-9725
Inspection Request Scheduled For: Date: 12/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 024804-01 360.737-9725
Corrections/Com - • •
F- 1 gs-6046
PASS PARTIAL APPROVAL fl CANCEL NO ACCESS
F IL E CALL.FOR INSPECTION El ADDITIONAL FEES ASSESSED
' t4 Inspector: Date: Phone #: (503) 718-