Permit CITY TI CARD ELECTRICAL RESTRICTED ENERGY PERMIT
i7 I DEVELOPMENT SERVICES PERMIT #: ELR2005 -00255
Ic 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/30/2005
. PARCEL: 1S135AB -01004
SITE ADDRESS: 10220 SW GREENBURG RD 150 ZONING: C -P
SUBDIVISION: LINCOLN CENTER /TWO LINCOLN LOT: JURISDICTION: TIG
Project Description: Relocate thermostat.
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 MCKINSTRY CO.
ONE SW COLUMBIA #300 5400 NE COLUMBIA
PORTLAND, OR 97258 PORTLAND, OR 97218
Phone: Phone: 503 331 - 0234
Reg #: LIC 40981
ELE 26- 1190CLE
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 8/30/2005 $75.00
[TAX] 8% State Surchaq 8/30/2005 $6.00
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 or direct questio s to OUNC at 503 - 246 -6699.
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.
Electrical Permit Applicatism FOR OFFICE USE ONLY'
. , . .. . .
Ci I,
AtUt[IVE ' A R- - iv- d , .---- . _
, L.!iity of Tigard
Date/B : - - „Ublirliallbail Permit No.: __ ,.....i. 4
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960J6 3 0 2005 _411411iii Date/B : Other Permit:
Inspection Line: 503.639.4175 61 . Date Ready/By: WI 0 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
I rQr1I
C l 1 -F '7, ' .`'.., ti:VriailfilV: .". 7',1
0 New construction EXI Addition/alteration/replacement Please check all that apply:
0 Service over 225 amps, comm'l DHazardous location
0 Demolition 0 Other:
, 0 Service over 320 amps - rating El Buildng over 10,000 sq. ft.,
1.414: : .:: 1: :V.1:',,,:' of I- and 2-family dwellings 4 or more new residential
0 1- and 2-family dwelling Z Commercial/industrial 0 Accessory building ['System over 600 volts nominal units in one structure
0Building over three stories OFeeders, 400 amps or more
El Multi-family 0 Master builder 0 Other:
['Occupant load over 99 persons ['Manufactured structures or
JOB so::t".1*0:**T* :4: ''- :;.!: ElEgress/lighting Plan RV park
Job no.: 753281 Job site address: 10220 SW Greenburg Rd 0Health-care facility ['Other:
Submit 2 sets of plans with any of the above.
City/State/ZIP: Tigard, OR 97223 The above are not applicable to temporary construction service.
,; i ii 'WOED 1J4g1V
Suite/bldg./apt. no.: 150 Project name: Ticor Title
Description Qty. Fee. Total 1 **
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 I
Limited energy, residential 75.00 2
Tax map/parcel no.:
Limited energy non-residential 75.00 2
),i7E,Sgit176■If ;OF04.W''' '''' .4. ;. Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Relocate Thermostat
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
it ," ; , T ,,, v , ,,,:„, ltgktfbkwj - e -" Eii; ., m :, : ,4, -..„ t:i ::,. itvAilonnwir4 ;! ,, i , 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: Equity Office Properties 601 amps to 1,000 amps 240.60 2
Address: One SW Columbia Blvd, Ste. 300 Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: Portland, OR 97258 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
:0 A.17 , ! 4 14,14 , 466,i ' ,,,,!,,, ZRE",-,'Ere6SffiX.'cififii :,f1;,iiit A. Fee for branch circuits with
- - -'' " - ' - '?,i-;; %',' - ' ' - '. " ' 4 2 ":= .141 '''' ''' " ' ''''''- service or feeder fee, each
6.65 2
Business name: McKinstry Company branch circuit
B. Fee for branch circuits
Contact name: Jason Carver without service or feeder fee,
46.85 2
Address: 12021 NE Airport Way each branch circuit
Each addl branch circuit 6.65 2
City/State/ZIP: Portland, OR 97220 Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: (503) 331-2461 Fax: : (503) 331-6906
Sign or outline lighting 53.40 2
E-mail: jasonc@mckinstry.com Signal circuit(s) or limited-
14313 ',::111-;',"''''',5:iaatOtOht*dt0-#",:!'d,01111!*,1*;:tft',A621:4,,::'F:r,,,i energy ration, pan alteration, or
Page 2 2
Business name: McKinstry Company
Each additional inspection over allowable in any of the above
Address: 12021 NE Airport Way
Per inspection 62.50
City/State/ZIP: Portland, OR 97220 Investigation per hour (1 hr mm) 62.50
Phone: (503) 331-2461 Fax: (503) 331-6906 Industrial plant per hour 73.75
felt:14132KIMMIcAt)IttitWatas*Ii4M
CCB Lic.: 40981 Electrical Lic.: 26-1190CLE Suprv. Lic.: 2274LEB Subtotal
Suprv. Electrician signature, required: (e.4s ... A__, Plan review (25% of permit fee)
A State surcharge (8% of permit fee)
:i
Print name: ( Date: 8/30/05
4 yA.4..... Oti'y :
„
e, , 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: — . 1 (...,' a r Date: 8/30/05 * Fee methodology set by Tri-County Building Industry Service Board
** Number of inspections per permit allowed.
1:313uilding3Permits \ ELC-PermitApp.doc 12/03 440-4615T( 10/02/COM/WEB
' OF TIG RD
L u ING DIVISI \ . ., PERMIT #: r 66
ELR2005 -00255
13125 SW Hall Blvd., Tigard, " 97223 DATE ISSUED: 8/30/7005
Phone: (503) 639- 4171
p, ':� .1u�i'�II
Inspection Requests (24 Hrs.): (50 639 -4175
INSPECTION WORKSHEET FOR \DATE: 8/31/2005 TIME: 7 :03Am PAGE: 36
SITE ADDRESS: 10220 SW GREENBUl * � D 150 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER /I/O COLN LOT #: TYPE OF USE: '
PROJECT NAME: TICOR TITLE
DESCRIPTION: Relocate thermostat.
OWNER: EQUITY OFFICE PROPERTIES UST, . #:
CONTRACTOR: MCKINSTRY CO. PHONE #: 503 - 331 - 0234
Inspection Request Scheduled For: Date: ; 3.1/2005 Pour Time:
Code # Inspection Description on it . Contact # Message
136 Low voltage 0 4688-01 603.572 -1641 Y
Corrections /Comments /Instructions:
Jill 's ON)
14 PASS n PARTIAL APPROVAL n CANCEL f NO ACCESS
n FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: CT Y V o g cL--- Date: ,I Phone #: (503) 718- 2.4 Li