Permit . 'a 4
I" CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
i lar - COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00028
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/1/2007
PARCEL: 1 S135AB -01004
SITE ADDRESS: 10220 SW GREENBURG RD 200 ZONING: C -P
SUBDIVISION: LINCOLN CENTER /TWO LINCOLN LOT: JURISDICTION: TIG
Project Description: CRUISE MASTERS Low voltage /Voice and Data.
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 TEAMTLI.COM DBA TELECOM LABS INC
ONE SW COLUMBIA #300 700 INDUSTRY DR
PORTLAND, OR 97258 SEATTLE, WA 98188
Phone: Contact #: PRI 206 -575 -9100
FAX 206 -575 -9900
FEES Reg #: ELE 37- 860CLE
LIC 156946
Description Date Amount
[ELPRMT] ELR Permit 2/1/2007 $75.00
[TAX] 8% State Surcha 2/1/2007 $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 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: -
1, Zdkizt .711 ‘ 4 , 6 Ze t &e .) _
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.
Eledricatl Permit Application s FOR OF ICE (SE ONLY_ .
d '- - L7' ' '''Rec e i ved � P ermit N o. ` ��
City of Tigard FEB . Plan Review
2007 DateBy: yr/2 if ,40 Permit tr
;I 13125 SW Hall Blvd., Tigard, OR 97223 C
i Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
TI G A R D Inspection Line: 503.639.4175 CITY OF 'R 'i OAR D Date Ready/By: larisi See Page 2 for
Internet: www.tigard- or.gov BUILDING r I�.rIr't y 1 Notified/Method: J Supplemental Information
- - - TYPE OF WORK ' ' .. PLAN REVIEW .
El New construction f _� Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
•
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling IX CommerciaUindustrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "l - ", "13 ",
1001 -IP or more. occupancy.
Job no.: Job site address: S � ( ete h ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: 1 'Z " �t ❑ H ealthcare facilities. El Supply voltage for more than
x % /�J i O 0�0� ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: C Xtn C �' s4 ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map/parcel no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential
'DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
_(�( Limited energy, multi - family
!ice .. L . ,- 4 A- CA C)'Z Ut_ SAAVZ residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation
€✓W +'"V i (1� 91p V e rv.a.:JS. 200 amps or less 80.30 2
- ❑ PROPERTY bWNER . • ` Or TENANT 201 amps to 400 amps 106.85 2
L_ 401 amps to 600 amps 160.60 2
Name:
CYtl 1SQ-.'� INS`TYlc- 601 amps to 1,000 amps 240.60 2
Address: / 0 2a Sc...) r s,re S'fe .). Over 1,000 amps or volts 454.65 2
City/State /ZIP: ' i 2 d2 9 -)x,3 relocation services or feeders installation, alteration, and/or
Phone: ( q' 7 /) � Fax: (� ) �� 4:.- 200 amps or less 66.85 1
�� ' -�^ l S O 201 amps to 400 amps 100.30 2
Owner installation: This installation is being made on property that I own which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
- ❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: —' ..� \
r t ,. B. Fee for branch circuits
without service or feeder fee,
Contact name: 46.85 2
A h S Q- (� first branch circuit
Address: YO9 5k..3 I %e8-. l r -» Each add'l branch circuit 6.65 2
^ 7 ' Miscellaneous (service or feeder not included)
City/State /ZIP: ' �J / 0 2 9 3 Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: (713) 372, p., i Fax::(V23) 6z9-9c7 only 66.85 2
E -mail: br 2 4\ - vN S P --` L e_Ai, ...- ` -i t „ (.,,�'s- Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: �^ 1l i ` Signal circuit(s) or limited-
. eisr, ,^i l l,, La"— energy panel, alteration, or
Address: - 700 r 1- extension. Describe: Page 2 2
t l r-y .
M City/State /ZIP: S DA }{ (. , LAJA / S S /V Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: 4 5-7S'_ 9i 0--0 .V Fax: (.7 �� _ 55\QV Investigation per hour (1 hr min) 62.50
CCB Lie.: / Electrical Lie.: rv. Su Lie.: Industrial plant per hour 73.75
��' y 37 ....2 p �O7tE� ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required ;_ - -71 1 I 0 7 Subtotal:
Print name: ` Ib Date: _ 1 _ 07 Plan review (25% of permit fee):
State surcharge (8% of permit fee):
Authorized signature: TOTAL PERMIT FEE: ' r '
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
CITY OF TIGARD A
BUILDING DIVISION
400,,,,A PERMIT #: ELR2007-00028
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 211 / 2007
Phone: (503) 639-4171 esolimiiiii".
Inspection Requests (24 Hrs.): (503) 639-4175 A I
....„..,,, --.
INSPECTION WORKSHEET FOR DATE: 2115i2007 TIME: 7: ODAM PAGE: 59
SITE ADDRESS: 10220 SW GREENBURG RD 200 CLASS OF WORK: .
SUBDIVISION: LINCOLN CENTER/TWO LINCOLN LOT #: TYPE OF USE: ,
PROJECT NAME: CRUISE MASTER
DESCRIPTION: CRUISE MASTERS Low voltage/Voice and Data.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: TEAMTLI .COM DI3A TELECOM LABS INC PHONE #: , 206-575-9100
Inspection Request Scheduled For: Date: 2115/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 043421-02 503-780-3222 N
\I V iS
Corrections/Comments/Instructions:
..0 1/
l'AASS n PARTIAL APPROVAL n CANCEL El NO ACCESS
I I FAIL I CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: Cy- N 4y66 (--E Date: 2 - 4 5 Phone #: (503) 718- tifq,