Permit CITY TIGAR ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2005 - 00082
41 DATE ISSUED: 4/11/2005
--° 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1 S135AB -01004
SITE ADDRESS: 10220 SW GREENBURG RD 250 ZONING: C -P
SUBDIVISION: TWO LINCOLN - TOWN OF METZGER LOT: JURISDICTION: TIG
Project Description: Category 5 data wiring.
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 EMMONS ENTERPRISES
ONE SW COLUMBIA #300 20525 S UNGER RD
PORTLAND, OR 97258 BEAVERCREEK, OR 97004
Phone: 503 - 293 -2745 Phone: 503 -632 -3535
Reg #: LIC 106940
ELE 3- 304CEP
FEES SUP 570LEA
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 4/11/2005 $75.00
[TAX] 8% State Surcha 4/11/2005 $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 questions to OUNC at 503 - 246 -6699.
Issued By: ` L f2 Permittee Signature: ..-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.
4-1 1 -205 9 : 07AM FROM EMMONSERPR I SES 503 632 8329 P. 2
1 RECEIV
, ----
4*---...-
Electrical Permit Applicatio 1 1 2005
IAI IN
City of Tigard
V DC.it— P erm i t N ° . :
13125 SW Hall 13lvd_., Tigard, OR 97223 CITY -... T , .. , Plan Rinnew Other Permit:
Phone: 503.659.4171 Fax: 503,59R.1
Inspection Line: 503,639.4175 ... ‘2.!... Daus ReadYIBT Sri: 1 ,,.._ 121 see Nye suppkinentai ooPrmation 2 for
ti ethod: LT r
Internet www.ei.tigard.M.us 96° BUILDING DI ''':-'jk.N:'1,.. , DILteraficdirm
iii ,.,:::::,'..;,;: * :, ••••,;•:,:•1., •:.,....• • • : :..: ... • ::.
0 'kw construction a] Additionialtaationfreplaccrneut Pioallo cheek all that appV:
OService over 225 amps, comml Oliazardous location
0 Demolition 0 Othr e 08crvicc over 320 amps - rating CIBuiking over 10,000 sq. ft.
• 7VCIO: 1Ifl)CTIO ::::::. ................. . :,...., ,,h,.. of 1- and 2-fairdly dwellinn 4 or more new residential
1- and 2-family dwelling Ea Commercial/industrial 0 Accessory building El System over 600 veils nominal units in one structure
0 Building over three st,ories [' Feeders_ 400 amps or MO K e
1:1 MUlti•farnilY 0 Master builder 0 Other: DOccupant toad over 99 persons 0 Manufactured structures or
• '''''•• ''''' • •'• • '''•'•"-''10A'SITE•INPORIPolaTiON:i ;0341X4)Cie , i......„: :,.4 .,.... . : . • . „.„. •:•:. „ OF:gess/lighting plan RV park
1 EIHealth-care
Jeb no.: i Job site addrcss: 10220 SW Greenburg Rd _ , - 2
Submit seta of plans with any of the above,
City/State/ZIP: Port land , OR 97223 The above arc not applicable to temporary coagruction service.
- '
Suite/bldg./ap ::'.:':',..:...;:.':.::'.;,?:::.•.'..;:.:=:',...',;4,,...v::,:.P.10tit;:i.f.X.E.a164131,4:.V.':;.?:"::::
t_ no.: 250 1 Pw name: Academy _Mortgage • .
Description Qty. r . rim, Tong 1 *"
. ' .. —
Cross street/directions to job site: New residential single- or multi-faultily lweIling unit.
—• Includes attached garage. .
1,000 sq. ft. ur less 145.15 4
I
Subdivision: Lot no.: Ea, add') 500 sq. ft. or portion 33,40 1
— . -- Limited energy, residential 75.00 2
Tax map/parcel no.: Limited energy, non 75,00 2
A •• • _,: '
.i.,'•:• •i:T ',•,:% : .,•:'.: . ..-'Y'/d)LSOri44710,N,P,F•?.:***A:i':•:::{ 1 .:.i:/".'•::''..•:,::'•;'',.ii......i.::.:•:.' , •'.'.:: ) 'L , Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Category 5 data wiring for Academy Mortgage sen „ re,ders installation, alteration, and/or relocation
200 amps or kis [ H0.30 I 2
106,85 2
:t.t ti)ifiiliiii4ttiti:!,?:::;.: •,;::er:,,.,.Z,..:113.4*i4W.:.::'....i4.:e,.
' • • 201 amps to 400 amps
10.60 2
Name: Academy Mortgage — 601 amps to 1,000 amPs 240.60 2 .
-
Address: 10220 SW Greenburg Rd, Suite 250 Over 1,000 ap
ms or volts
— _ _ 454.65 — o
- Reconnect only 66,85 2
.......'
City/State/AP; P0 rtland, OR 97223 Temporary services or feede , rs instwwation. alteration, and/or
-- neltantion
Phone: ( ) Fax: ( ) 200 amps or leas 66.85 1
Owner installation: IRS installation is being made on property that I own which is not 201 amps to 400 amps 106.30 2
intended for sale, lease, rent, or exchange, aecordiag to ORS 447, 449, 670, and 701. 401 arnps to 600 amps 2
. ,._
Owner signature: Date; Brand( ctreuic s -new, 1.21■..eratlo t, or extension, ij_ and
A .... ... , . . . . . .......... .`..
...','.'?..''''.'' ..... ' ,,-‘...."'"''': ;+:;...',:.' '0 .,..:,:".: A. Fee for branch circuits with
., .. . . ... . .. ., .. .. .., . . ..... .. . .... ... A.,. . . . .. . ,. ... . ., .. . , . servioe or fender fee. each 6.65 2
Business name'. Emmons EnterDrises Inc branch circuit
B. i•ee for branch circuits
Contact name: Gail Emmons without service or feeder tee, 46,85 2
each branch circuit
Address: 205.25 S. Unger Rd Each add'i braneh Circuit 6.65 2
City/State/ZIP: Beavercreek OR 97004 hollseelbuteous (service or feeder not inducted) .,.--,
Pump or irrigation circle 53.40 2
Phone“ 50 632-3535 Fax: : ( 5 0 3) 632 signor outline iighting 53.40 - .
2
— - —
1 artnnw,44111C..@-,i--14.•111 Signil circuit(s) or limited-
r ''',.... : °IcIBY Pank4 alivral or
i° *1
.. - ' ' n ' extensiori. Describe: Page 2 75
Address: 2525 S. • Unger Rd 0j2
Business name: •
,,.... •
Each additional inspection over allowable in in of the abo c
0
Per inspcxlion 62.50
_
Cil yiSmearP: Be aver c r e ek , OR 97004 investigation per hour (t ht min) 62.50
Phone'. (503) 63203535 I Fax: (503) 632-6329 ftulustrial plant per hoar 73,75
-
:••:-:'. • • . •'•Ig114CiElltit.,. . i;iltitifii
CCM-ie.: 106940 Electrical Lie.: 3 - 3 OzICEIFSuprv. Lio.: 57 OLEA subtotal 75 00
,„„,_
Suprv. Electrician signature, required: A 1.4 Plan review (25% of permit fee)
State surcharge (8% of permit fee) , .
.
....
I/
Printmne: Gary E. Emmons Dale: 4/11/05 TOTAL PERMIT FEE 81.00
Authorized signature:
This periat applicstion expires if a permit lo not obtained within 180
..alarillaalltaeLaet - days
Print nm after it has been accepted as convict&
ae: G r ill . Fee methadolo & set 1,y Tri-County industly Servie ca
Ttuildine, c Fird
to rr e •••• _
4
.......- ** Number of inspections net DCMlit a) lowed.
CITY OF TIGARD
•
BUILDING DIVISION PERMIT #: ELR2005 -00002
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/11/2005
Phone: (503) 639 -4171 4)yptvq_ i
Inspection Requests (24 Hrs.): (503) 639 -4175 ''
INSPECTION WORKSHEET FOR DATE: 4/14/2005 TIME: 7:10AM PAGE: 36
SITE ADDRESS: 10220 SW GREENBURG RD 250 CLASS OF WORK:
SUBDIVISION: TWO LINCOLN - TOWN OF METZGER LOT #: TYPE OF USE:
PROJECT NAME: ACADEMY MORTGAGE
DESCRIPTION: Category 5 data wiring.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #: 503 -293 -2745
CONTRACTOR: EMMONS ENTERPRISES PHONE #: 503 -632 -3535
Inspection Request Scheduled For: Date: 4/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low- voltage 004527 -01 503-632 -3535 Y
Corrections/Comments/Instructions:
T w Lo\ C.M )\ c s ) \No c-pLL
\AP L, . I � Th lb 15 I\ � ` of y
- To NM 0.
3
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Datel�, Phone #: (503) 718 -
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005 -00082
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/11/2005
Phone: (503) 639 -4171 , ,n oltIl'i \ .
Inspection Requests (24 Hrs.): (503) 639 -4175 „
INSPECTION WORKSHEET FOR DATE: EJ2/2006 TIME: 7:10AM PAGE: 71
•
SITE ADDRESS: 10220 SW GREENBURG RD 250 CLASS OF WORK:
SUBDIVISION: TWO LINCOLN - TOWN OF METZGER LOT #: TYPE OF USE:
PROJECT NAME: ACADEMY MORTGAGE
DESCRIPTION: Category 5 data wiring.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #: 503. 293.2746
CONTRACTOR: EMMONS ENTERPRISES PHONE #: 503-632 -3535
Inspection Request Scheduled For: Date: 5f2/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 005766 -01 503.348 -0563 Y
Corrections/Comments/Instructions:
r r n ' 4
C f .
I
/
..PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
'7 L
Inspector: /� Date: . �J Phone #: (503) 718-