Permit CITY OF 1'I GARD • ELECTRICAL PERMIT -
.__ RESTRICTED ENERGY
''41,, DEVELOPMENT H PMENa r SERVICES 639 -4171 DATE PERMIT E1 /8 20004 00347
•
13125 SITE ADDRESS: 10220 SW GREENBURG RD 410 PARCEL: 1S135AB-01004
SUBDIVISION: TWO LINCOLN - TOWN OF METZGER ZONING: C -P
BLOCK: LOT: JURISDICTION: TIG
Project Description: Job No 750758 relocate 3 24V T -Stats
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: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: T -STATS X
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: 503 4152 - 4800 Phone: 503 997 - 0234
Reg #: LIC 40981
ELE 26 1190CLE
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 11/8/2004 $75.00 Elect I Final
[TAX] 8% State Surchar€ 11/8/2004 $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 952-001-0110
through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions • OUNC at 1' 24%. -6699.
Issued by I i // Permittee Signatur: _ (
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 639 -4175 by 7:00 P.M. for an inspection needed the next business day
1
x
',cal Permit Application fl Q FOR OFFICE USE ONLY
. T. g 11, R ece i ved j � _ U �D� WI� I ���~
^ l i a and �� Date/By: l Permit No. l
11ti•i,, W41 -fa B lvd., Tigard, OR 97223 Plan Review MO �Q s�o
Phone: 503.639.4171 Fax: 503.598.1960 i `t'i(i Date /By: Other Permit: `
Inspection Line: 503.639.4175 Date Ready /By:
Juris: ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
„• :;...,a' ;•. -., ; - -„ mot...
a ., ✓ ,� a ;s;;
�,. ,TYPE OF, ORK. <,F ,, - ., ..._,- �... , , -''
.� . ... -.� I , A; ;t REVIE W � H ,.
❑ New construction ® Addition /alteration/replacement Please check all that apply:
❑ Demolition ❑ Other: over 225 EHazardous Service r 2 amps comet' Hazar location
._.;.,� -, ;-: ";��. r . � :GATE+GORYOF�CONSTR[7 N r' � -,; ��, ", ;� ❑ of e l i and2efamilydwellings ttg B o l � n orenew O re O sidential t
:
_-� � t- r - 5_�,db�°3,s . _. :., .,_ -,,,- S"s,•s�9k'3k,tF£�., . ; c f.,m 'kx , s _ ; , - "- - , j ' ..,, -�F. , .. ,. we,,,
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building ['System over 600 volts nominal traits in one structure
['Building over three stories ['Feeders, 400 amps or more
❑ Multi- family ❑ Master builder ❑ Other: persons ['Occupant load over 99 e Manufactur ed structures or
JOB°`Si I ORMATJON:ANI OGATION,,� ," ['Egress/lighting lan P ark
' �. ;:;�s- ,' ';� - RV .. P
❑Health - care facility ❑Other:
Job no.: 750758 Job site address: 10220 SW GREENBURGE RD.
Submit 2 sets of plans with any of the above.
City/State /ZIP: PORTLAND, OR. . The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: SUITE410 Project name: BNC MORTGAGE ,
Description Qty. Fee. 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'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: energy, non-residential 75.00 2
v
_ ` Limited nergy non entta
€s:; °"'` ors % �; , or modular
� ,� � ,. � � ; �D , WUIti{; °� °_�:-:� Each manufactured o
":- izix•. »l S .�:,,<iiE:t�..�..?_w5..s,� , ,..., ,. _, .: � _n s . .... ......... .;.. .. .
.
RELOCATE 3 24V T �qJ dwelling, service and/or feeder 90.90 2
V �v Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
to amps 106.85 2
;; ®PROI°ERT -Y OWNER % i ENANT
_ , _ "-* 401 amps to 600 amps 160.60 2
Name: EQUITY OFFICE PROPERTY 601 amps to 1,000 amps 240.60 2
Address: ONE SW COLUMBIA BLVD. Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State /ZIP: PORTLAND, OR. 97202 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
"° ''e£' ,0,—# A. Fee for branch circuits with
"` AP
P GAN'I`�. >- ";` � , I ( ONTA>� T �PE RS OIy- ?�'� < - °; .:.
���� ° =�:�. �:: ":.-- �,., 3:., :'.....-_ § -;_:_. ' - ::; .�a- �,� -.' ,:: � ".: ;- ..- „,,,,<,,.::� � . service or feeder f each
e fee, e 6.65 2
Business name: McKinstry Co. branch circuit
B. Fee for branch circuits
Contact name: PAT CRAPPA without service or feeder fee,
each branch circuit 46.85 2
Address: 5400 NE COLUMBIA BLVD. '
Each add'l branch circuit 6.65 2
City/State /ZIP: PORTLAND, OR. 97218 Miscellaneous (service or feeder not included)
Phone: (503) 331 -0234 Fax: : (503) 331 -6906 Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
': ' C° , k ::::RIT energy anel, alteration, or
extension. Describe: Page 2 2
Business name: McKinstry Co.
Address: 5400 NE COLUMBIA BLVD. Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State /ZIP: PORTLAND, OR. 97218 Investigation per hour (1 hr min) 62.50
Phone: (503) 331 -0234 Fax: (503) 331 -6906 Industrial plant per hour 73.75
,` ��„ '.L EG _RIC i*01IT ) S��” _ : - -,4,. 13
CCB Lic.: 40981 Electrical Lie.: 26- 1190CLE Suprv. Lie.: 2274 Le $ Subtotal '75
Suprv. Electrician signature, required: �n 1 ,� Plan review (25% of permit fee)
U v State surcharge (8% of permit fee) 6 , 0 0
Print name: Date: 11 -3 -04
v� =� t T TOTAL PERMIT FEE g I, D V
Authorized signatur / � This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: /� VC Date: 11 -3 -04 * Fee methodology set by Tri-County Building Industry Service Board
** Number of inspections per pennit allowed.
i:\ Building \Permits\ELC- PettnitApp.doc 12/03 440 -46 1 5T( 1 0/02/COM/WEB
CITY OF TIGARD 24 -Hour
BUILDING .,Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: - (563) 639 -4171 MST
BUP
Received Date Requested J AM PM BUP
Location /L) 2 iJ /J10 Suite 4 7 / /0 MEC
Contact Person P ( ) vp' 03-63 PLM
Contractor Ph ) SWR
BUILDING Tenant/Owner b IV ELC
Footing ELC
Foundation Access:
Ftg Drain ELR 40 —0 6 3q7
Crawl Drain
Slab Inspection Notes: ( 2 _ SIT
Post & Beam
Shear Anchors 1 L U U U C S t 1b
Ext Sheath /Shear \
Int Sheath /Shear
Framing (� (� l ,,, /
Insulation 1 L s V mo- V � 1 4 }�
Drywall Nailing l
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In r
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
•
•oug -
UG/ a•
ow olta• tY
Fire Alar
❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PAS PART FAIL
SITE _ 0 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA /
Approach /Sidewalk Date �/ ! 0 Inspector 1 � Ext
Other:
Final DO NOT REMOVE this inspection record f om the job site.
PASS PART FAIL