Permit 17 . CITY O F T I G A R D ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00191
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/15/2007
PARCEL: 1 S 135AB -01002
SITE ADDRESS: 10220 SW GREENBURG RD 417 ZONING: R -12
SUBDIVISION: LINCOLN CENTER /THREE LINCOLN LOT: 009 JURISDICTION: TIG
PROJECT: FUJITSU
Project Description: Low voltage for HVAC.
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 AMERICAN HEATING
ONE SW COLUMBIA ST #300 1339 SW GIDEON ST
PORTLAND, OR 97258 PORTLAND, OR 97202
Phone: Contact #: PRI 503 239 - 4600
FAX 503- 239 -7038
FEES Reg #: ELE 26- 993CRE
LIC 33135
Description Date Amount
[ELPRMT] ELR Permit 6/15/2007 $75.00
[TAX] 8% State Surcha 6/15/2007 $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, • • • - • is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility otification Cen _ . Tho - rules are set forth in OAR 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain copies of these
rule- or direct questions • o N . 503.246.6699 or 1.800.332.2344. � [
Iss ed By: t _ OA" _ / Permittee Signature: / -•-• / ` ? r c/ 4 n G X e 5 ! c
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.
•7 \ .
E1`ectrit al Permit Application FOROFFICE.uSEOvLY "
City of Tigard Deccee�l3ea PennitNo.: E ' ,
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 y �'�a' h ✓1}l��l W '�il Date : Other Pernu
B t:
� t
Inspection Line: 503.639.4175 Date Ready/By: See Page 2 for
�
Internet: www.ci.tigard.or.us Notified/Method: Supplementallnformation
,�•a��� . <a 's'';Y .�.`<, s5 �d��.s..:;I!;&7D..r �� ,��� .''.��:.7K.�,:�`��1 '^��� ,"`, f�-Y._ �: 'sri= t;�..'s s2 i;,y= "t':' ^'.r, '`
❑ New construction % Addition/alteration/replacement Please check all that apply:
❑Service over 225 amps, comm'I ❑Hazardous location
❑ Demolltlon ❑Other: ❑Se rvice over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
o 1 -and 2- family dwellings 4 or more new residential
❑ 1 - and 2 family dwelling i ommercial /industrial ❑Accessory building
❑System over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders, 400 amps or more
❑ Multi family ❑ Master builder ❑ Other ❑Occupant load over 99 persons ❑Manufactured structures or
, i ter° a :tee ; paw '- e . RV park
x� 6 f� d� G ❑ Egress/lighting plan
� ,, 1 G uj � 1 ❑Health - care facility ❑Other:
Job no.: Job site address: ���'� ll`-' (�1 Submit 2 sets of plans with any of the above.
J
City /State /ZIP: T C14�- � 0 � The above are not applicable to temporary construction service.
� 't ' •
� a � '3fir,�'yX��' „ ° *1'.r`Fy,'S;1�.�D;�s�`�i; iv`_i�;l %r i'�; • -' ,; . ' r
Suite/bldg. /apt. no.: t-\47 Project name: 1 (�QIVI _ De :edpnon Qt P «. r tai ••
Cross streetldirections to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.: Ea. add'I 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
Each manufactured or modular
hJ
/ V ,l — c�fjL
, � ` v dwelling, service and /or feeder 90.90 2
i l ( £ ('- Services or feeders installation, alteration, and/or relocation
J 200 amps or less 80.30 2
a amps mps to 400 106.85 2
401 amps to 600 amps
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 '::stallation: 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
` ��. ,3�`e. 1`., � ` ' , V�I„'"�� u � • i6.,>1•���.M` � � .. � " ®., -�.� %��, tr� � ;,;:,� -A: servic or c wi
teachh -- - -
Business name: .�p � branch circuit 6.65 2
��� l �� 1 ' ( B. Fee for branch circuits
Contact name: �\�! without service or feeder fee, 46.85 2
I �� G r � � each branch circuit
Address: I ti✓ ' Each add'I branch circuit 6.65 Z
City/State/ZIP: • 'O Y* ..fl (� t O (Z C ) a 0 ) Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: (V355) a3 _ (. I Fax:: (:E) 6?:) Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
energy panel, alteration, or
extension. Describe: I Page 2 2
Business name: l �' • cc —
Each additional inspection over allowable in any of the above
Address: t .� 3 G � � c.;j � �'�(( I , Per, inspection 62.50
City /State/ZIP: T k)o4. l f (3 q Investigation per hour (1 hr min) 62.50
a Industrial plant per hour 73.75
Phone: () -y (p 30 Fax: (j) -1 O 38
CCB Lie.: �3 t 3 5 Electrical Lic.: 3 C L Sup . Lie.: y (j Subtotal
�( / /
Suprv. Electrician signature, required: J ,' � � ,. Plan review (25% of permit fee)
�/ t O State surcharge (8% of permit fee) (/� -
Print name: 3k v I U n / Date: ' TOTAL PERMIT FEE �� • O U
t l ( S� _ I
/
Authorized signature: � 6 , - 4 (i — This permit application expires if a permit is not obtained within 150
days after it has been accepted as complete
Print name: f . yy), (yl. `J l � u d Date: V —1 5--(j7 ' Fee methodology set by Tri- County Building Industry Service Board
" Number of inspections per permit allowed.
is\ Building \Perrnits\ELC- PemviApp.doc 12/03 440- 46t5T(10 /07JCOM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007-00191
, 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/1512007
Phone: (503) 639 -4171 I t
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/19 /2007 TIME: 7:01AMY1 PAGE: 76
SITE ADDRESS: 10220 SW GREENSURG RD 417 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/THREE LINCOLN LOT #: 009 TYPE OF USE:
PROJECT NAME: FUJITSU
DESCRIPTION: Low voltage for HVAC.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: AMERICAN HEATING PHONE #: 503 - 239 - 4600
Inspection Request Scheduled For: Date: 6/19/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 050444 -01 503. 209-0731 N
Corrections /Comments/ Instructions:
S ❑ PARTIAL APPROVAL n CANCEL n NO ACCESS
FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
ctor: Date‘
ate / _ Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR200I- 00191
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/15/2007
Phone: (503) 639 -4171 girr4��iiVfl�'�I nk
Inspection Requests (24 Hrs.): (503) 639 -4175 J
INSPECTION WORKSHEET FOR DATE: 6/19/2007 TIME: 7:01AM PAGE: 76
SITE ADDRESS: 10220 SW GREENBURG RD 417 . CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/THREE LINCOLN LOT #: 009 TYPE OF USE:
PROJECT NAME: FUJITSU
DESCRIPTION: Low voltage for HVAC.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #: I
CONTRACTOR: AMERICAN HEATING PHONE #: 503 - 239-4600
Inspection Request Scheduled For: Date: 6/19/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 050443 -01 503.209 -0731 Y
Corrections /Comments /Instructions: •
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL I NO ACCESS
I I FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: ' - (` 7 Phone #: (503) 718-