Permit °�""` CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00491
. DEVELOPMENT SERVICES DATE ISSUED: 8/7/03
.,I II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S135AB-01004
SITE ADDRESS: 10220 SW GREENBURG RD 501
SUBDIVISION: TWO LINCOLN - TOWN OF METZGER ZONING. C -P
BLOCK: LOT : JURISDICTION: TIG •
Project Description: Install 11 branch circuits
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 10 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
EOP LINCOLN, LLC WILLAMETTE ELECTRIC INC
10260 SW GREENBURG RD PO BOX 230547
SUITE 100 TIGARD, OR 97281
PORTLAND, OR 97223
Phone: Phone: 503 - 624 - 3631
Reg #: LIC 75059
SUP 19655
FEES ELE 34 -283C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 8/7/03 $113.35
[TAX] 8% State Tax 8/7/03 $9.07 Rough -in
Elect'I Final
Total $122.42
•
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. i i
Issued By: 01111/ / Permit Signature: a(
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 7:00pm for an inspection the next business day
Electrical Permit Application Received .FOR OFFICE USE O;�LY•
p .D Electrical
0 Date/By: O -7 -193 o � Permit No.: 4 7 G7'� cz`i/
Cit of Ti and RECEIVED Planning Approval Sign
Y b Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 AUG 0 / 2003 Date/By: Permit No.:
Phone: 503 -639 -4171 Fax:-603-598-1.960 / iH,� r � t Post- Review , Land Use
‘..1 i 1 f 'Jr I RARE' il I,; Date/By: Case No.:
Internet: www.ci.tigard.or. 1" P - - i ` � Contact Juris.: ❑ See Page 2 for
24 -hour Inspection Request: 5 639 -4 Name /Method: Supplemental Information.
, ._. .. TYPEiOF WORK ,SM. Y : °t , - _ '0 'JEAN REVIEW Please check all that:a t
❑ New construction Demolition ❑ Service over 225 amps- • health -care facility
commercial ❑ Hazardous location
Addition /alteration/replacement ❑ Other: ❑ Service over 320 amps- rating of ❑ Building over 10,000 square feet,
. ., CATEGORYOFiGQNS. TRrt. IcTIQI'O`ta_'A;,,.;:;. ,,. 1 & 2 family dwellings four or more residential units in
0 1 & 2- Family dwelling .Z Commercial/Industrial ❑ System over 600 volts nominal one structure
❑ Building over three stories ❑ Feeders, 400 amps or more
J Accessory Building ['Multi-Family , ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
D Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other:
K , q, . . l i- y, 'i 5;4 », Submit sets of plans with any of the above.
JOB. SITE ATION ;; r 7; ;� T
The above are not applicable to temporary construction service.
Job site address: (OZ.LO Su) nALI..• 1,u.55 rid ' °'F °° :,.,x I' >zr t;:T; FEE * :SCIiEDUliFI? , o;; p.:!`.:r;:l ?i. y`"':r
Suite #: 1 1 Bldg. /Apt. #: Number of inspections per permit allowed
Uescriptlon Qty Fee (ea.) Tool
Project Name: 14-e A Fwt f'(1 New residential- single or multi - family per
Cross street/Directions to job site,.) dwelling unit. Includes attached garage.
Service Included:
c, nJ GC (., CV 5 ( 1000 sq. for less 145.15 4
Each additional 500 sq. 11. or portion thereof 33.40 I
Subdivision: I Lot #: Limited energy, residential 75.00 2
Limited energy, non residential 75.00 2
Tax map /parcel #: Each manufactured home or modular dwelling
;•kh : 1.';,.V1 . 'DESCRIPTION,IOF WOR1040i so Ioi service and/or feeder 90.90 2
Services or feeders - Installation,
Pr•-„ 7t /art .9 .42 ,4--e,,;._® �.., f alteration or relocation:
200 amps or less 80.30 2
201 amps to 400 amps 106.85 2
IIppff 7, s 401 amps to 600 amps 160.60 2
'y F,) 1'. • 0 ...., ,, OWNER' i,fl'4', +'! ®' , it 13 -' °��'. 601 amps to 1000 amps 240.60 2
Over 1000 amps or volts 454.65 2
Name: Reconnect only 66.85 2
Address: Temporary services or feeders - installation,
alteration, or relocation:
City /State /Zip: 200 amps or less 66.85 I
Phone: Fax: 201 amps to 400 amps 100.30 2
p�pY�ri�y�i1 �,. , 401 to 600 amps 133.75 2
} °�' '` Branch circuits - new, alteration, or
•
N ame: extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 6.65 • 2
City /State /Zip: B. Fee for branch circuits without purchase of / c
service or feeder fee, first branch circuit / 46.85 � b 2
Phone: I Fax: Each additional branch circuit /U 6.65 . 2
E -mail Misc.(Service or feeder not included):
,1� � ,.ES? ,!,. : O o ° °' F }' y �, } rc •
.j N `* Ea s oroull • l• • h tin cle 53.40 2
:4..‘. c . e�.�iE4;.M.. � .`s..FN�<Ift.l`1��... r?�'�i+ tit"' sign lighting
Job No: 4 S Signal circuit(s) or a limited energy panel,
alteration, or extension Page 2 2
Business Name: w , (1,‘ M t ti Fl e c 1'41 r I,,.. ,- Description:
Address: f o 6 , Z.30 sy
p Each additional Inspection over the allowable in any of the above:
City /State /Zip: • -1't5 A et r) OA / 2- Z k / Per inspection per hour (min. 1 hour) 62.50
Phone: 6 z A(- 36 3 / Fax: 624 an &- Investigation fee:
CCB Lic. #: . `T 5 cj Lic. #: 34 - 26-3 C Other
- wilirait vt'qz :.iElec "trlcarPvrml' ;F'ea*m:. •i' tVry.EFRA
Supervising electrician Subtotal
signature required: A Plan Review (25% of Permit Fee)
PrintName: OA .v 1- f.e__ L c. #: /16 - S State Surchar :e 8% of Permit Fee
TOTAL PERMIT FEE $ 1 2 7, `I L_
Authorized Notice: This permit application expires if a permit is not obtained within
Signature: • Date: 180 days after It has been accepted as complete.
"Fee methodology set.by Trl- County Building Industry Service Board.
' (Please print name) .
i :\Dsts\Permit Forms\ElcPermitApp.doc 01/03
•
Electrical Permit Application - City ,af Tigard
Page 2 - Supplemental Information
LIMMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all systems $75.00
Check Type of Work Involved:
Ej Audio and Stereo Systems
n Burglar Alarm
Garage Door Opener
El Heating, Ventilation and Air Conditioning System
Vacuum Systems
0 Other
COMMERCIAL WORK ONLY:
Fee for each system $75.00
(SEE OAR 918 - 260 -260)
Check Type of Work Involved:
0 Audio and Stereo Systems
0 Boiler Controls
n Clock Systems
0 Data Telecommunication Installation
Fire Alarm Installation
IiVAC
0 Instrumentation
❑ Intercom and Paging Systems
Landscape Irrigation Control
0 Medical
Nurse Calls •
ID Outdoor Landscape Lighting
Protective Signaling
0 Other
Number of Systems
* No licenses are required. Licenses are required for all
other installations •
i:\Dsts\Permit Forms\ElcPermitAppPg2.doc 01/03
CITY OF TIGARD 24 -Hour
•
BUILDING Inspection Line: (5031639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
•
Received Date Requeste ^ 2 AM PM BUP
Location /0 2 2-() Suite f -5 MEC
Contact Person P' ) PLM
Contractor WAThiLilvt .2 . e Ph ( 503) (o2 36 � SWR
BUILDING Tenant/Owner .�r v�.ca,- J — VD 3 -6 Sig /
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing pp�� k`` 1 / �( �q 1 �
Firewall I— K� ` , � ► L' l�' S Jt D UAo4l`C
Fire Sprinkler
Fire Alarm �\ 0 �('\
Susp'd Ceiling �J
Roof
Other:
Final
PASS PART FAIL
PLUMBING
•
Post & Beam
Under Slab
Rough -In
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
�EL�CTRIEAL
Service
Rough -In
UG /Slab
Low Voltage
Fi rm
Final Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd.
7 ART FAIL
El Please call for einspectio' RE: Unable to inspect — no access
Fire Supply Line
ADA fr Approach /Sidewalk Date Insloe Ext
Other:
Final DO NOT REMOVE this inspection record from t e job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639r4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP •
Received Date Requested ` - 3 AM PM BUP
Location / 0 ha (/ Suite 1 MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) epoZ T' r SWR
BUILDING Tenant/Owner ELC 3 - 6 Y?/
f
Footing
ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
itjy--""
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab �—
Rough-In
Water Service
Sanitary Sewer /4P-1
Rain Drains �
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke
Final
PASS PART FAIL —
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Fi Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE Please call for rein section RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspect° `` Ext
Other: -
Final DO NOT REMOVE this inspection record from th Job site.
PASS PART FAIL
CITY OF,TIpARD 24 -Hour .- . , , - - :.
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639-4171
BUP
Received Date Requested � /` —f AM PM _ BUP
2
Location /0 0 >64-e OVA w] 4d • Suite 5-2) 1 MEC
Contact Person Ph ( ) _ PLM
Contractor VW-tam/Wire e_1200-- . Ph ( r!o2.-4. 3 63/ SWR c!
BUILDING Tenant/Owner ._.0
.O -pr .. e D ELC .3 —O t q/
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: ( ice SIT
Post& Beam 0.--044 a -- 7
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation h► r� 1 C 8 LS d: Ao lZ 1 IQ 0
Drywall Nailing ] '�V
Fire wall 1-- ' v n N T \( oe
Fire Sprinkler u of 6
Fire Alarm r C 1 I N i LEI_
Susp'd Ceiling \1 � }
`d
Roof l� /` .
Other: L
Final D S �- maf(L iSle i AID-- t, (SN� l� \ j VOC: (�
PASS PART FAIL p }
PLUMBING E o •
Post & Beam
Under Slab n / ' n5-
Rough -In S s3'M'+i ., LQ ` B L-E A A
Water Service
Sanitary Sewer Qt Lo W L,..e\ L i \ V EL .
Rain Drains /�
Catch Basin / Manhole v
Storm Drain
Shower Pan * k� V --. W\ C, k c c A B L
Other: rN
Final 1■-`y I N 6 N C [ti� 1 �� 6 Vk-�
PASS PART FAIL !
MECHANICAL
Post-& Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL _
Service
Rough-In .
UG /Slab 6
Low Voltage i D
Fire Alarm Z V 4'
Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART tett
SITE El Please call for reinspection RE: El Unable to inspect— no access
Fire Supply Line I // �` n
ADA Approach /Sidewalk Date c6 l b 03 In spector �� I ) W \i Ext
Other:
Final 0 NOT REMOVE this inspection recoM from the job site.
PASS PART FAIL