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Permit C ITY O F TIGARD CARD ELECTRICAL PERMIT � PERMIT #: ELC2004 -00660 t � fi DEVELOPMENT SERVICES DATE ISSUED: 10/14/2004 ■ n! 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171 PARCEL: 1S135AB -01004 SITE ADDRESS: 10220 SW GREENBURG RD 500 SUBDIVISION: TWO LINCOLN - TOWN OF METZGER ZONING: C -P BLOCK: LOT : JURISDICTION: TIG Project Description: T.I. (8) 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: 7 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: EQUITY OFFICE PROPERTIES TRUST WILLAMETTE ELECTRIC INC ONE SW COLUMBIA #300 PO BOX 230547 PORTLAND, OR 97258 TIGARD, OR 97281 Phone: Phone: 503 - 624 -3631 Reg #: LIC 75059 SUP 1965S FEES ELE 34 -283C Description Date Amount Required Inspections [ELPRMT] ELC Permit 10/14/200 $93.40 [TAX] 8% State Surcharge 10/I4/200k $7.47 Rough -in Elect'I Final Total $100.87 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or 1 -800- 332 -2344. Issued By: ) �j Permit Signature: -e_ Q, 4 OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day OCT 14 2004 11:12AM HP LRSERJET 3200 P.2 • E ectrica1.Eermit Applicca Ell VE FOR OFFICE USE ONLY City of Ti �}�+ � / %/ - a V -4 (./ CA L 13125 SW Hall Blvd., Tigard, OR 97223 Ul 1 I Plan Review Phone: 503.639.4171 Fax: 503.598.1960 200'' '''' 'H , r ti'l 1 1 , D : Other Permit. Inspection Line: 503.639.4175 C ITY O Ti'-' - a�- ��1,. Date Ready/By: !a See Page 2 for Internet: www.ci.tigard.or.us At Notified.' fethod: Supplemental Information BUILD N , " - 1 , ENI • ""T: '', IP I 11 ,,' Wrx (. 4 ail„ •� ...11.1114 i i j r t- " ,nt,.r'�0*.1 xt... 8C "148108 ! 'f.M .. i ' l' n. Ilk i v '. l =n R ? : . ri�,.e I 1 " i .x1 I "' F , k �r <1, 6,1, •. , - " r, r i 7 ! tc Z o i z . ��$•'.�•� �:..: rtr , / ;.. ■ i.. rC i i k,`sul�w.u13�d1�tY�- .u�`8'�!�. ❑ New construction T/ Addition/alteration/replacement Please check all that apply: ❑ Demolition ❑ Other ['Service over 225 amps, conun'l ['Hazardous location ' it �� 5 y', ` t� i I r �i , " a " °``"''' {{ r ` � Orin t 9 "'" n i c ❑Service over 320 amps -- rating ❑Huildng over 10,000 sq. ft., i talli 1 a Il ! F LI,`1 " 37 { {.i"' ` M CRI 7 �Tr ; 4:1 '. . f � i..il(�+i i IIH: �, .r,t.,�_ =.!�_r,,,�i�..a.�sn�+rs ?, _,�,,,1}, g 1� ,����,{��. ,.. "~��;�;;;•,_,..}� of 1- and 2- family dwellings 4 or more new residential ❑ 1 - and 2- family dwelling 5ir Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure ❑ Multi - family ❑ Master builder ❑ Other: ['Building over three stores ❑Feeders, 400 amps or more � y lti Ui , ,i , a 1e ❑Occ ant load over 99 persons DManufactured structures or { , di 'Sr f8. � &i l ItYG ttiYlillC�� l� +hFluumth�4iwwr uP P r�fi� �t��1����+ 1 F ' ss � �a� :�i���'�if�rrt�u.unreA;, { jt€ l(il�',���It,�IT CIE gress/lig RV park Job no.: ; t,( Job site address: l 0 Z.Z0 , C' 61 Rd ❑Healthcare facility ❑Otove • 5uhmt' 2 sets of plans with any of the above. City /State/ZIP: T- i#I0 0 9)- t Z The above are not applicable to temporary construction service. !y4;i ~i� , Suite/bldg. /apt. no.: �'Q fJ Project name: C ip t i aF:uA eu t 8 -.lf ,il �9titt ^,%?;, " ' •* ` A) L � � � Desrirptlan Qty. Foe. Total .. Cross street/directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. 2- L. t ", C 'e.) S 1,000 sq. ft. or less 145.15 4 Subdivision: I Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map/parcel no Limited energy, residential 75.00 2 (f 7� Limited energy, non-residential 75.00 2 ��g d �t`Cillw� ((' ��� r 3 . 'r � iKt{ i fX �pm6 Ify� la�, (t� #�t "��,s'z l u '�, "�� •� � � ¢iii,totra+.., 4s..i'u ' CaKl , 315, .1.k�ar -u j `i INA, ' .f�1ti: , S4. la : Inelatt4:4. 'F rit h.... �l Tr,r+, I t6, 1' G Is Each manufactured or modular dwelling, service and /or feeder 90.90 2 T'r JP% o‘...n.. ,T 1 Mk (_40- Services or feeders installation, alteration, and/or relocation � J 200 amps or less 80.30 2 f II, " t , ite.gic1c` n i Atdi.1 16,? 1ti� Y. '� I 1 t.. (Nig.l 6 Wi111 ht l rferrii� l'utdigi, ui t N , ' ,;i 1 d 401 amps to 600 a mps 160.60 2 Name: e O 0 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 t.,,....... L.) s ��"� Reconnect only 66.85 2 City/State/ZIP: d Vs Temporary services or feeders installation, alteration, and/or Phone: (103) 24 . t{t-a& I Fax; ( ) relocation 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 , Y �^a�' t tint ri sk r , j i g' � �7 ' RM lid' i' `ai if irigiV �0i �' ; , r�i�y llm i r' i f `h lry a " A. Fee for branch circuits tj" with : �� � .x�sr2t� it.a;l. ns�l ,t_. �.,.r,.�,..,rill.,i .,...i.n ,,, -1,.x. 0.-... rear. :,:.thclnir t�l�..uiik,.., , service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits r Contact name: without service or feeder fee, r 46 4/, S' 2 Address: each branch circuit I .�' Each add'l branch circuit .7. 6.65 &t ` - ' 2 City /State/ZIP: Miscellaneous (service or feeder not included) Phone: ( ) I Fax:: ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 Email Signal circuit(s) or limited- "flr yl' aryl !l4 ` >Nl ' , u� � ° lt`iud A 'i`r4 r ' 1'n " 'w x ;?i g ' 1 a: �; energy panel, alteration, or � -, � 1 fit_. u zl� �.c�: ..,r�>Itt, �f i �?�r.b '' extension. Describe: Page 2 2 Business name: L 1I li . l (i 'Lte �, - nu. e Address: sQL Each additional Inspection over allowable in any of the above d ' f� G 2zG Per inspection 62.50 City/State/ZIP: Z 6 Q" 9'7- 2' / Investigation per hour (1 hr min) 62.50 •Phone: (s;rs ) b ZN 3b ( g( Fax: '3) ir pi Z4 3 r Industrial plant per hour 73.75 "��+itn•l �� ;<�ii�s��h . M �'� „1��.�ru,� �:... rr � rt �ti °"`�, i t i t lhi ,,.k .,tl ° +I., = °r,:..• :r .... CCB Lic.: 7 Uy � Electrical Lie.: 31 % Le Suprv. Lie.: � 4' r - S Subtota: 9f 3, v Suprv. Electrician signature, required: / Plan review (25% of permit fee) j - State surcharge (8% of permit fee) .9 -( -}- Print name: D i4 Ad f , c'. Date: 10' -G 4.-1 TOTAL PERMIT FEE 4' 1 5© &?. Authorized signature: This permit application eapiree if a permit is not obtained within 180 days after it has been accepted as complete Print name: Date: • Pee methodology set by Tri- County Building Industry Service Board **Number of inspections per permit allowed. i' BuildingkPermits \ELC•PermitApp.doc 12 440- 4615T(10/02/COM/WBB CITY OF TIGARD 24 -Hour BUILDING Inspection ne: (503) 639 -4175 • INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested / AM PM BUP Location / --c) Suite �� vC MEC Contact Person Ph '7 ) ! -04a PLM Contractor Ph ( ) a ' �__ 3_ _ SWR BUILDING Tenant/Owner ELC 66 Footing ELC c Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Sr Anchors Ext ee'1 Ext Sheaea th/h /Shear 1 °� / 3 / 6e)6`-�=--k Int Sheath/Shear Framing Insulation J /� 1� (} 1: Drywall Nailing J r J Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling (/ • Roof Other: Final PASS PART FAIL PLUMBING )497 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 ELECTRICAL Service .ug lab Low Voltage N R_ G - — C e- 2 8 - ' ]/p � , \ )n5 - 7 1 A/ L. Fire Alarm ` ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. t PART FAIL SI ❑ Please call for reinspection RE: ❑ Unable to inspect - no access Fire Supply Line ADA i Approach/Sidewalk Date 6 Inspector C� Ext Other: Final DO NOT REMOVE this inspection record rom the J o, site. \PASS PART FAIL