Permit s .
1 . 4 ilb
CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
PERMIT #: ELR2005 -00315
-Ai
DEVELOPMENT H BMENg Tigard, -639 -4171 DATE ISSUED: 9/30/2005
PARCEL: 1S135AB-01002
SITE ADDRESS: 10220 SW GREENBURG RD 551 ZONING: R -12
SUBDIVISION: LINCOLN CENTER /THREE LINCOLN LOT: 009 JURISDICTION: TIG
Project Description: Limited energy for HVAC. Job No. 505426
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: 503- 293 -2745 Phone: 239 -4600
Reg #: LIC 33135
ELE 26- 993CRE
FEES SUP 2640LEP
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 9/30/2005 $75.00
[TAX] 8% State Surchart 9/30/2005 • $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 R 95 - 01 1 0. ou may obtain copies of these rules or direct ques ns t O NC a1503 -2 6 -6699.
Issued y: / Permittee Signature: l nod I lan e5 er
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.
. .
• -
ntectAical Permit Application
- • • ' FOR OFFICE USE ONLY •
City of Tigard
...1110.;4,,wIlieisk Date/B :
Received 0
r 1
Phone: 503.639.4171 Fax: 503.59 111W111 Permit No.:E449446 5/
Date/By: r 6 I
13125 SW Hall Blvd., Tigard, OR 9 _,.
CEV\1 P Ian Re view
11T..V.,' Other Permii.
Inspection Line: 503.639.4175 • '. - ,,...14, 1,4 II Date Ready/By: • WIA 63 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
Mt* .5Aktif%;"4';2',W.~:WX.OUAti,Vi,'-'24kWilj'At , , k4/.51/ , 0:: ; -',V,Vit : ,` 0.1. if:Wrig:ZilaTitit4FifteSAAVAW.t4i$0,NrA-34, :','-^
Rallerafe •:%:=a;a0, .:3147.• Ugu,:.1.1WOLAMW..) ki.... , ,.",-',' z
0 New construction X Addition/alterei0 v Agfa) Please check all that apply:
0 Detnolition 0 Ulf pITY Or ' XI []Service P
Service over 225 am s, comm'l 0Hazardous location
It •1 " 11 Service over 320 amps - rating 0Buildng over 10,000 sq. ft.,
s
' t=' fetie - : :4:::1
, :;a24 - & of 1 and 2 dwellings 4 or more new residential
0 1 - and 2 dwelling Commercial/industrial 0 Accessory building ESystem over 600 volts nominal units in one structure
0Building over three stories [Weeders, 400 amps or more
D Multi LI Master builder D Other:
00ccupant load over 99 persons 0Manufactured structures or
r ,,,,, , /-1,... ,, , plan 4 ,- . D , , -= ' - 0 4 . ' ^'' r - 4A`
3., ., ..,A Lj egress/ lignting l RV park
Job no.: 5 6 q.N, 1 Job site address: / Se.ti 0Health facility 00ther:
'ziree-or)4644-rei i Submit 2 sets of plans with any of the above.
City/State/ZIP: - 774a r - Doe The above are not applicable to temporary construction service.
or 7-- taTalWORWWWITiarke.5.N.ff2::
r Suit Adg./apt. no.: Project name:pp
L
7 Description Qty. I Fee. Total I **
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 I
Limited energy, residential 75.00 2
Tax map/parcel no.:
• Limited energy, non-residential 75.00 2
3mizr,m-zwm.„,.._ 0 _.,,,,,,,,, ; - ..- Ti ..t7.2 -.....*C .'":1-VA-M74774irdrait-WIM.
Each manufactured or modular
dwelling, service and/or feeder 90.90 2
/1 ---
'7 veir 0 S AL- Services or feeders installation, alteration, and/or relocatio
200 amps or less 80.30 2
'' ''''' - ' 45111 ' ;'E llal'a -tg4 a 4 - 411 - 1. 4 - ao 1 amps to 600 amps 160:60 2
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: ( ) I Fax: ( ) 200 amps or less 66.85 - I
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
az.li.1_ Li7:41.gbali,- •.--rw, oi : ..- , ..'.: ,., ,;_1,. gti ....: ..F .Te .., i m 7, : -. ' ..ne :,-,40'W4-- service or feeder fee, each •
6.65 2
Business name: /9,- ',- ,,, ,, r fer'l ...IC, branch circuit -
B. Fee for branch circuits
Contact name: c/ - • rie)e 7 without service or feeder fee, '
46.85 2
each branch circuit
Address: /39 s& •-• / 4 , _, , s4_
Each add'I branch circuit , 6.65 2
City/State/ZIP: . as 2 0 7 22 0 .2 - Miscellaneous (service or feeder not included)
19 j
Phone: (303) AR, .., „a I Fax: : (223) 221, 7d32 Pump or irrigation circle
Sign or outline lighting 53.40
53.40 2
E-mail: Signal circuit(s) or '9 limited-
IRSNOPIOWISSIVMEWVIONMWANOCAVIIIAINWIIMMRCZI energy panel, alteration, or
extension. Describe: 4V alt Page 2 2
Business name: ' O m er i 94 Z C 4 ''
Address: 0 4 . 3j ,...5 Each additional inspection over allowable in any of the above
Per inspection 62.50 .
City/State/ZIP: 70°00.94-4,014/ 2 2 2-e 2- Investigation per hour (1 hr min) 62.50
Phone:SO ,..9 37... 4 4 0
239 7.-sd Industrial plant per hour 73.75
24 -66-.2 e4.4 - e 1
MittirMataktealtaantatitAW
CCB Lic..,23)3„3 Electrical Lti 493 , Suprv. Lic.:2 y a _ j " Subtotal .75 00
6.
Suprv. Electrician signature, required:,--....., / ." Plan review (25% of permit fee)
State surcharge (8% of permit fee) 67 ,. OC
Print name: & \ Date: 9/3 / _ s°
TOTAL PERMIT FEE g1 .0e)
Authorized signature: This permit application expires if a permit is not obtained within 180
-
days after it has been accepted-as complete
Print name: 74
e i li a ,„,,,,, e-, Date: 9 30 4 ..1. . Fee methodology set by Tri-County Building IndustryService Board
" Number of inspections per permit alMwed.
i:\Building\Pcrmits\ELC-PermitApp.doc 12/03 440-4615T(10/02/COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005=00315 "A
I l 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/30/2005
Phone: (503) 639- 4171Np,���iii+h
Inspection Requests (24 Hrs.): (503) 639 -4175 .�' __
INSPECTION WORKSHEET FOR DATE: 10/7/2005 TIME: 7:05AM PAGE: 64
SITE ADDRESS: 10220 SW GREENBURG RD 551 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/THREE LINCOLN LOT #: 009 TYPE OF USE:
PROJECT NAME: APEX SYSTEMS
DESCRIPTION: Limited energy for i Job No. 505426
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #: 503 -293 -2745
CONTRACTOR: AMERICAN HEATING PHONE #: 239 -4600
1 Inspection Request Scheduled For: Date: 10/7/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135\=+ Low voltage 017724 -01 503 - 572 -9557 N
Corrections /Comments /Instructions:
P .
•
M PASS n PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector, l Date: /3--/' c Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION
PERMIT #: ELR2006-00316
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/30/2005
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 11/4/2006 TIME: 7: 08A1v1 PAGE: 36
SITE ADDRESS: 10220 SW GREENBURG RD 561 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/THREE LINCOLN LOT #: 009 TYPE OF USE:
PROJECT NAME: APEX SYSTEMS
DESCRIPTION: Limited energy for HVAC. Job No. 505426
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #: 503-293-2745
CONTRACTOR: AMERICAN HEATING PHONE #: 239-4600
Inspection Request Scheduled For: Date: 11/4/2005 Pour Time:
Code # Inspection Description Confirm # . Contact # Message
199 Electrical final 020384-01 603-572-9557
Corrections/Comments/Instructions:
•
I I PARTIAL APPROVAL El CANCEL EI NO ACCESS
I I FAIL CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector:
kl-e—,AA Date: I Phone #: (503) 718-
•