Permit CITY OF TIGARD ELECTRICAL ENERGY
RESTRICTED ENERGGY
�4111 DEVELOPMENT H Hall r S � ERV SERVICES 5 -00020
— 13125 (503) 639 -4171 DATE ISSUED: 2/1/2005
SITE ADDRESS: 10220 SW GREENBURG RD 615 PARCEL: 1S135AB -01002
SUBDIVISION: THREE LINCOLN -TOWN OF METZGER ZONING: R -12
BLOCK: LOT: 009 JURISDICTION: TIG
Project Description: Relocate 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: X PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
EQUITY OFFICE PROPERTIES TRUST PORTLAND MECHANICAL CONTRACTORS
ONE SW COLUMBIA #300 2000 SE HANA HARVESTER DR
PORTLAND, OR 97258 MILWAUKIE, OR 97222
Phone: Phone: 503 656 - 7400
Reg #: LIC 151807
ELE 3- 483CLE
FEES Required Inspections
Description Date Amount Low voltage
[ELPRMT] ELR Permit 2/1/2005 $75.00 Electrical final
[TAX] 8% State Surchart 2/1/2005 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted by the Oregon Utility Notification Center. Those rules are se forth in OAR 952 - 001 -0010
throug •AR 95 -901 -0100. You may obtain copies of these rules or direct questions o OUNC at (503) -6699.
Issue. •y ,�l, �L Permittee Signature y
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
f
■
Electri,ca t ermit Application FOR;OFFICE USE ONLY
4'
City of 7lgard Received
Date/By: �
13125 SW Hall Blvd., Tigard,
Permit No.: E.4.401•40,6"
ard, OR 97223 y
g Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 - Od '41,� (tit Date/B : Other Permit:
Inspection Line: 503.639.4175 Ca . - e! 1 Date Ready/By: 1111M j � El See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: _ i Supplemental Information
'�",."- .�v_ - €,, �- ' ' - , -5° - E3's - ,�.ri�a.I!T?zXt:�.w`- a'�',=` -e r� ��,3`: :'a'�'..� :.�i b^', fit, �;;= '�t°�:':F: 7. { < _
' ^4v. �:?tw�sy�:? �,' ,..� -s a"�. .,.ti, � -; �,° �:� k.. .� `ski ° -e .r.. "tier :?;�,(""f4 . , L��
�:' ��. �::.�; � .� �.. �:.:;,� .,�, ,,�Qli��,,,'OR "�:'�`> .�,.:�,w � ....,, �:.:1,� ._ a, ...,w�.- :- r ._ „. �' :- =; ':`' .
� .m:. ��'«i) n - ��.��.�'.-�s�t ^�.�ar �t:�r car.. a�. �,. ���+ s��, x�x4c.CsT� '.3��'s+” >.aw..�rs�en...��e*$:. a,.. ....... w,> �,t��tG : r __ .._,., . ,
❑ New construction ❑ A ion/alteration/replacement Please check all that apply:
['Service over 225 amps, comm'l ['Hazardous location
❑ Demolition Other: Service over 320 amps - rating Buildn over 10,000 s
ir±`' ±�,;, ;t�;.� ��,fi� =�
r a,�•',' yx- .t: >;� rs�. �� x ;:�s.� - _y;- .,"�;«, ?:.�;�t�, ;�,, =s aa�'i „;s.� � �u�' ` �. ��� ❑ P $ ❑ g sq. ft.,
q
t�
�� ' - � �OF�ON =T ,.� �" �' "�t, ? �., of 1 and 2 family dwellings 4 or more new residential
1: ' . a,.� . €1 ?,.�;d'. s. a . ,.�.,;,.-.,,, . 4 : ,r2*z:2� .. . . ..
z. �.. c,. >» sal �14,iAa 1us€as,, 1
❑ 1- and 2- family dwelling I Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
Building over three stories ❑Feeders, 400 amps or more
❑ Multi - family • E Master builder E Other:
_ occupant load over 99 persons ['Manufactured structures or
111:-:,,c2014;;; '?:?�.:i;w•r,e' .zss »us';c¢ >. - r?,?i:- :.; -.° Pa t,va °z °' ". `t,'.xc;,".`'�' �.,W xxy?' RV
1:$,SaTNFQ T <)b 1NDTLOGri`I'I,ON WW WW- ❑ Egress/lighting Ian ark
P
� �� �.. .. wxe a a' ��/ .. a.. I„ P
Job no.: Job site address: �i� f � ❑Health -care facility ❑Other:
• �d�' � lI ��i Submit 2 sets of plans with any of the above.
City /State /ZIP: The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.:Z 1 Project name: AR,6r / ': ' ° '' FE�Ex §tOi , „ : ..
A.
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: 1 Lot no.: Ea. add'1500 sq. ft or portion 33.40 I
Limited energy, residential 75.00 2
Tax map /parcel no.: •
y rn 1 , r ;. n ..» : _, :, : =•v M:.'. ri. Limited energy, non- residential 75.00 2
ri , : V` � , . D ai Itj; TIO�N I n ` ORIf t 4 tt z
} � f YA ,,, Each manufactured or modular
• •a3'°'��E. a, �'a�. ,..��.. a. �* � "m ..s,..:.:. a :� „o:.
/� �� dwelling, service and /or feeder 90.90 2
� 0_44 r� / - S7��S Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
cox.. s, �4; . €.,.. �y,_ „ >' >;�: ,,,. u'Rx ;� ,r s, : 201 amps to 400 amps 106.85 2
� � K 'd2 I. ii , —m O W N ,, , F , : i 40. 1iS alii i t E A L' ; a i l a „
'
. ...,, zsm a �, �. ".�:. ';.. > .r .. b� M sans 401 amps to 600 amps 160.60 2
Name: 1d.11 77 C) t e.--€ fiddt /e 7E �2u5T 601 amps to 1,000 amps 240.60 2
Address: ev ) e Lu �,,/4, 4 , ,#. sec) Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State /ZIP: P T A Q / L 9 7 9 - 5 - 1 Temporary services or feeders installation, alteration, and/or
Phone: ( ) 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
Yr ' ~''. � .�,{ 4 �1�,, / t, ° tom" > r : , r. (',�} n , '” 1 A. Fee for branch circuits with
..: P.^ we.1: ' .'- ` ti` : F . ,:,, 4y 4 , 6`".,%.., Y, ' �X5'' ik' '�' ' ' s ^y T i,,.}.'''' ?F , C e • �ll�` S°Yr0• '' .
�3x,s_.� Rte„ .. � .,, ,.., . o va „, m service or feeder fee, each
Business name: branch circuit 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee,
each branch circuit 46.85 2
Address: Each add'l branch circuit 6.65 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
E -mail: Signal circuit(s) or limited-
P :, a , - '' :,;_�'F; ` aA1 > ,, .. :tt-, A 1 ” :.���;�:��� i `s a.';;,. s,,•-. a i .;. ;; f - .` ^:= ': energy panel, alteration, or
-- ,,I c ` GO C ®R 4, aw . E a , �'''
extensto D crib : Pag 2, j 2
Business name: ® � 4 , „ . � 4064G � �,t O S ,( P
Each dditional inspection over allowable in nay of the above
Address: 6720 p U 6,E /457/1),51 1//9ir''v0N 2)r .
Per inspection 62.50
City /State /ZIP: ' L4 i w.4/ c, 0 g 7 z.. 2- 2_ Investigation per hour (1 hr nun) 62.50
Phone: ( i ) 65Fz„ 74, (?l/ Fax: ( ) Industrial plant per hour 73.75
CCB Lic.: / 57e , 7 1 , 1 i L • r i g "�3 J ,, S ic.�?S73zA/.3 Subtotal
Suprv. Electrician signature, required: / / 1181364A Plan review (25% of permit fee)
Print name: J OQC.I S , '� � Date: a ,/_ s---- 4A
State surcharge (8% of permit fee)
er / 7 TOTAL PERMIT FEE
Authorized signature: , - / i . / This permit application expires if a permit is not obtained within 180
�� days after it has been accepted as complete
Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board
** Number of inspections per permit allowed.
i:\Building\Permiis\ELC -P itApp.doc 12/03 440- 461ST(t0 /02 /COM/WEB
Electrical Permit Application - City of Tigard ,. tf• 4
Page 2 - Supplemental Information `
LIMITED ENERGY PERMIT FEES:
IW�'.*xa..,,.�.ry cs��MIWA; �:urw �r +.iy" WOr '�++��'�p�
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ A udio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ H eating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ O ther:
. g , :.:E ¢ = WORK UNIX
•
Fee for each commercial system $75.00
(SEE OAR 918 - 260 -260)
Check 'Type of Work Involved:
❑ Audio and Stereo Systems
•
•
El Boiler Controls
❑ Clock Systems
El Data Telecommunication Installation
❑ F ire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ O utdoor Landscape Lighting*
❑ Protective Signaling
•
Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
i:\ Building \Permits \ELC- PermitApp.doc 04/03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005 -00020
i1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/1/2006
Phone: (503) 639 -4171 Dtom
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/5/2005 TIME: 7:09AM PAGE: 51
SITE ADDRESS: 10220 SW GREENBURG RD 615 CLASS OF WORK:
SUBDIVISION: THREE LINCOLN -TOWN OF METZGER LOT #: 009 TYPE OF USE:
PROJECT NAME: FIRST FRANKLIN
DESCRIPTION: Relocate t- stats.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: PORTLAND MECHANICAL CONTRACTORS PHONE #: 503. 656 -7400
Inspection Request Scheduled For: Date: 4/5/2005 Pour Time:
• Code # Inspection Description Confirm # Contact # Message
135 Low voltage 003709 -01 603 -606 -1931 N
Corrections /Comments/ Instructions:
,a
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
Li FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: /1' Date: r �✓ Phone #: (503) 718 -