Permit A, {� ELECTRICAL PERMIT -
CITY TIGARD RESTRICTED ENERGY
_ .IUI DEVELOPMENT SERVICES PERMIT #: ELR2003 -00383
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/18/03
SITE ADDRESS: 10260 SW GREENBURG RD *' PARCEL: 1S135AB -03400
SUBDIVISION: LINCOLN TOWER -TOWN OF METZGER ZONING: C -P
BLOCK: LOT: 014 JURISDICTION: TIG
Project Description: Pedestrian Link, limited energy for access control system. Job No. S3773
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: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: ACCESS CON X
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
EOP LINCOLN, LLC SELECTRON INC
10260 SW GREENBURG RD 7225 SW BONITA RD
SUITE # 100 TIGARD, OR 97224
PORTLAND, OR 97223
Phone: 892 -2500 Phone: 639 -9988
Reg #: MET 00002446
LIC 64341
ELE 26- 497CLE
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 12/18/03 $75.00 Elect'I Final
[TAX] 8% State Surchart 12/18/03 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not
started w' 1$Q days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you t ollow rules dppted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 throuc
Iss ed by 1 41 4 Permittee Signature / �Ir r
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
Electrical Permit 1 ± lication . _A r , ' .
�, Date received: /g—MoJ Permit no. gL , -� 003g3 g% 1 City of i is $ :i � ® Pro e cda no.: . - • • date:
.�,� F•1,1 3' pp
1 no
City ofTigard Address: 13125 S'en'1-1 ' vd, TigtiralWei 97223 Date issued: 4 By 1% Receipt no.:
Phone: (503) 639 171 ` 1.,
Fax: (503) 598 -1960 OG� .�
,(�Q►► QN Case file no.: Payment type:
Land use approval: I(4 O , 6u,1P 3 - 00 029
`' VVgl et4t;IMZ':Vle=:tik;itoggt ai il_ : t ; :: ;.; °s; .,F , ¢i' . a;
❑ 1 & 2 family dwelling or accessory E Commercial /industrial ❑ Multi- family ❑ Tenant improvement
❑ New construction Addition/alteration /replacement ❑ Other: ❑ Partial .
Ii b r - f u .� - li r - + e i ,. , ,s 'ice " ' & . f a t -r 4- s r "�' ei. �- "" K
r 4 „ , , JOB S I T E I .. a> ,,n
4 x?°5 . � 1';! sr`3_-� " � ,z1 ^ ;�r �� r,..r� -.� �._�, _ - '' ,.,� ., �kik4f...�, � .Y^i x � i, , �.SC rte.
Job address: IbZUU 5N/J A1,,-r t) ,n'1t Y G R ' a.. Bldg. no.: Suite no.: Tax map /tax lot/account no.: -'
Lot: Block: Subdivision: J .
Project name: L, 5 .. a L. .. __ and location of work on premises: )bvJ V6) aCtP—SS Cm'
Estimated date of completion/inspection:
` _ - ' CONTRACTOR- APPLICATION ; �. ite . g; s n - 3 w { t FEEfSCHEDIII,E m t s ; 4:
Job no: C; .,, 531-77) Fee .Max
Business name: s A.,-, \ , Description Qty. (ea.) Total no. insp
1 `` New residential - single or multi- family per
- 1
Address: 1.25 ( t'\ r3 dwelling unit. Includes attached garage.
City: State: UQ ZIP: 0214 - Service included:
1000 sq. ft. or less 4
PllOrie:�_ Fax: E Q. Each additional 500 sq. ft. or portion thereof
CCB no.: L s.\'\ \ 1 Elec. bus. lic. no: "Z,L - 14 q`1C,06 Limited energy, residential 2
City /metro lic. no.: bhut21'-}1-41,5 _ Limited energy, non residential 2
. Ali -,...w..... `, i2 l 63 . Each manufactured home or modular dwelling
'ignature : upervis ng e'•ctrician (required) Date Service and/or feeder 2
r - Services or feeders - installation, •
Sup elect name (print) r [• License no
alteration or relocation:
`ga } x 5, . 1 4 ` PROPERTY OWNER '' a 4 ,A- .' y 200 amps or less 2
Name (print): 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: State: ZIP: Over 1000 amps or volts 2
Phone: Fax: I E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, or relocation:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps 2
Owner's signature: - Date: 401 to 600 amps 2
MAI �'Lr Q `` a Z R 4 ENGINEER T ,, ; i g s Pit 1 1;, Branch circuits- new alteration,
or extension per panel:
Name. A. Fee for branch circuits with purchase of
Address: ° service or feeder fee, each branch circuit 2
•
City: State: ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: . E - mail:
Each additional branch circuit:
III „, , �� OLAN RE ' I cheek all tt at' a ,, ,, ` , Misc. (Service or feeder not included):
O Service over 225 amps - commercial ❑ Health -care facility Each pump or irrigation circle 2
❑ Service over 320 amps - rating of 1 &2 ❑ Hazardous location Each signor outline lighting 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, ` -15.°I)
❑ System over 600 volts nominal more residential units in one structure alteration, or extension*
❑ Building over three stories ❑ Feeders, 400 amps or more *Description:
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egress/lighting plan ❑ Other: Per inspection I I I I
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Permit fee $ -- 7S .CC.
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application
❑ visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ la, (?(.
Expires accepted as complete. TOTAL $ , Uh
Name of cardholder as shown on credit card
. $
Cardholder signature Amount 440 -4615 (6 /00 /COM)
\ .
i
CITY OF TIGARD 24 -Hour
BUILDING Inspection, Lino; (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
�/ •// BUP
Received �'/ / g•-to" o Date Requested - 7AM PM BUP
Location (a D — - Suite MEC
Contact Person PLM
Contractor d Ph ( 7- SWR
BUILDING Tenant /Owner >1 ��,-Q 6?. (nAfkiu ELC
Footing
Foundation ELC
Ftg Drain Access: ELR Q PS
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam ex-LA dUU1.-4---"'
Shear Anchors Y\i 0 b (Li igQ' U
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation (,12y�� 1� ?)C , _ r` P4 R-- 6 61). (0
Drywall Nailing U h�
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling C
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
ELECTRICAL
Service
Rough -In
UG /Slab
g ow Volta
Fire Alarm
• 'ti� PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE 0 Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
D at e Inspect �� _ % Ext
Approach/Sidewalk P
Other:
Final DO NOT REMOVE this inspection record fro the Job si e.
PASS PART FAIL