Permit r CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
"� ' '. COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00314
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/5/2008
PARCEL: 1 S135AB -03400
SITE ADDRESS: 10260 SW GREENBURG RD 350 ZONING: C -
SUBDIVISION: LINCOLN CENTER /LINCOLN TOWER LOT: 014 JURISDICTION: TIG
PROJECT: PRO MED
Project Description: Low voltage for voice and data system.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA /TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: • HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: :
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
SHORENSTEIN REALTY SERVICES MCCOY ELECTRIC CO INC
ONE SW COLUMBIA ST #300 2014 SE 9TH AVE
PORTLAND, OR 97258 PORTLAND, OR 97214
Phone: 503- 412 -4800 Contact #: PRI 503 -234 -7521
FAX 503 -234 -9473
Reg #: ELE 26 -82C
FEES LIC 8277
Description Date Amount SUP 2175S
[ELPRMT] ELR Permit 11/5/2008 $75.00
[TAX] 12% State Surch 11/5/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
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 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.
left Issued By: Permittee Signature: e_� � G� ,
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.
Nov,..:5. ; .2008 4:03PM MC COV ELECTRIC - ^ No. 7605 P. 1
E lectric a l Permit A pplication .. FOR OFFICE USE ON. ... . •
City of Tigard QQ De ed � 'enttitNo.: . Y . g— j-, /4
.. w 13125 SW Hall Blvd., Tigard, OR 972 e �O Q O Plan Rev iew e J
{. U1he Permit: • • il
Phone 50:.639.4171 Fax: 503.598.1960 .,(,\I V o ' J DntNBv:
TI(3ARU inspection Li 503.639.4175 \ P D Ready/By: Sui >. El See ry 22 tor
Internet: waaM'.tigard- or.goy '�'� . s, edRvtethnd• p ' ^ Supplemental l Inform
yr ,... ; ' „
^it ' .TY:Pk Ok 1 O bt •' t ^ ` .7, t. �•,••.. FL[1 V IEW ,
1 � ,
, construction ❑ Service or feeder 400amps more SOU, of plans: Building over checked
stones.
El New con �� Addltlonlaltcratio , acement
� - apply is 1`
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and hoaiya,ds.
, it q t 1l a ;: " 13 °° 1 , ry f +(,1: ! eecccds 10,0(1(1 amps at 150 volts or ❑ Floating buildings.
.
. I4r;. +h 1 Cb , ;:l.. � #-;L f'I011f .!":','I''''':''''" 1 'i ^ . less to ground, or exceeds 1 4,000 ❑ Commercial•use agricultural 1 - and 2 - family dwelling.Cornmercial /industrial ❑ Accessory building amps for all other installations. building:
❑ Multi family ❑ Master y builder ❑ Other: ❑ Fire pump ❑ installation 7 derived system.
u i Oa 1r i sa i /' 101VM l T Il1 L(- ' N . ) `.4 TfOl±l, 1, t ! ! ,, 6i :, . of a motor load of I.2 ", "1-3", cd
or
p . mergcn s st
.,... , .. .:. .� � .., l ❑Addition ❑ .. ^ ,.., E ....
,lob no.: likil L. job site address: ll + 100HP or more occupancy.
I ( , - _ , a • . L 04 ❑ Six or more residential units, ❑ Recreational vehicle parks.
0 Health-care facilities. ❑ Supply voltage for more than
City /State /ZIP: 600 volts nominal.
r • ` ❑ Hazardous,locations.
" 0 Service or feeder 600 amps or morn
Suite/bldg. /apt, no Project name: 1� , u I —1 ► .
Cross street/directions to - job site: `� Dtseriptioo Qty. Fen Total '
• New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 I 4
Ea, add'I 500 sq. ft. or portion 33.40 I
Tax map /parcel no.: „� ���EE�))� Limited energy, residential
t : ., J ' w . , , a i∎ e . AEI: *1 t A .,. l1 e-1 i t , 1 11'7' ®trio, 1' ` Nlfbl a ° (with above sq. ft.) 75.00 2
L energy, multi - family 75.00 2
1 Il Li residential (nth above sq, ft.)
Services ders installation, alteration, and/or relocation
, mot
— 7F amp or fee less 80,30 2
>' " i IEE'. 0'-8� V . tl+ b4 it > r l " .� , 1 1 I 7 201 amps to 400 amps
ll
I :j! �d `E I ENENI . ;, wi 106.R5 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation _
Phone: ( ) I Fax: ( ) 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 f 00.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133,75 2
Branch circuits - new alt eration, Or cxt[ngion, per pa
Owner signature: Date: A. Fcc for branch circuits with
a , t n , , yvs
l ,� ' '�`' t 1 + « , ' �711 Pawl 6 , N shove service or feeder fee, 2
,.^. . iar �. b. {'.a, '.'� , tbv.7. I''f each branch circuit
6.65
Business name: McCoy Electric B, Fee for branch circuits
r�, n �, r A. KPl1 without service or feeder Ice, 46.85 2
first bland, uut,ult
Address: Sank Each add'l branch circuit 6.65 2
-- Miscellaneous (service or feeder not included)
City /State/ZIP: same Each Manufactured or modular
90.90 2
- dwelling, service and/or feeder
Phone: (503) 234 -7521 Fax: : (503) 234-9473 Reconnect only 66.85 2
E -mail: i:slopergmccoyeleetrie.com Pump or irrigation circle 53.40 2
ti o1 yr. .,,, „n, t r� 1 , t v a ( , • or out li tin 53.40 2
{
c ,.w..,,. ",3"<... il�, ;n '"�u,'9�,r �,IiSYI�� '�`�i��l,�d •..b ,. . ,I. :,�.cVl.l -� t�i 1 •, S 1� � n 8
Electric Signal panel, or limited-
Business name: McCoy energy panel, alteration, or
Address: 2014 SE 9 Ave ex-tension. Describe: 1 Page 2 2
City /Stale /ZIP: Portland, Or 97214 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 234 -7521 Fax: (503) 234 -9473 Investigation per hour (1 hr min) 62.50
CCB Lie.: 8277 Electrical Lie.: 26 -82C Suprv, Lic,: 217SS Industrial plant per hour 73.75
1wf a iiF.fTRiCl�is., .. 1- ... t•.•,.1:
. ". .:
at =',,,,x ;! „ '.� ; .......:. ”` �3: RM1T ;:FETSDS ;: .:.:.: : ti.,:
Suprv. Electrician signature, required' / / Subtotal: NM= r;.a4 _r._-
lir Print name: James R. Hall Date: Plan review (25 %of permit fcc):
Slate surcharge (12% of permit fee): M_
Authorized signature: TOTAL PERMIT FEE: '.,. -.-
This permit application expires if a permit is not obtained within 180
Print name: Date: days diterit has been accepted as complete.
'
Number f inspections al lowed pat permit.
I:\Buiidiny \Permits \ELC- NUmikApp.doc 05/23 /06 440 -46111(11Po5 /COMI'/LB
CITY OF TIGARD . •
BUILDING DIVISION PERMIT #: FLR.1008-00314
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/5/2008
Phone: (503) 639-4171 k bailtviit
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: i 2/2008 TIME: 7 PAGE: 52
SITE ADDRESS: 10260 SW GREENBURG RD 350 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/LINCOLN TOWER LOT #: 014 TYPE OF USE:
PROJECT NAME: PRO IVIED
DESCRIPTION: Low voltage for voice and data system.
OWNER: SHORENSTEIN REALTY SERVICES, PHONE #: 603.412-4800
CONTRACTOR: IVICCOY ELECTRIC CO INC PHONE #: 503-2347521
Inspection Request Scheduled For: Date: 11/12/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 077 503705-1306
Corrections/Comments/Instructions:
)\A/\
RA PARTIAL APPROVAL CANCEL r NO ACCESS
El FAIL El CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector: G N6sresLf" Date: 11 1 Phone #: (503) 718-
— .