Permit . OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00380
•
DEVELOPMENT SERVICES DATE ISSUED: 6/24/2004
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 1 S135AB -03400
SITE ADDRESS: 10260 SW GREENBURG RD 350
SUBDIVISION: LINCOLN TOWER -TOWN OF METZGER ZONING. C -P
BLOCK: LOT : 014 JURISDICTION: TIG
Project Description: 1 branch circuit: office cleanup.
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 CRC: 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
10260 SW GREEN BURG RD #100 PO BOX 230547
TIGARD, OR 97223 TIGARD, OR 97281
Phone: 892 -2500 Phone: 503 - 624 -3631
Reg #: LIC 75059
SUP 1965S
FEES ELE 34 -283C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 6/24/2004 $46.85
[TAX] 8% State Surcharge 6/24/2004 $3.75 Rough -
Total $50.60
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: � Permit Signature:
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: 1910 `J 5
Call 639 -4175 by 7:00pm for an inspection the next business day
IIIIV, . pm
.
Elect Li-mit A p lication7-n ,
- .. FOR OFFICE, USE ONLY •
City 'o Tigard • ' *
KtkIM V .. ... C LI
A Received
Date/By: ' 0 . ,,,, 0
' .
Permit No.2 _ A po —00 39 11
13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie.
Phone: 503.639.4171 Fax: 503.59k119 3 60 2, 200
40 Date/B : Other Permit:
Inspection Line: 503.639.4175 jUil -14 ell I ' Date Ready/By: Jul See Page 2 for
Internet: www.ci.tigard.or.us
CITY OF TIGARD Notified/Method: I 1(-1 Supplemental Information
33: rrnitttetAratW6W#'IVRt.,,S24'grgift4PMV*g 31-LID.VZ:Pr.M3V.VWg,4IT'A.IgrkgItIw'',;';.3..r:;,=',.3
Miggi 1
atlICA ,.: '.:: 't./.4/....-,4,-, 1 :w FATrea; --__ ,i6‘: lik;.,-aii:;:,A.:4 fit* :.-'
0 New construction Addition/alteration/replacement Please check all that apply.
L fl Service over 225 amps, comm'l 0Hazardous location
I Demolition E Other:
['Service over 320 amps - rating 0Buildng over 10,000 sq. ft.,
llr ' ll-ll "' T. :' ? 6I - ifeiiii1 1 0i -i iM - siliklibi■iljgr%ais .4-71 F r i - eaM of 1- and 2-family dwellings 4 or more new residential
illao: , ' , :i 0 W , !, o.4,4::-. "i-,:lwk4w.i r " , ,:1xxx.xxxVi.'"ACt'. 7 'frIt. A-0 •i:'' ,...,.,,..
D 1- and 2-family dwelling 'Commercial/industrial 0 Accessory building ['System over 600 volts nominal units in one structure
['Building over three stories ['Feeders, 400 amps or more
0 Multi 0 Master builder 1:: Other:
['Occupant load over 99 persons 0Manufactured structures or
&rkTNIVI'ON 4 ,,, _' lw
reilkzar.i : ITKVFqNMPoNtkNP.AnM9„lft*agcath 0 Eg,ressilighting plan RV park
Job no.: 6, I( 6-- Job site address: tbz4 0 g Lkj C4144,J1445 Rd. 0Health-care facility ['Other:
Submit 2 sets of plans with any of the above.
City/State/ZIP: Ts , ?} z t ? The above are not applicable to temporary construction service
fk-
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Suite/bldg./apt. no.: 2 ru Project name: L e s„... A . , ‘ s 5 6
Description 1 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: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map/parcel no.: •
_,, ,, Limited energy, non-residential 75.00 - 2
trani Each manufactured or modular
- ---.. dwelling, service and/or feeder 90.90 , 2
Cl — a- ur t e..4 .7t c Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
moix-- vi r - i,t,: - -ihiis i wq : i4wiaimi;7v . .4n7 4 201 amps to 400 amps 106.85 2
4 :40- A.W&:.: %, , ,, ,,,,re:! • y,,,,,,,..„,eaVULS).,'4,? :' 401 amps to 600 amps 160.60 2
Name: E p 601 amps to 1,000 amps 240.60 2
Address: l
,
g,_/ , ,.. 4.•
4,..., I 4.0%. .f : :t___A.... -° I 4 /6!) Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP ( I c...,k t no.... 1 9-2-3 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (56 8?„2„.... g Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which 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
4 * .
tll A Fee for branch circuits with
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 y 2
Address:
Each addll branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax: : ( ) Sign or outline lighting 53.40 2
E Signal circuit(s) or limited-
2-0 energy panel , alteration , or
extension. Describe: Page 2 2
Business name: L ,. (( m ,.. ti...e g 7 i c / r____
Each additional inspection over allowable in any of the above
Address: p e ) 6, 2 .37) _-- i ___
Per inspection 62.50
City/State/ZIP: T _ ,, 0 Of'l_ 9 )-24-- ( Investigation per hour (1 hr min) 62.50
0 t5 di- LL
Industrial plant per hour 73.75
Phone: (S ) 6 _ 4 3 t I Fax: (SV3 ) 62 il -2..c( 3 s- maa5 lowilk7,
CCB Lie.: , 7.5 , 0 s 1 Electrical Lie.: , ..7 y -2S34_Suprv. Lie.: /,4 C Subtotal 116 E:_.--
Suprv. Electrician signature, required: /4 .---, . Plan review (25% of permit fee)
State surcharge (8% of permit fee) 7 1-r
Print name: r r Date: i, ...1 I
TOTAL PERMIT FEE IFs--
Authorized signature: 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 Tn-County Building Industry Service Board
** Number of inspections per permit allowed.
i: \ Building \ Permits \ ELC-PennitApp doc 12/03 440-4615T(10/02/COM/WEB
Electrical Permit Application - City of Tigard •
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
°RESIDE.,.
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
n Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
n Other:
Fee for each commercial system $75.00
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
n Audio and Stereo Systems •
n Boiler Controls .
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control*
n Medical •
Ti Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
is\ Building \Pemvts\ELC- PemtitApp.doc 04/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested a ( AM PM BUP
Location —k -,-M sa,/ -c Suite ‘5, MEC
Contact Person Ph ( ) vZl 9 PLM
Contractor Ph ( ) c701 y- 36 "/ SWR
BUILDING Tenant/Owner ELC Z D e-/-663F0
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain �
Slab Inspection Notes: SIT
Post & Beam —
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear t.
Framing
Insulation j �1
MPP r V f w�- J pl V/
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole 6\t 50 tr6 330)
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
Low Voltage
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
Please call for reinspection RE: 111 Unable to inspect — no access
Fire Supply Line � �Q l�
ADA -161
1 -' A p !u/vt -
Approach/Sidewalk Dat Inspector �' Ext Pp
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL