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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00378 tt l�`Ih DEVELOPMENT SERVICES DATE ISSUED: 6/24/2004 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S135AB-03400 SITE ADDRESS: 10260 SW GREENBURG RD 385! 315 SUBDIVISION: LINCOLN TOWER -TOWN OF METZGER ZONING: C-P BLOCK: LOT : 014 JURISDICTION: TIG Project Description: 10 branch circuits. 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 CIRC: 9 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 GREENBURG 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 [TAX] 8% State Surcharge 6/24/2004 $8.54 [ELPRMT] ELC Permit 6/24/2004 $106.70 Rough - Elect'I Final Total $115.24 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or 1-800- 332 -2344. Issued By: kl _ ,) Permit Signature: D� Gt/I,Qaf2 ►C_et OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: 90,6 S Call 639 - 4175 by 7:00pm for an inspection the next business day Electrical Permit Applica im `- FOR OFFICE USE ONLY City of Tigard `! — V.N." \‘'' Received pemutNo. l � • Date/By: A / I l Y i r 13125 SW Hall Blvd., Tigard, OR 97223 a A �4O P1anRevie Phone: 503.639.4171 Fax: 503.598.1196 , ` I �Q / � NGA N Date/B t. Other Perm Inspection Line: 503.639.4175 55 - (3[ . ! v,jj Date Ready/By: El See Page 2 for Internet: www.ci.tigard.or.us c % , Qr n N 1 tS0 Notified/Method: Supplemental Information ',, Est ?*R ,;,07: `, - " '..r,-. x. Ric "=.- 2£ d ��., i ,.. wwgt r �. , ;'• .� .;. -- E .1;::�. ,•. :: F ,4,Fi y+-,., . . B.L n+$v..,° -^4 e. "3} . ;� .�.A i , ' "f` -t•& w',I ` 'r, ._, t vc�".�. 'xt �' i' k'. I 5 �{.,, �s3"�'i'aw� � ..':; -�hCy� ,?rya �. -. ; �' �. ��... F ���R I �� � ::�',�',+a;t��"?x k Fc `.4t„w�..,. i �� � `�'' •s��` � .� - V„ ' L NI2�vLFsVV - ❑ New construction ddition/alteration/replacement Please check all that apply: El Demolition El Other: Service over 225 amps, comm'l Hazardous location ,a.„,.. q : F , x;. �....a =:r ,: w :tea. _,,,. :.r.,F< r,a� Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., au, . z A ,A 6 ORY OF t°C ' U Cfia t s - k , , s of 1- and 2- family dwellings 4 or more new residential ❑ I- and 2 family dwelling 3 Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure ❑ Multi - family CI Master builder ❑ Other: ['Building over three stories ['Feeders, 400 amps or more n . ,,. _, yt Y _ ..,M , ' , v-.vv ❑Occupant load over 99 persons EManufactured structures or ' at4 �i fFJOB SIT A:TO. MA.TIONO DCOI OSATXO r � ! . - - ❑Egress /lighting plan RV park ❑Health -care facility ❑Other: Job no.: J Job site address: /L� Z (� 0 e 't e 9 q k¢t 6� t>4� Submit 2 sets of plans with any of the above. City/State /ZIP: 7 S to rt (j 9 7- i •_' / The above are not applicable to temporary construction service. � a * . Suite/bld /apt. no.: yg(� Project name: �lwS T �, . ; ' r. i3 "FEE:: SOKI*IEs: i., L( c Description Qty. - Fee. Total ., Cross street/directions to job site: L1 w r.+12 _(D Irl New residential single- or multi - family dwelling unit. Includes attached garage. • ' ■ t r t. ' 6 (> 1,000 sq. ft. or less 145.15 4 Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 Yv.� �.3 a P f - � xx �.%, .. x+x, '�+. .a� , F,t T' � " 33a". Limited energy, non - residential 75.00 2 IS ' , ?' , p ESCRI'PTIQN OF ii7:6 _,$� x ?; . _. Each manufactured or modular ..� $— dwelling, service and /or feeder 90.90 2 I — Piv�..,... i1�n� -7 e to t' 4,44... Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 , A v. ss a;, :mx - a r 4 ,.. 441F,.'. r -9? 44^,,- 44 . g..,°. 201 amps to 400 amps 106.85 2 -W- "PR®aElii' WNERt ' '.,' 4 * ENANT *'?V ti P P ,..r .., z7,,: .8. , ,, - _, ^.. z. - oIl, � .,Z- . , u:. �.< 401 amps to 600 amps 160.60 2 Name: 9 u 1p 601 amps to 1,000 amps 240.60 2 Address: /6A 60 O ff "? (,() l D � Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City /State /ZIP: ( 4 ,ems q' 5 Temporary services or feeders installation, alteration, and/or Phone: (5b5 via, - 9, �� 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 i A i'Vr N " l " ri EO�T A. Fee for branch circuits with , ; . . 4 - ,..r.. ., . ,4... = s` �COIVTAG - RS P ... ,o, .: service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, each branch circuit I 46.85 w S� 2 Address: Each add'1 branch circuit '7 6.65 S'19 2 City /State /ZIP: Miscellaneous (service or feeder not included) Phone: ( ) Fax: : ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited - r> ;: a -: M energy panel' alteration, or a:'t- ����.x:,,.. ,��`� , ». :�� :�.:,.r.� -, G,01rTRAGT'OR„ �r.r.: *� ' �,^� x ��° Y P w;' Ewa:» e. mac t extension. Describe: Page 2 2 Business name: � 11 Or ri { e; t t c f C (A.. z Address: r0 bu x Z 4 ) Li Each additional inspection over allowable in any of the above Per inspection 62.50 City/State /ZIP: ii C0� °0 I - Investigation per hour (1 lv min) 62.50 r/ Industrial plant per hour 73.75 Phone: (SOA Z 4 _ 6 ( Fax: ( S-03 ) 6 Z - Vi 3 O z ;,E_L'E( I' IZ IC_ A L ` d-:R [;TT EES "° r' "4',_° CCB Lic.: +� o c -9 Electrical Lic.: 3t. _ L3 L — .. Suprv. Lic.: /94 —S S u b tota l id 4 0 Suprv. Electrician signature, required: /4 7 5 ' Plan review (25% of permit fee) Print name: �— .., Date: _ Z _G State surcharge (8% of permit fee) gi s �� ' L TOTAL PERMIT FEE * // S , Zy 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 Trt- County Building Industry Service Board " Number of inspections per permit allowed. i:\ Building \Pemtits\ELC- PermitApp. doc 12/03 440- 4615T(10/02 /COM/WEB Electrical Permit Application - City of Tigard • Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: .ASIDE . _ Wqaa `` 42,42,51VIN Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i\ BuildingPermits \ELC- PeimitApp.doc 04/03 CITY OF TIGARD 24 -Hour BUILDING Inspection ine: ; ,(503) 639 -4175 INSPECTION DIVISION " Business Line: (503) 639 -4171 MST BUP Received Date Requested 3 AM PM BUP Location r J !ii L_ - % Suite (37 S MEC Contact Person Ph / ) PLM Contractor Ph ( ) 6 3/ SWR BUILDING Tenant/Owner ELC ale) d ((-463 7<? Footing ELC Foundation Access: Ftg Cr Drain 14/v N 701�� -- ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath /Shear Framing Insulation PQ �� / ,f�//� �Lj Drywall Nailing �`�" 1 / ��0 �7 v 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 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 411P17. PART FAIL • Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. • Please call for reinspection RE: El Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date 3 Inspector i6AA - ii - priztesaY Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL