Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00740
A DEVELOPMENT SERVICES DATE ISSUED: 11/17/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S135AB-03400
SITE ADDRESS: 10260 SW GREENBURG RD 530
SUBDIVISION: LINCOLN TOWER -TOWN OF METZGER ZONING. C -P
BLOCK: LOT : 014 JURISDICTION: TIG
Project Description: (1) service, (40) branch circuits.
Job # 757.
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: 1 W /SERVICE OR FEEDER: 40 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 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
ONE SW COLUMBIA ST #300 PO BOX 230547
PORTLAND, OR 97258 TIGARD, OR 97281
Phone: Phone: 503 - 624 - 3631
Reg #: LIC 75059
SUP 1965S
FEES ELE 34 -283C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 11/17/200' $346.30
[TAX] 8% State Surcharge 11/17/200 $27.70 Rough -in
Elect'l Final
Total $374.00
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.
Issued By: Permit Signature: Sc �, p, \q
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 7:00pm for an inspection the next business day
III Nov 17 2004 8: 12FIM HP LFISERJET 3200 p.2
Electrical Permit A i t tic A :II! ER/ 1 Olt rlI l li I. l .i.. u\I:1
City of Tigard " n Received B "/ 7 JO Permit No_: 6 lid y_ 7y I ,
13125 SW Hall Blvd., Tigard, OR 97223 1 7 ! Review
Phone: 503.639.4171 Fax: 503.598.1960 NOV Pla / B Other Pernik
Inspection Line: 503.639.4175 CITY OF TI = l 'f 1 Date ' ® See Pa i 2 for
Internet www ci tigard.or.us Ndtitied/Method Su mfo imat i oo
'l�" .ul 49i� 3 ' ' a fi .' " Yz,'y3 i.,,..ot°rti 'b'\i'' r .. iu I F±� "v C ,o
..444 4'%i' � �a.it 5 x ii t.: , iU�, T ,Y V' £ 5. s l al.� m �,k' t'p. .� L� )4: 4 ,16 .. all` a t G"t . ± V: l1K ' . , , i . t ,r ' k lq.il a "':n.<
. .:14.2 .6ft' k._:4c t i I et4�,, ! :A.A ' ', -;gsV itt'4 -4s.w. - l,m. - ' s. - a ,3' t s S ►, o ��� R i yr a
f�1t .'. "'�kF�Y.{EkY,,:,'�.:tjR,SX,lY•S tu``Lr� .a: � ��,a*u,�Pe«s , ,}� ', }' k, s.s c ��ta�'3sase H. „s e .¢`�a +�5 �� •' r,,,.,,
❑ New construction Lit Addition/alteration/replacement Please check all that apply.
❑ Demolition 0 Other 0 Service over 225 amps, comm'I ['Hazardous location
r,' i� `t� l31j" rSs�tse �er3T'; ['Service over 320 amps -rating ❑ Buildng over 10,000 sq. ft.,
iif ,.wa � ;p �est u.r„ii c ri Fi.i - ' i. `sifter ; zeki,, sk.>3 . r y 't „ of 1 - and 2 dwellings 4 more new residential
❑ 1- and 2- family dwelling .®, Commercialindustrial ❑ Accessory building ❑ System over 600 volts nominal units in one structure
❑ Building over three stories ❑Feeders, 400 amps or more
❑ Multi - family ❑ Master builder ❑Other:
r It - €,, � i ,_ u,,a M ast ❑Occupant load over 99 persons ❑ Manufactured structures or
n . 9 i x r.�' t e l l = = gg1:1 {� 7 e $ sFt r, 6 ,*' li n 1„s 4 *' 4 P ayF� #� ,, RV park
x.. a ax 100 ; .. ?..-trl!.>.� o :_centsdud.1,reretarthrtr 3teake...k s ti v. 4aitf z� , % ;=t l' krl"ul...1Ix ' J a ❑ Egress lighting plan P
Job no.: 7 j 2-- Job site address: /x266 $ C44,4 Jj u p „,,, ( ❑Health -care facility [Other:
Submit/ sets of plans with any of the above
City / State/ZIP: T issra 0 0 9 2 z i The above are not applicable to temporary construction service
Suite /bldg /apt no.: / Project name: . t€ t � c, 'u!t .ZZIZ n r. E `itV �E'
� �`/ (a .t. ' `� u C (l ( »n..- Qty. Fee. Tag wr
Cross street/directions to job site: New residential single- or multi -family dwelling unit.
� Includes attached garage.
Li r,/ Car -Y4. -- 1 d Aau ex _cu C ?O 1,000 sq. ft or less 145.15 4
Subdivision: I j ot no,: Ea. add'I 500 sq. ft or portion 33.40 l
Limited energy, residential 75.00 2
Tax map /parcel no.
t a�� .x k 4 a , , Limited energy, non - residential 75.00 2
?e tr,. ' t . J � , x'd� ^�L s� .sn � - �?; �`, � �r� ��a i ss5 r ��X r�� v, •,:��� t? p�, , gy
„ r� c k.r roc.:, :at i �§ a.1niv: s� * >� i Wkn i i n l �'? is f Bach manufactured or modular
dwelling, service and/or feeder 90.90 2
-r ""` f ILK. 1.4 l 4► A Services or feeders Installation, alteration, and/or relocation
200 amps or less . / 80.30 6-0 3G 2
A r a3 , ac s r x ea wn la f cv _
'le/ 5 r:54 ,444.1;g em s `liAli 4s,4iz,ra, kti t' • t p'i `b a ., < ' 4 , ;1 A 401 amps to 600 amps 160.60 2
Name: C,6 P 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: 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
a ` } `fix `ff v 3 r cR I M S� " 4 r`iF M' a .•�r ° ? �tfi a� }� at 'T A Pee for branch circuits with
,.uatf 'ctav `� �3tir ratan d.e eh . �Y: , . di, ' ,;,a.' +' v .M.zCa. lfr :" ? ithts,Ttw` 7 3
service Or frxdr+r fat:, each
Business name: branch circuit yv 6.65 2(4 2
B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
Address: each branch circuit
Each add'] 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 -
i , � a� b''t i.'¢'t "vs' i'.P �t ' F +� �G �y i r qr cr,.'s 1 ' M 'a is L s , ''h a L i`i�"iti - 'R' °
energy el, alteration, or
Business name: extension. Describ Page 2 2
� )1, ital,,,.e4.4, ec�r,.tc /w -
Address: 6 g 2� U y } Each additional inspection over allowable In any of the above
Per inspection 62.50
City /State/ZIP: -1-- ( f , n Q A - 99-2-g I Investigation per hour (1 hr min) 62.50
itt Industrial plant per hour 73 5
Phone: ( ) 6 t k - 340 T ( Fax: ( ) 4, 2.K - Z5 3 5- j � # /arrEFEb� 1 't' ,;.: i. v., f ti
CCB Lie.: � ) -- 0 5 --. Electrical Lic.: g Li_ 2 g3c Suprv. Lic.: r 4z S �- Subtotal 3 1 / 4 7_4--
Suprv. Electrician signature, required: A L- Plan review (25% of permit fie)
Print name: J kN F.. rte. Date: it '? -e V State surcharge (8% of permit fee)
TOTAL PERMIT FEE '3 it y,
Authorized signature: This permit application expires It a permit is not obtained within ISO
1 days after it has been accepted as complete
Print name: Date: • Fee methodology set by Tri- County Building ]ndualry Service Board
" Number of inspedtions per permit allowed
isl Buildieg \ Permits 1EGGRtmitApp.doe 12103 404613T(O WM/COM/WEB
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line:. (503) 639 - 4171 MST
BUP
Received Date Re uested f — / AM PM BUP
Location I' a - ( , —e-e) 6 J Suite S30 MEC
Contact Person ) PLM
Contractor Ph ( ) 6 a T 33/ SWR
BUILDING Tenant/Owner ELC SOD ' -I�d 7 M
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall 6-k Ocy lb - d �
`�
Fire Sprinkler r 1 / p `�'
Fire Alarm (>v � 1�1 1 a `� &niD W (7-1 1 �:P P9€ C r f -- AN 0 C U-(D -J �
Susp'd Ceiling ��
Roof L ‘1\)i,I10 L 1vd°0\ � ,� 0 Pe l`yk(9�►y 2�'n
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough-In
Water Service
Sanitary Sewer .
•
Rain Drains
Catch Basin / Manhole
Storm Drain
r7 ./
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL 1-L.4 C AR,D "Qcc R/$
Service 1 1/4 .
Rough -In ' a u c�G 41
UG /Slab
Low Voltage
Fire Alarm
6 e6. PART FAIL E Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE - Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line ' '
ADA 6—
Approach/Sidewalk Date �' l y C � Inspector' Est
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL