Permit , CITY OF TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVIC PERMIT #: ELR2005 -00401
° 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/8/2005
PARCEL: 1 S 135AB -03400
SITE ADDRESS: 10260 SW GREENBURG RD 1150 ZONING: C -P
SUBDIVISION: LINCOLN CENTER /LINCOLN TOWER LOT: 014 JURISDICTION: TIG
Project Description: Low voltage for fire alarm.
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: X OUTDOOR LANDSC LITE:
OTHER: • HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
EQUITY OFFICE PROPERTIES TRUST T & L COMMUNICATIONS INC
ONE SW COLUMBIA ST #300 PO BOX 87387
PORTLAND, OR 97258 VANCOUVER, WA 98687 -7387
Phone: Phone: 360 - 737 - 9725
Reg #: LIC 67787
ELE 37- 428CLE
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 11/8/2005 $75.00
[TAX] 8% State Surchaq 11/8/2005 $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
star within ; days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
y to follow rules a. o• -d by e Oregon Utility Notification Center. Those rules ar- set for in OAR 952 - 001 -0010
t rough O A; 952 -00 -01 W mu may obtain copies of these rules or direct qu -: on: to It' NC at 50 - 246 -6699.
Is ued By: _ / L Permittee Signature:, / /r /A...„
Re B kqA)
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.
Electa-i xl" 'srrnit Application - FOR OFFICE'.USE ONLY J : • ' -
City g Reciv of Ti and Recived . lye 6 - 4 ri1_� Permit No.: �/�
` .. ) 0 /
` y- g �
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 / w' " " " "�0.;1!, )Ij� e Date/B . • Other Pe. it:
Inspection Line: 503.639.4175 _1__ .11.:. Date Ready/By: WM ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
TYPE OF WORK . PLAN REVIEW -
❑ New construction Addition /alteration/replacement Please check all that apply:
❑ Demolition ❑Other: 0 Service over 225 amps, comm'l 0 Hazardous location
❑ Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
.'CATEGORY "OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ 1 and 2 family dwelling Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family ❑ Master builder ❑Other: ❑Building over three stories :Weeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE 'INFORMATION' AND LOCATION . ❑Egress/lighting plan RV park
Job no.: Job site address: /a).1,0-56 �yv 6e- y ❑He ❑
��/ Submit t 2 -care facility 2 sets of plans with any of the above.
above.
City / State/ZIP: Po if '( -- 0 re4 ,...-/ The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: I ISO Project name: (� n olt� Tot. - FEE* 'SC HEDULE
Desc r i ption I Qty. I Fee. I Total l ""
Cross street/directions to job site: 0 s)c� St C , IA 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
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 1 75.00 2
•
• DESCRIPTION OF WORK Each manufactured or modular
3 I l , dwelling, service and/or feeder 90.90 2
��- N � ✓x� �
� Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
0 PROPERTY OWNER ❑ TENANT . 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: 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
relocation
Phone: ( ) 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 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
. ❑ APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with
I service or feeder fee, each 6.65 2
Business name: '[`LZ___ 6.cim 04u 0 f c c . branch circuit
1 i B. Fee for branch circuits
Contact name: P � SS 13 ,.GS L c-t./ without service or feeder fee, 46.85 2
each
Address: f ` b e' 0 � 7 E Z r brhc circuit
� � j Each add'I branch
branch cuit 6.65 2
City / State/ZIP: d � ( i
ik s Miscellaneous (service or feeder not included)
C Pump or irrigation circle 53.40 2
Phone: &66) Q F7 Z s` Fax: : (, 6c 73T7 n Y8 Sign or outline lighting 53.40 2
E - mail: T Signal circuit(s) or limited-
"
' CONTRACTOR, ' . energy panel, alteration, or
t . / extension. Describe: Page 2 2
Business name: �-G (� �l��Z u ti ( G S
Address: (��� g�3�� Each additional inspection over allowable in any of the above
• �� Per inspection 62.50
City / State/ZIP: /4 /4..,,� 3& � W® Investigation per hour (l hrmin) 62.50
Phone: (_7,0) 73? r2 2 - 5 — Fax: 6 7237 1 ilr Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES* -
CCB Lie.: ( j '77f 7 Electrical Lic.: Y ).,2LE" Suprv. Lic. `'yf Subtotal
Suprv. Electrician signature, required: L � V 41..A...,../ Plan review (25% of permit fee)
?-
Print name: L. i k `� � L et _ \ Date: 1 k-- �- 0 S State surcharge (8% of permit fee)
�f "lJ TOTAL PERMIT FEE
Authorized signature: ` ./G'G,� / !w�-� Tbis permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: ' .> B Lc S W Date: ' E <-- O --- * Fee methodology set by Tri- County Building Industry Service Board
** Number of inspections per permit allowed.
i:\ Building \Permits \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:
IDENTIAL WORK ONLY:
Fee i r all residential systems combined........ $75.00
Check pe of Work Involved:
❑ Au. o and Stereo Systems*
❑ Burgla • larm
❑ Garage Do • Opener*
❑ Heating, Ventil. ion and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY: .__ _,
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 . stallation
Vj Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Pagi - g Systems
❑ Landscape Wig.' ion Control*
❑ Medical
❑ Nurse Call
❑ Outdoor andscape Lighting*
❑ Prot: tive Signaling
❑Oter
Tot. number of commercial systems:
*No4icenses are required. Licenses are required
for all other installations
i:\ Building \Permits\ELC- PermitApp.doc 04/03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2005.00401
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/13/2005
Phone: (503) 639 -4171 Amer Ipu�uj
Inspection Requests (24 Hrs.): (503) 639 -4175 ,',
INSPECTION WORKSHEET FOR DATE: 11/23/2005 TIME: 7:00AM PAGE: 57
SITE ADDRESS: 10260 GREENBURG RD .150 CLASS OF WORK:
SUBDIVISION: LINCOLN .ENTER /LINCOLN TOWER LOT #: 014 TYPE OF USE:
PROJECT NAME: :SIDIA T
DESCRIPTION: Low voltage fro ire alarm.
OWNER: EQUITY OFFICE ' dOPERTIES TRUST, PHONE #:
CONTRACTOR: T K L COMMUNICA ONS INC PHONE #: 360-737 -9725
Inspection Request Scheduled For: Date: 11/23/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 022324 -01 360-737-9725 N
Corrections /Comments / Instructions:
r 1pfku P �'r`�' `- • A ( tsacC
LAI v LDacJ
PASS n PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: cr Y Oe Date: 14 2 1,5 - CePhone #: (503) 718- VZtA
CITY OF TIGARD
BUILDING DIVISION
Aik PERMIT #: ELR2005-00401
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/8/2005
Phone: (503) 639-4171 kosilob
Inspection Requests (24 Hrs.): 503) 639-4175 .-4,W4J!.
INSPECTION WORKSHEET FOR DATE: 11/10/2005 TIME: 7:02AM PAGE: 102
1
SITE ADDRESS: 10260 SW GREENBURG RD 1150 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/LINCOLN TOWER LOT #: 014 TYPE OF USE:
PROJECT NAME: OBSIDIAN
DESCRIPTION: Low voltage for fire alarm.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: T & L COMMUNICATIONS INC PHONE #: 360-737-9725
Inspection Request Scheduled For: Date: 11/10/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
13\ Low voltage 020890-01 60-737-9725 Y
Corrections/Comments/Instructions:
J
R.‘ r tk Li - ?3() InD,16
D
PASS fl PARTIAL APPROVAL EI CANCEL fl NO ACCESS
FAIL I I CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: /7 i
Date: ,1 0 /3" Phone #: (503) 718-