Permit C ITY OF T I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT
l DEVELOPMENT SERVICES PERMIT ELR2006 - 00237
' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/28/2006
PARCEL: 1S135AB-01003
SITE ADDRESS: 10300 SW GREENBURG RD * ** ZONING: C - P
SUBDIVISION: LINCOLN CENTER /ONE LINCOLN LOT: JURISDICTION: TIG
Project Description: 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 SIMPLEXGRINNELL
ONE SW COLUMBIA ST #300 6305 SW ROSEWOOD
PORTLAND, OR 97258 LAKE OSWEGO, OR 97035
Phone: Contact #: PRI 503- 693 -9000
FEES Reg #: ELE 26- 946CLE
LIC 149921
Description Date Amount
[ELPRMT] ELR Permit 9/28/2006 $75.00
[TAX] 8% State Surcha 9/28/2006 $6.00 REQUIRED ITEMS AND REPORTS
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 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 estions to OUNC at 503 - 246 -6699.
��} 1410
Issued By: UtI ..� Permittee 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:
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.
' e lectrical Permit Application. F OI L ° O OFFICE ONLY
City of Tigard l=� I� ® R e a e "Mani a o a3 >
Permit No.: 06 _
13125 SW Hall Blvd., Tigard, OR 977 423 2 8 d
II., g `r P 6 2006 Plan Review Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 Date/By
T I G.A R l7 Inspection Line: 503.639.4175 Date Ready/By: luris: El See Page 2 for
. Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK. PLAN REVIEW
• ❑ New construction Igj Addition/alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ I- and 2- family dwelling Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
- ❑ Emergency system. larger separately derived system.
. JOB SITE INFORMATION AND LOCATION ❑Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.12Z, to) Job site address: /03bO Su. (, BoQLf pa) Six 100HP
or more occupancy.
❑
❑ Six or more residential units. Recreational vehicle parks.
I ��
Clty /State/ZIP: 4
9 ❑ Health -care facilities. ❑ Supply voltage for more than
' � 1 3 ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: OkE u ,3(Ot.., J erri 7el2 ❑ Service or feeder 600 amps or more.
FEE SCHEDULE _ •
Cross street/directions to job site: Description I Qtr. I Fee. I Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.40 I
Limited energy, residential 75.00 2
, • DESCRIPTION OF -WORK (with above sq. ft.)
�j, 114E- Limited energy, multi - family
AI E- ExkS -- r I I3C„i �_ F1 {'-( S residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I . ❑ TENANT 201 amps to 400 amps 106.85 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: ( ) Fax: ( ) 200 amps or less 66.85 I
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 599 amps 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date:
A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
. Business name: B. Fee for branch circuits
without service or feeder fee
Contact name:
first branch circuit 46.85 2
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
. Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR' Sign or outline lighting 53.40 2
Business name, I l„ l x C�a.i m kett, Signal circuit(s) or limited -
energy panel, alteration, or
Address: Le30< ( SW D ST extension. Describe: ( Page 2 7� 2
• City / State/ZIP: LAVE_ CE(jJ � 1 D� 9 7D3� Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) (. j • 9(ZO Fax: (SbS) 67c- e' SZ/
Investigation per hour (1 hr min) 62.50
• CCB Lic.: / 49'9Z( Electrical Lic. 26 - 9'C Q ([E Suprv. Lic.:36j5) ( • Industrial plant per hour 73.75
• . ELECTRICAL PERMIT FEE
Suprv. Electrician signature, required: Subtotal: 7 S'. DO
Print name Cr) i Date: 9 . zB -a6, Plan review (25% of permit fee):
State surcharge (8% of permit fee): l.a . t7u
Authorized signature: TOTAL PERMIT FEE: B 1 . 00
• This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\ Building Wermits\ELC- PemMApp.doc 05/23/06 440- 4615T(l1/05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
``RESIDENTIAL WORK ONLY
Fee for all residential systems combined $75.00
Check Type of Work Involved:
El Audio and Stereo Systems*
❑ Burglar Alarm
E l Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
El Other.
I COMMERCIAL WORK ONLY:. V
Fee for each commercial $75.00
system
•
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
El Audio and Stereo Systems
❑ Boiler Controls
El Clock Systems
❑ Data Telecommunication Installation
III Fire Alarm Installation
❑ HVAC
❑ Instrumentation
El Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
El Outdoor Landscape Lighting*
E l Protective Signaling
❑ Other
•
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\ Building \Permits\ELC- PermitApp.doc 03/23/06
. _`
CITY OF TIGARD • .• ��mu o ��n mo�m��n���
BUILDING DIVISION PERMIT #: ELR2006-00237
13125 SW Hall B|vd,Tigard, OR 97223 D ATE ISSUED: 9/28K2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 _IS- a11—
INSPECTION WORKSHEET FOR DATE: 11/14/2006 TIME: 7:02AK0 PAGE: 4
SITE ADDRESS: 10300 SVV8REENBURQRQm" CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/ONE UNCOLN LOT #: TYPE OF USE:
PROJECT NAME: NE UNCOLN CENTER
DESCRIPTION: Fire Alarm.
OWNER: EQUITY OFflCE PROPERTIES TRUST, PHONE #:
CONTRACTOR: SI&4pLEXGR| PHONE #: 603
Inspection Request Scheduled For: Date: 11/14/2000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 039750-01 971'506-8685 N
\
Conecdano/Conih1ehto/Tnatruodona:
"� m� � ������h�
' "o`. ` ' _~
2 ern
A Ass I I PARTIAL APPROVAL 0 CANCEL NO ACCESS
I I FAIL 0 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: NU LE Date: \ l k oic. Phone #: (503) 718- 2110 ^