Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00286
DEVELOPMENT SERVICES DATE ISSUED: 4/28/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S135AB-01003
SITE ADDRESS: 10300 SW GREENBURG RD 220 ZONING: C -P
SUBDIVISION: LINCOLN ONE /RED LOBSTER /CASA L LOT : JURISDICTION: TIG
Project Description: (4) branch circuits. Job # 873.
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: 3 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: 503 - 412 -4800 Phone: 503 - 624 -3631
FEES Reg #: LIC 75059
Description Date Amount SUP 1965S
ELE 34 -283C
[ELPRMT] ELC Permit 4/28/2005 $66.80
[TAX] 8% State Surcharge 4/28/2005 $5.34 REQUIRED ITEMS AND REPORTS
Total $72.14
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: , ^ �� Permittee Signature: qP C 0 \ ,n
OWNER INSTALLATION ONLY 44
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 r,RPR 28 2005 7:02RM HP LRSERJET 3200 p.2
Electrical Permit AD .- :. p, N ED FOR OFFICE USE ONLY
City of Tigard Dec Permit No.: , �1
Tigard, OR 97223 Received
13125 SW Hall Blvd., Ti -,, ti , � 3�w��‘
g . fl Plan tN
Phone: 503.639.4171 Fax: 503.598.1960 APR 2 ' 1+10 :ille Date/B : Other Permit:
Inspection Line: 503.639.4175 C',TY •TIG , ".r4-�',=''!., Date Ready/By: Bf See Page 2 for
Internet: www.ci.tigard.or.us � L k � O wl+ Notified/Method Supplemental Information
lrG t Kli r l .y -emu 51-7,, h ti < L f ' ,, sF a 7 ; p .. w . ' 4,T r -,- " d . Vi v 4,,n, F i; 4 .te 1 , , tee
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it . [.. �` fP 71;� a?I = . ,t5s '`z 4 i E f tk., . " - Y' 1 ' k4:z. t - -4 ; i ... �, i'f , . ? `,� 1 R _. - •'
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❑ New construction •I :. ddition/alteration/replacement Please check all that apply:
❑ Demolition Other ❑Service over 225 amps, comm'I ❑Hazardous location
, � 7 y ch^ Nn , 3 ❑ Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft,
, i t , r , j llf. l � ' pd 1 , 4 sil ett • irf" ` 5 . ` . , r of 1 - and 2- family dwellings 4 or more new residential
O. ❑ 1- and 2- family dwelling ,'d Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
(D Multi - family ❑ Master builder (] Other: ❑Building over three stories ❑Feeders, 400 amps or more
}1 € » ° ,„ to y , , e s i a ❑Occupan t load over 99 pers ons CI Manufactured structures or
, y is 4 ; ,q l! 0� i 1 ..•.,,,_.. ; i' ( r 4,,°.,(irr ti '�� �s . gress hltin lan P
'.���R3� �. � . ?l�a i ra tltt 91 tt i ' �` �b • .... � ❑E g g P RV park
['Health facility ❑Other:
Job no.: +9.3 Job site address: ( D %ao f tJ c 5 vrk Submit 2 sets of plans with any of the above.
City/State/ZIP: T & e 3 The above are not applicable to temporary construction service.
`I
Suite/bldg./apt. no.: 2� Project narrte K . ; , r 4 -r'i; : . : f 1 ,, ; oo, ai,r, +JN . s,. X . ...= .' ,
I �ZA /! t' v.... Description Qty. Fee. Total
. Y �" ,
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
/� Includes attached garage.
1 L ,/ ev-1. -- U 22G _ 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
,� 1. 1. 1„i S�`_ �.,e+� { �r , h ; o ,., ; SgreA tr ,� , r � , • „ y � ti5 Limited energy, non - residential 75.00 2
.'i' 1 • 1 it - 1:1 , `"..11::::. - ,2 1 1 11.Zi i �l`1';'r Or R d '11 5 � '� i m il • , 't l `' mlxlN A �t P u.d.w& reT mi i tk n
Fli. c �,�i of , �11 Each manufactured or modular
• dwelling, service and/or feeder 90.90 2
1 pM (M - 4 V ' i Services or feeders installation, alteration, and /or relocation
I 200 amps or less 80.30 2
1: L+ . ai a 1
.'k s s . L t r � ��µ. •,ia+ f i1.. , y' ��. Ff '� �rh'' G iamoil _ 1 -, 201 amps to 400 amps 106.85 2
� r �i tMI % ' he 401 amps to 600 amps 160.60 2
Name: _o 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
i'� ry, G oa SEC% x51 - te.�A ■� „ 'Ft 6 liltt9U r k•:, -ty` p . �+ - � -` k � _
... r x 1. :.1.'.1 il3d s ...fi 1 i U ilt g i4, 0 r i 'oet� iW }tk I" U i ' � a A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
Contact name: B. Fee for branch circuits •
without service or feeder fee, } 46.85 4./ C 2
Address: each branch circuit
Each add'l branch circuit 3 6.65 /1 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Pax:: ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E-mail: Signal circuit(s) or limited-
l K(" , SEitl t ; t _ .� : r ^ .: iC !'.+ l 3,. , aMSTIN 11 f u energy panel, alteration, or 2 2
Business name: extension. Page
�1t(a. Et r�iAu c I N __ -
Address P 4, Z-� g-',1,1 Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State/ZIP: T tAr. to , Investigation per hour (l hr min) 62.50
5 Industrial plant per hour 73.75
Phone
• ( -�) �s'Z '3 E. n Fax • (VS) (o21 - Zi7;'d' .J`'i. 1r t) 1 8i 1;�::;^a!" ;t
CCB Lia: Electrica Lic.: Suprv. Lic.: .ux:�>'��,fi,�,n,�.:•� ,�.�w.: �,.r��..:�.�,....���. ....,.,.�,:3...... �.:::::,,..-
9 5�, , 3 -Z�3 L- pn ($6 - Subtotal 6 `
•
r gig
Suprv. Electrician signature, required: 4 per
Plan review (25% of permit fee)
Print name: D+ r Date: , 24 Q� . State surcharge (8% of permit fee) 3
TOTAL PERMIT PEE 4 2 1 4 I
Authorized signature: '
� t T his perm application If permit not within 1 0 /
days after It has been accepted as complete /
Print name: I Date: " Fee methodology net by Tri- County Building Industry Service Board ,
" Number of inspections peerpemiit allowed. /
i:\ nuilding \Permitcl3LC- PemdtApp.doc 12/03 4.40- 4615T(10 /02/COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 00286
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/28/2005
Phone: (503) 639 -4171 / nr' /Ni ht
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/2/2005 TIME: 7:12AM PAGE: 19
•
SITE ADDRESS: 10300 SW GREENBURG RD 220 CLASS OF WORK:
SUBDIVISION: LINCOLN ONE/RED LOBSTER /CASA L LOT #: TYPE OF USE:
PROJECT NAME: KFORCE PORTLAND
DESCRIPTION: (4) branch circuits. Job # 873.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #: 503-412-4800
CONTRACTOR: WILLAMETTE ELECTRIC INC PHONE #: 503. 6243631
Inspection Request Scheduled For: Date: 6/2/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 008214 -01 603- 624 -3631 N
Corrections /Comments/ Instructions:
7
PASS El PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ���'� Date: � ' � Phone #: (503) 718 -