Permit CITY TIGARD RD ELECTRICAL RESTRICTED ENERGY PERMIT
I SERVICES PERMIT #: ELR2006 -00259
Al DATE ISSUED: 10/23/2006
' ---� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1 S 135AB -01003
SITE ADDRESS: 10300 SW GREENBURG RD 265 ZONING: C - P
SUBDIVISION: LINCOLN CENTER /ONE LINCOLN LOT: JURISDICTION: TIG
Project Description: Tristar Ins. Group. Data /Telecommunications.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
EQUITY OFFICE PROPERTIES TRUST COMMNET SERVICES
ONE SW COLUMBIA ST #300 MICHAEL F KERN
PORTLAND, OR 97258 7075 SW ARMITAGE CT
WILSONVILLE, OR 97070
Phone: Contact #: PRI 503 -539 -1851
FEES Reg #: ELE 1714LEA
LIC 97334
Description Date Amount
[ELPRMT] ELR Permit 10/23/200E $75.00
[TAX] 8% State Surcha 10/23/200E $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 questions to OUNC at 503 - 246 -6699.
Issued By: �`' 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.
} S —
Electrical Permit A p p t.. i 1 '�
llcatio :: .f FOR OFFICE USL.ONLI:
City of Tigard Date/By J
Permit No.: L 0‘ -
13125 SW Hall Blvd., Tigard, OR 972230CT 23 2006 Plan Rev 7
Phone: 503.639.4171 Fax: 503.598.1960 !hr..n ; 1 j `'� \ D ate /B Other Permit:
Inspection Line: 503.639.4175 . 1 1. = '! ! Date Ready/By: MI 10 See Page 2 for
Internet: www.tigard - or.gov '‘✓;- ='- I lA, jf`yi';.b.y Notified/Method: Supplemental Information
A t TYPE OF WOR a a ; ' ' PLAN REVIEW
.l New construction ❑ Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑ Other: ❑ m
Service over 225 amps, com'l ❑Hazardous location
❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
• CATEGORY OF CONSTRUCTION of I- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling ii CommerciaUindustriat ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi family ❑Master builder ❑Other: ❑Building over three stories ❑Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE. INFORMATION AND LOCATION ❑Egress/lighting plan RV park
❑Health -care facility ❑Other:
Job no.: Job site address:
4O1ov S.W. 6S/Qa't/ei" € ,eD Submit 2 sets of plans with any of the above.
City /State/ZIP: /0447 DX 97.223 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: ,45 [Project name: FEE* .SCHEDULE
Description I Qty. I Fee. I Total I ••
Cross street/directions to job site: .G /.r/GOlid GNT7 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 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
.S/.,5'1 1, .(_ ./did frVI1 yyr‘LC Cd /H,rt�rt� /Cs �ON.f Services or feeders installation, feeder 90.90 2
Services or feeders instaallation, alteration, and /or relocation
LlatIAVA/b°r 200 amps or less 80.30 2
201 amps to 400 amps 106.85 2
❑ PROPERTY OWNER A TENANT
401 amps to 600 amps 160.60 2
Name: 7 2 (�/`15. ��e 601 amps to 1,000 amps 240.60 2
Address:
5; -°4/(----
;- ,,� 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 ..
4n. APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: L&, j,.tl t/ 7 36i't . t 3 branch circuit
Contact name: //j 1W/fit/ B. Fee for service circuits
without service or feeder fee, 46.85 2
first branch circuit
Address: 72 7 41;e4t / TR 6",C c7 . Each add'I branch circuit 6.65 2
City / State/ZIP: /Z$p, / f c7s 70 Miscellaneous (service or feeder not included)
3) f / j7 ! ` Pump or irrigation circle 53.40 2
r
Phone: S S Fax: ( )
Sign or outline lighting 53.40 2
E -mail: "f/f / .,t 'Ae: ,1 ,(/ ' Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: ( Page 2 2
Business name:
Address: /97yj Each additional inspection over allowable in any of the above
" Per inspection 62.50
City /State/ZIP: Investigation per hour (I hr min) 62.50
Phone: ( ) Fax: ( ) Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: 97331/ Electrical Lic.: /TN/4x Suprv. Lic.: Subtotal
Suprv. Electrician signature, required -A zz / Plan review (25% of permit fee) .
State surcharge (8% of permit fee)
Print name: /j1/c ! ` /` ci Date:/ A 3 -4 TOTAL PERMIT FEE �/ , eo
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 Tri- County Building Industry Service Board
" Number of inspections per permit allowed.
• P\ Building \Permits\ELC- PermitApp.doc 12/30/05 440- 4615T(10 /02/COM/WEB
Electrical Permit Application - City of Tigard • • .
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY3�_. � ___
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
El Burglar Alarm
❑ Garage Door Opener*
El Heating, Ventilation 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: .
El Audio and Stereo Systems
El Boiler Controls
❑ Clock Systems
Data Telecommunication Installation
❑ Fire Alarm Installation
•
❑ HVAC
•
El Instrumentation .
El Intercom and Paging Systems •
El Landscape Irrigation Control* . • , .
❑ Medical
❑ Nurse Calls ,
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
El Other, . .
Total number of commercial systems: / •
•
*No licenses are required. Licenses are required
for all other installations
I:\ Building \Permits\ELC- PermitApp.doc 12/30/05
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2006-00269
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/2312006
Phone: (503) 639-4171 Olt
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 10/26/2006 TIME: 7:04AM PAGE: 36
SITE ADDRESS: 10300 SW GREENBURG RD 265 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/ONE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: TRISTAR INS. GROUP
DESCRIPTION: Taster Ins. Group. Data/Telecommunications.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: COMMNET SERVICES PHONE #: 503-539-1851
Inspection Request Scheduled For: Date: 10/26/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 038869-01 503-539.1851
MC( NAL
Corrections/Comments/Instructions:
&WASS n PARTIAL APPROVAL 7 CANCEL I NO ACCESS
7 CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED
Inspector: NUS Date: M 24j Ob Phone #: (503) 718- 18410
•