Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00773
DEVELOPMENT SERVICES DATE ISSUED: 12/7/2004
" L '' 11 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S135AB-01003
SITE ADDRESS: 10300 SW GREENBURG RD 375
SUBDIVISION: LINCOLN ONE /RED LOBSTER/CASA L ZONING: C -P
BLOCK: LOT : JURISDICTION: TIG
Project Description: (3) branch circuits.
Job # 765.
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: 2 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 12/6/2004 $60.15
[TAX] 8% State Surcharge 12/6/2004 $4.81 Rough -in
Elect'I Final
Total $64.96
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: L_c Permit 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 639 -4175 by 7:00pm for an inspection the next business day
DEC 06 2004 4:32PM HP LFASERJET 3200 p. 2
1%iectrit a l- P e r m i t Ai Heat t 1.. A s p 1.,.R. t ► l rit 1 . I ` , 1 ( / \ 1.1
City of Received _
® -1--,0 Permit No.: G , 7
13125 SW Hall Blvd., Tigard, OR 9722 0 %% " Abk Plan Review Other Permit:
Ph one: 503.639.4171 Fax 503.598.1960 , DeB
Inspection Line: 503.639.4175 �� h r i
wa Dane Ready/ By. RI Page 2 for
Internet: ww..tigard.or.us
r •��Gn Notified/Method: Supplemental Information
<� +- ni "?:3`.. „a,. ":-r: 3.'•f31, v.; FA ''4 ;1 i" `t * ?tigg T�+n,_ T M i- ` l.. i'� gt4 �`� i..r ty
z 51, 1��royy3�im ..�-v:t,.. ���� � ?.�s.� ,� ��� o � A p� �VY� 5.,��Y� yg�¢�, q e`,,5 x¢ fl:ie.,s�P �° (�' L•¢ij
:2,i' ta��+�' "1et'k-a. t Y a4 S 2i `s'a9v-,� , ° j 3, ` t i i.. : ; M t .. i . : W 4 iti ,'4_ ., hhv` r � tt� i a e th '. �. x tl ,Zage4r4.11. " ti .vii .,i. to s ` ..,,z, ;O .� S;; Ls.ilt d::.ct: , 1. 5:, v
.�1. '�"" � 8 � t�:� t "� yy s � S � x '� �.d',�aa..'�.'. �.YnL��i. ��.Y i + sr ��1...�.
'.. �J6fi�......<rl �4 2. . FS{Rl �( tihi(�Sa k "°d 6 �'Y� � �t.+�Y;t:..}J L K-.
❑ New construction , F :: I dtti,rV' {aration/replacement Please check all that apply:
O � ❑Service over 225 amps, cormn'1 ['Hazardous location
Burl over 10,000 s . &,
❑ Demolttlon ❑ Service over 320 amps -raring dug q
�`t . t1 ,4 y yi u mr t ` o p 'h','fji n <' 1stg z'6tr . n ?, s �c s�p+er�la a 2/ z+43 c{ . 1147j041:04.4444143 .
�d + ;� �. �, t, 1 c 4, g p* i an gt I ,' s . of 1 -and 2-family dwellings 4 or more new residential
a�i. di '�s.�t�'�i�,:�s��.G;i��4�': t ,t��i, r�sv:��u�r� +a tf:c4.r..�� �!��a.,.la+cr�xcL.:.r�. +zuY::+,Lu4 :�.��.a, vm,�.....s n>s., '�:w units in one structure
1- and 2- family dwelling C'∎ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal
Feeders, 400 amps ix more
[(Building over three stories P
❑ Multi-family ❑ Master builder ❑ Other: ❑Occupant load over 99 persons ❑Manutacmred structures nr
r �a n a 2/,r s t ra �, yx L ss„•r �t` rw i ti t "A r . ❑ g> P,h g Plan
RV park
� 4� t t If .,, i Ak a , . 1 � �1€a s a + t , «3' ; : lg,h E silt tin
t.b� .. _...x, : f , -ui]C a�s..'.tn.finci. za z t z.�1f.s.a. 2. 0.6.0::.:414A1.144,4 � ❑Health -care facility ❑Other:
' ��� �,�
Job no.: 9-t Job site address: fo:t'..fa... ( dje( Submit 2 sets of plans with any of the above.
ty )
City/State/ZIP: The above are not applicable to temporary construction service.
.y-. � if ., � JJ f t t ,, , l �P, ewa wcy+:7a� F 4 X4 T € "4;s1mf'i'x.is� { W.{'k { u t, . � � 1 u 1 "e x �'aH r9 n�
J ��=iliF�
Suite/bldg. /apt no.: 2?- rwA,.vC�
y' (Project name: Zeit/ £ �
neripden QV p rout ••
Cross street/directions to job site: L S v ?l-' 1— New residential single -or multi - family dwelling unit
Includes attached garage.
1,000 sq. R or less 145.15 4
Subdivision: ` Lot no.: Ea. add'1500 sq ft. or portion 33.40 1 _
Limited energy, residential 75.00 2
Tax map /parcel no Li mited energy, non - residential 75.00 2
si„, S '* i 'ndvrta ,,,a 4 a .s aat.��:v.x ,�+Y'N'rYyn u��rn'�o•it`y3t Each manufactured or modular r.,:
. a.L_ ra .At,. 1 at,.xtx ..'i'.t'� -�`.3 .. t. i -i2Ei *,za 0, 'ilt£rcR. ,at. i4 u. �a :r[ gtii `t ?.�:iit•. "" iii;
J ` tt � ' c dwelling, service and/or feeder 90.90 2
1 ,.,.%. t t M if ✓) f',te.,,.,,re Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
. v , ,it- c �,.ift -yK a, y y 201 stops to 400 amps 106.85 2
d � �"i� .� •�,r A' , ',�l"�91`.4�Y gyp'. ^ - ' 14 k'� { '��4 a y R €'"' , "}tE'�f' � f � !+(� h}'2� C '�ZkY�i .
i £, �` ° n * -. , 401 amps to 600 amps 160.60 2
ti' ,s , „ 11 414; x.. :r ';drui. xs �+ t"ttit� # f mug 441 air `
Name: e0 1 601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
Address: Reconnect only 66.85 2
City /State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 1 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 an to 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
t ;gar a »ea• r r t eta ,; , , K - � i mft q e� s , nevi• A. Foe for branch circuits with '
n Alk c,5 ri i I c dr • �hr Ili s* � -. a a4 g t .r, e tt ��
s o.x,' k �al�L� a +Snaii?.:l��a,srat 7 ?t.. aTsz ➢.��z 4 zxd„c ;.dr�tca.2 asu sir aeak3et, ifF. P` serv or feed f ee, cac 6.65 2
Business name: branch circuit .
B. Fee for branch circuits
Contact name: without service or feeder fee , 46.85 �1� C 2
each branch circuit
Address: Each add'i branch circuit - r! 6.65 _ f3 � 2 •
City /State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax: ( )
Sign or outline l ighting 53.40 - 2
E-mail: Signal circuits) or limited -
U , �'s $Qraia =r``Y 3 ' � '�,' ' �'` §r ai . ''tA : yc72•"� ' ,. '}e �i�{,a i dyK . .��'1�1 d q { �" F ener
2 gy panel, alteration, or
ts�� u.F .Yfly O ki 3c�r"9Yis�� i.xi.`#lM ere..: d „cJvFx kr�fu kl.F?f5�eIe € tie3
extension. Describe: Page 2 2
Business name: (x},1(4 ex,. a d`( I(,,t. e Tilt c (,....c.___ -
Each additional inspection over allowable in ally of the above
Address: e 11 ,Sex. 236 s 7 _ Pa inspection 62.50
City/State/ZIP: T2 1 wit”? C n 99-26- ( Investigation per hour (1 hr min) 62.50 .
Industrial plant per hour 73 75
Phone: (.523 ) (c2s! - SG, ( Fan: ) 2 Y - Z$ Aff rS ri e Z r CLY >,;5 �, ate Mar s r , .� . ,..
CCB Lie.: /5-6 5 i Electrical Lie.: ' 1( - C. IC. Suprv. Lie.: ii s Subtotal q / 5—
Suprv. Electrician signature, required: Plan review (25% of permit fee)
State surcharge (8% of permit fee) 9r b
Print name: 01 i.- f r • Date: /2 _4 _ , y TOTAL PERMIT FEE y r f b
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
istaciimngPennits \Eraretmiuhpp.aoc 12/03 44046 15Tt10/02/cohvwra
CITY OF TIGARD 24 -Hour - ,
BUILDING Inspection Line: (50$) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received Date Reques ed /c � 7 AM PM _ BUP
Location 6 • 4J !! dA I Ai_ J AP Suite 373 MEC
Contact Person Ph ( I ) PLM
Contractor Ph ( ) 67 ' — 3 3/ SWR
BUILDING Tenant/Owner ELC
Footing ELC r-d1OL V- 0c7 7 3
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: 3 ) SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear •
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof •
Other:
Final
/44
PASS PART FAIL
PLUMBING
Post & Beam
• Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains •
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Firee Alarm
..1 PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE LI Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA Date / L Ins ecto / 4 Z'�' - _ j , Ext
Approach/Sidewalk P
Other:
Final DO NOT REMOVE this inspection record oni the job site. .
PASS PART FAIL