Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
1
DEVELOPMENT SERVICES PERMIT #: ELR2006
� IW 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/10/2006
PARCEL: 1 S 135AB - 01003
SITE ADDRESS: 10300 SW GREENBURG RD 410 ZONING: C -
SUBDIVISION: LINCOLN CENTER /ONE LINCOLN LOT: JURISDICTION: TIG
Project Description: Voice & Data.
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 ORE -COM TELECOMMUNICATIONS
ONE SW COLUMBIA ST #300 13826 S. MEYERS RD. #2127
PORTLAND, OR 97258 OREGON CITY, OR 97045
Phone: Contact #: PRI 503 -381 -7281
FEES Reg #: ELE 34 -691 CLE
LIC 152834
Description Date Amount
[ELPRMT] ELR Permit 10/10/200€ $75.00
[TAX] 8% State Surcha 10/10/200€ $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 ollow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR •.• - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503 - 246 -6699.
Issued By: ,,,
f l 3 1 2 Permittee Signature: I . 1
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.
Electrical Permit Application ' . i �olzoFFICE USE O ��IY / - :-
City of Tigard �p ,: Date/ Received a / / �L / Permit
No. / L W (, -Oao2/ ,t
a 13125 SW Hall Blvd., Tigard, OR 9.7223= \ .
g v Plan Review
• . ' 1 ,1 2 ` Phone: 503.639.4171 Fax: 503.598)1960 — Date/B . Other Permit:
TIG A R > D Inspection Line: 503.639 O C T . 1 ^ (' Daze Ready/By: ® See Page 2 for
Internet: www.tigard or.gov `) Notified/Method: Supplemental Information
TYPE OF WORK' %: i "' * " y. " ' y,, PLAN REVIEW
• ^.e 9�r5A1
El New construction Addition/alter
� atton / repla r: e Y AYOV "]I ce ment . • 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
❑ 1- and 2- family dwelling KCommercial/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 ", "l - ", "l -3 ",
Q� 100HP or more. occupancy.
Job no.: Job site address:
ID 5lf•l�j° �v Y'�7 • ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: 1161;41 (O Z-2 El Health-care facilities. ❑ Supply voltage for more than
t t�. / ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Li f) Project name: U Vc f,. A 4� ❑ Service or feeder 600 amps ormore.
�`\ y FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total 1
r�
New residential single- or multi- family dwelling unit.
L 11"G . 'tbtrOER -- 7-- 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 1
Limited energy, residential 75.00 2
• DESCRIPTION OF WORK (with above sq. ft.)
. Limited energy, multi - family 75.00 2
VO1C C •¢- j)P4 UA4 (, /MT' residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
• 200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ 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 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 599 amps 133.75 2
. Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
A APPLICANT ❑ CONTACT PERSON above service or feeder fee,
((��� each branch circuit 6.65 2
Business name: plat' "CzThA._ - reECOMfAtt?N ICJ43'T't -pJ 5 B. Fee for branch circuits •
without service or feeder fee, 46.85 2
Contact name: Doit� Q � first branch circuit
. Address: i 313-2 it s 0,,p - 2 Z'l Each add'l branch circuit 6.65 2
n Miscellaneous (service or feeder not included)
City /State/ZIP: o � C.1`C''1 , cK .- 1-104 S Each manufactured or modular 90.90 2
s ;01.�?Z Fax :: 03 657_. 4113 Reclnne,tonly 66.85 2 and/or feeder
Phone:
( a ) ( ) I 3 Reconnectonl
E -mail: cle ,.., ea. o.' - G A" , C„a "A.. Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
•
Business name: Signal circuit(s) or limited -
�l energy panel, alteration, or
Address: extension. Describe: Page 2 2
City/State/ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( )
Investigation per hour (1 hr min) 62.50
CCB Lie.: 1 $39 Electrical Lic.:3y_ C.E Suprv. Lie.: '8 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES •
. Suprv. Electrician signature, required: ` Subtotal:
Date: Plan review (25% of permit fee):
Print name:
Dou �9' in-10 -0‘ State surcharge (8% of permit fee):
Authorized signature: TOTAL PERMIT FEE:
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 \Permits\ELC- PermitApp.doc 05/23/06 440-4615T(1 I /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:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
• ❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
• ❑ Other: '
4 'COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
•
•
system
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
. ❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls - -
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
•
❑ Other
Total number of commercial systems:
•
*No licenses are required. Licenses are required
for all other installations
C\ Building \Permits\ELC- PermitApp.doc 0323/06
CITY OF TIGARD
BUILDING DIVISION .
PERMIT #: ELR2006-00246
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/10/2006 .
Phone: (503) 639-4171 IVA t
Inspection Requests (24 Hrs.): (503) 639-4175 ...„, -....
INSPECTION WORKSHEET FOR DATE: 10/13/2006 TIME: 7:00AM PAGE: 3
SITE ADDRESS: 10300 SW GREENBURG RD 410 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/ONE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: BUCKENDORF
DESCRIPTION: Voice & Data.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: ORE-COM TELECOMMUNICATIONS "0 0‘,3 Cr, .\) PHONE #: 503-361-7281
Inspection Request Scheduled For: Date: 10/13/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
03E11138-01 503-381-7284 Y
\otc\ Vollf4A,
• - • . • II II - 1 ructions:
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Il k
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6I
PAS 7 PARTIAL APPROVAL El CANCEL NO ACCESS
—
I FAIL r7 CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector: Gm NI ( 6 ( 6 1 -C - Date: t ° I I 31 06 Phone #: (503) 718- ZA
. ,.