Permit ELECTRICAL PERMIT -
CITY TIGARD RESTRICTED ENERGY
DEVE Hall O PMEN Tigard, o
SERVICES -00379
2CES (503) 639 -4171 DATE ISSUED: 12/17/03
/
SITE ADDRESS: 10260 SW GREENBURG RD * ** PARCEL: 1SI35AB 03400
SUBDIVISION: LINCOLN TOWER -TOWN OF METZGER ZONING: C -P
BLOCK: LOT: 014 JURISDICTION: TIG
Project Description: Limited energy for fire alarm wiring. Job No. 23 -672FA
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:
EOP LINCOLN, LLC CAPITOL ELECTRIC CO INC
10260 SW GREENBURG RD 11401 NE MARX ST
SUITE # 100 PORTLAND, OR 97220 -1041
PORTLAND, OR 97223
Phone: 892 -2500 Phone: 255 -9488
Reg #: MET 00004542
LIC 048748
SUP 3132S
FEES ELE I84d Inspections
Description Date Amount Low Voltage Inspection
[TAX] 8% State Surchart 12/17/03 $6.00 Elect'l Final
[ELPRMT] ELR Permit 12/17/03 $75.00
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
d within-480 issuance, o
days of issuancr 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 throuc
4„..•
ssued by !.�'`� � ■ , � / Permittee Signature X -
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 7:00 P.M. for an inspection needed the next business day
f
OFFICE USE ONLY
/\ .'•+. Electrical Permit Application Date received: Permit no.: • ',,,p —' V 7r
Project/appl. no.: Expire date:
I City of Ti
�, ,aL Y and g Date issued: By: Receipt no.:
CITY OF TIGARD Address: 13125 SW HALL BLVD, TIGARD, OR 97223 Case file no.: Payment type:
Phone: (503) 639 -4171 Fax (503) 598 -1960
Land use approval:
TYPE OF PERMIT
❑ 1 & 2 family dewlling or accessory • Commercial /industrial ❑ Multi- family ❑ Tenant improvement
❑ New construction • Addition /alteration /replacement ❑ Other: ❑ Partial
JOB SITE INFORMATION
Job address: 10260 SW GREENBURG RD City: TIGARD Bldg. No.: Suite no.: Tax map /tax lot/account no.:
Lot: (Block: N/A (Subdivision:
Project name: LINCOLN SITE, PH - (Description and location of work on premises: CONNECT FA CIRCUIT TO COILING FIRE DOORS
Estimated date of completion/inspection: 12/22/03
CONTRACTOR APPLICATION FEE SCHEDULE
Job no: 23 -672FA Fee Max.
Business Name: Capitol Electric Co., Inc. Description Qty. (ea.) Total no. insp
Address: 11401 NE MARX STREET New residential - single or multi - family per
City: Portland State: OR ZIP: 97220 dwelling unit. Includes attached garage.
Phone: 503 - 255 - 9488 IFax: 255 - 9488 IE - mail: darrellAcepdx.com Service included:
CCB no.: 48748 'Elec. bus. lic.no: 26 - 496C 1 000 sq, ft, or less $ 145.15 4
/metro lic.no.: N/A Each additional 500 sq. ft. or portion thereof $ 33.40
l'f!) /„yf,4 12/16/03 Limited energy residential $ 75.00 2
Signature of supervising electrician (required) Date Limited energy, non - residential $ 45.00 2
Sup. elect. name (print): Darrell McNeeI License no.: 3132 -S Each manufactured home or modular dwelling
- 'PROPERTY OWNER Service and /or feeder $ 90.90 2
Name (print): EQUITY OFFICE Services or feeders - installation,
Mailing address: ONE SW COLUMBIA, SUITE 300 alteration or relocation:
City: PORTLAND I State: OR IZIP: 97258 200 amps or less $ 80.30 2
Phone: 412 -4800 Fax: IE -mail: 201 amps to 400 amps $ 106.85 2
Owner installation : The installation is being made on property I own 401 amps to 600 amps $ 160.60 2
which is not intended for sale, lease, rent, or exchange according to 601 amps to 1000 amps $ 240.60 2
ORS 447, 455, 479, 670, 701. Over 1000 amps or volts $ 454.65 2
Owner's signature: Date: Reconnect only $ 66.85 1
ENGINEER • Temporary services or feeders -
Name: installation, alterations, or relocation:
Address: 200 amps or less $ 66.85 2
City: State: ZIP: 201 amps to 400 amps $ 100.30 2
Phone: Fax: E -mail: 401 amps to 600 amps $ 133.75 2
PLAN REVIEW (Please check all that apply) Branch circuits - new, alteration,
❑ Service over 225 amps - commercial ❑ Health -care facility or extension per panel:
❑ Service over 320 amps- rating of 1&2 ❑ Hazardous location A. Fee for branch circuits with purchase of
family dwellings ❑ Building over 10,000 square ft. four or service or feeder fee, each branch circuit $ 6.65 2
❑ System over 600 volts nominal more residential units in one structure B. Fee for branch circuits without purchase
❑ Building over three stories ❑ Feeders, 400 amps or more of service or feeder fee, first branch circuit: $ 46.85 2
❑ Occupant load over 99 persons ❑ Manufactures structures or RV Park Each additional branch circuit: $ 6.65
❑ Egress /lighting plan ❑ Other: Misc. (Service or feeder not included):
Submit sets of plans with any of the above. Each pump or irrigation circle $ 53.40 2
The above are not applicable to temporary construction service. Each sign or outline lighting $ 53.40 2
Signal circuit(s) or a limited energy panel,
alteration, or extension* 1 $ 75.00 75.00 2
*Description: FIRE ALARM CIRCUIT
Each additional inspectionover th allowable in any of the above:
Per inspection I I $ 62.50 I I
Investigation fee
Other
❑ Visa ❑ MasterCard Permit fee $ 75.00
Credit card number: / / Notice: this permit application Plan review ( ) $
Expires expires if a permit is not obtained State Surcharge( 8% ) $ 6.00
Name of cardholder as shown on credit card
$ withing 180 days after it has been TOTAL $ 81.00
Cardholder signature Amount accepted as complete.
—
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
� 2/2- Vel- AM PM BUP
Received ( T - D ate Requested 1
Location /0 Z 6 �� -0-44- n,cA Suite MEC
Contact Person I I) dY� Ph ( _ 1'4 ?7/ 5 ,6
Contractor �r$ ( Ph (() 5O 6 3 279' SWR �/
BUILDING Tenant/Owner --6703 75`"
Footing
Foundation ELC
g Access: LR - :d 3 7?
Ft Drain
Crawl Drain
Slab Inspection Notes: u LL J SIT
Post & Beam
Shear Anchors ' V\ C 0 \X) M� �s
Ext Sheath/Shear W VJ�
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
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
ow Voltage
Fire
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
S • Please call for reinspection RE: • Unable to inspect — no access
Fire Supply Line
ADA Date Z �� In spector Ext
Approach/Sidewalk
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL