Permit Er CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2006 - 00298
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/6/2006
PARCEL: 1 S 135AB -01003
SITE ADDRESS: 10300 SW GREENBURG RD 485 ZONING: C - P
SUBDIVISION: LINCOLN CENTER /ONE LINCOLN LOT: JURISDICTION: TIG
Project Description: LANDMARK. 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 BRITTINGHAM ENTERPRISES INC
ONE SW COLUMBIA ST #300 PO BOX 1978
PORTLAND, OR 97258 SISTER, OR 97759
Phone: Contact #: PRI 541 -549 -1977
FEES Reg #: ELE CLE48
LIC 144883
Description Date Amount SUP 925LEA
[ELPRMT] ELR Permit 12/6/2006 $75.00
[TAX] 8% State Surcha 12/6/2006 $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 or 1.800.332.2344.
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.
c
i. Electrical Permit ApplicationECEIV
'FOR OFFICE USE ONLY
111 City of Tigard r ii De e d 1 'e rmit No.: e ,, # '
13125 SW Hall Blvd., Tigard, OR 9722 b o b 2006 Plan Review ( `
D Other Permit:
Phone: 503.639.4171 Fax: —
Date/B .
Inspection Line: 503.639.4175 ��(Y OF °fiGARO DateReadyBy: la See Paget for
TIGARD
g g BU ILDING DIVISION Internet: www.ti ard -or. ov ON Notified/Method:
Dae Read Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction O ,Addition/alteration/replacement 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 DiCommercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB. SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", `T ", `9 -2 ", "1 -3 ",
' Job no.: Job site address: (0 309 e�,,� /1 f ep I00HP or more. occupancy.
G ❑ Six or more residential units. ❑ Recreational vehicle parks.
City / State/ZIP: • I Q2+ L A. C ` Co. 9'7 • ❑ Health -care facilities. ❑ Supply voltage for more than
/ / ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 965 Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I
New residential single- or multi - family dwelling unit.
' 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
VOvCze— 4- JIJ Ai j A residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
• ❑ PROPERTY OWNER Of TENANT - 201 amps to 400 amps 106.85 2
401 amps to 600 amps. 160.60 2
Name: I
M Pat 4 (.1) R -T c,A 6, -e 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
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
A. Fee for branch circuits with
❑ APPLICANT MI . CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name:
Qet Ty' nJG,b- (/}s-1 'i} tSe.S ltic B. Fee for branch circuits
✓ without service or feeder fee, 46.85 2
Contact name: t� ,,� aikn e� first branch circuit
Address: E'o 1k lc,1.6 Each add'I branch circuit _ 6.65 2
Miscellaneous (service or feeder not included)
. " City / State/ZIP: SStt-t`s on 97757 Each manufactured or modular
90.90 2
1 dwelling, service and/or feeder
Phone: ( 5 y/) S`{9 „ 1 9-7 - 7 Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name: 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 (I hr min) 62.50
CCB Lic.: "I t-N(jlj3 Electrical Lie.: LC 8 Suprv. Lic.:Gj25LCA Industrial plant per hour 73.75
• • ELECTR 1CAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal:
Print name: e e, /� Date: /E. 46 Plan review (25% of permit fee):
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 \Pennits\ELC- PermitApp.doc 05,23/06 440-4615T(11/05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
- RESIDENTIAL WORK °ON•LY,
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:
COMMERCLAL WORK ONLY: 1
Fee for each commercial $75.00
system
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
E l Audio and Stereo Systems
• ❑ Boiler Controls
El Clock Systems
❑ Data Telecommunication Installation
•
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
• ❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
• . ❑ Nurse Calls
❑ Outdoor Landscape Lighting*
El Protective Signaling
❑ Other
Total number of commercial systems: _
*No licenses are required. Licenses are required
for all.other installations
I: ' Building \Permits\ELC- PermitApp.doc 03/23/06
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BUILDING DIVISION ~°~,"~~~~,,°~" ~°.~.~°"~~.~ pERK4|T ELR2006-00298
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/612006
Phone: (503) 639-4171
Inspection Requests (24Hm�:(503)639'4175 ,�J�� ^ 1-
INSPECTION WORKSHEET FOR DATE: 12/8/2006 TIME: 01AM PAGE: 60
SITE ADDRESS: 10300 6WGREEWBURGRD485 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/ONE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: LANDMARK
DESCRIPTION: LANDK8ARK.Dxtm/7elmcnmmun\usdioOo.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: BRITTINGHAM ENTERPRISES INC PHONE #: 541'549'1977
Inspection Request Scheduled For: Date: 12/8/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 040018-01 971-506-1300 N
Corrections/Comments/Instructions:
•
ApAS8 PARTIAL APPROVAL �� CANCEL �� NO ACCESS
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FAIL fl CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
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]w [l��|�� / i �� Phone #: (503) 718- ,
|napmotInspector: ~^~� --~� Date: � �� \ gU /^�i^���
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CITY OF TIGARD
BUILDING DIVISION. J.A PERMIT #: FLR2006-00293
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/6/2006
Phone: (503) 639-4171 40/001,1
Inspection Requests (24 Hrs.): (503) 639-4175 A. - AIL
INSPECTION WORKSHEET FOR DATE: 1213/2006 TIME: 7:01AM PAGE:
SITE ADDRESS: 10300 SW GREENBURG RD 485 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/ONE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: LANDMARK
DESCRIPTION: LANDMARK. DatafTelecommunications.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #: '
CONTRACTOR: BRITTINGHAM ENTERPRISES INC PHONE #: 541_549.1977
Inspection Request Scheduled For: Date: 1202006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 040817-01 971-506-1300 N
Corrections/Comments/Instructions:
Al
PASS n PARTIAL APPROVAL I CANCEL 0 NO ACCESS
I I FAIL I I CALL FOR INSPECTION n ADDITIONAL, FEES ASSESSED
Inspector: I*6 L-IT Date: 1 11 a b( - ) Phone #: (503) 718-A
. ,