Permit t
CITY OF TIGARD ELECTRICAL PERMIT
•
PERMIT #: ELC2005 -00645
DEVELOPMENT SERVICES DATE ISSUED: 9/2/2005
° 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S135AB - 01003
SITE ADDRESS: 10300 SW GREENBURG RD 560 ZONING: C - P
SUBDIVISION: LINCOLN CENTER /ONE LINCOLN LOT : JURISDICTION: TIG
Project Description: (2) branch circuits.
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: 1 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: 503 - 293 -2745 Phone: 503- 624 -3631
FEES Reg #: LIC 75059
Description Date Amount SUP 1965S
ELE 34 -283C
[ELPRMT] ELC Permit 9/2/2005 $53.50
[TAX] 8% State Surcharge 9/2/2005 $4.28 REQUIRED ITEMS AND REPORTS
Total $57
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: A.Ae S Permittee Signature: (2j VV
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.
SEP 01 2005 10:50AM HP LASERJET 3200 p.2
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L .a trical Perm App lication ( { gip ., " . FOR OFFICE USE ONLY
M � �� l Dat eBY: ved G� J � � Pertn C�+�: cNo. �l,ti�•G'ds as i ! s"
, City of Tigard atel 1'3125'S W Hall Blvd., Tigard, OR 97223 1 Plan R:.vite:t l other Permit:
Phone: 503.639.4171 Fax: 503. 598.1960 9 'jO (i"�'` ° '1j1^1.' ^'I'' Date/B
f , ,� •
Inspection Line: 503.639.4175 Sr !� r . • Date Read y B y: 1wi RI See Page 2 tor
l lnformation
rd.or.us ot�edMMetnod
Internet: www.ciligard.or.us :.'� »'3. ."G:'1'". . ; 4� '� " : t r Ly: �f� . "}:� �: /`..t`, :; \'3'�i :ANT :. j i :.
!��3•-' ^, .' : t 'S1 c" "=. Y,`(.' . t't' l "" : i .S' P.: 7 ; .t ; l& '! t,.. • iik:' , �`, �
l�'� rr l,' 'C � q�,q , t e.. ,.'. 41 ,';t i E� n� -.:q 4 l. F 1, ,r . y,.• i��` s a is F , t " �:,: rs::,:-•.,: .r.t.. a ,... ,'�±�"• .
'9S- � :ta' { 1 c . � > Ay d�r o- {� a �. ddi...,..' i . .t��:. ., ?.la ::=�. '.',';�6'd..�i'� � '.• ° f ,
,.s,., •'` .,:2' i�tt .u� � - rx r<.az :....:�,;.x,:r.. l'v. •:. '�
i r 1� }.a Please check all that apply:
New construction Addifrdtrfai�e�a ton%ieplacement ❑Service over 225 amps, comm'l ❑Hazardous location
❑ Demolition ❑ Other: ❑Service over 3 20 amps - rating ❑ Buildng over 10,000 sq. ft.;
' t+ .7 i - '.`a tJ 1P 1, t1 "7. - : , a -"-'a. it I'T �, d Sri z: ' l ei li: ∎ T._ _ :; r E �,`' •.. n. -- s
,r • , x , 4 F €. )' , >'_ ` ,, , �,, ! € Utyt , �, � r ' r. ,y o 1- and 2- family dwellings 4 or more new residential
n � Y t , r �'= S>€s u a, z „t ,k •
� -�•t�� �� 'tom ^ln�.<`- �"� "t r ` ❑System over 600 volts nominal units in one structure
CI • 1 - and 2-family dwelling ® ComtnerciaUindustrial ❑ Accessory building ['Building over three stories ['Feeders, 400 amps or more
❑ Multi family ❑ Master builder ❑ Other: ❑Occupant Ioad over 99 persons ❑Manufactured structures or
1, Ji `
l ' i ;r �" f a F `s 7 t 1 r " r 4� tt 'I u i ig 1�4 1. -, RV park
4 g it i tfi i iitia t +, 1 i' €s,i 1i t kt ' e i " ,:, s i i r 4 ❑E p
�<�, �t.,>v -x'• 1n �,11c.L��,.�i.,t,�.)ie�':U ?s. tis_ jsl .�2 ,�u."e1.�.9.�. , .�. Diu �.:�'b ,¢S���i:...
Job no.: ❑ 0liter:
❑Health -care facility
( 5 �- Job site address: 1 3O e.., S� J �ftzv., . �2v r . Submit., sets of plans with any of the above.
City/State /ZIP: r....'4 (� o 1-z 2- `l The above are not applicable to temporary construction service.
T.1 a �� �"' i y��'dp�' � v �17� � G T g52.+tt..GFS MEWED �,1���S�L ,xetC k o '.." ,
Suite/bldg. /apt: no 546 I Project name: ( Q ` 1A,0 / i 4 Destrlplson Qty. Fee Total
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage.
" e S V r ( 1,000 sq. f. or less 145.15 4
I Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Subdivision: Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non-residential , 75.00 • 2
T`' ,, Each man or mo dula r
dwelling, service and/or feeder 90.90 2
� �t 1 kn n 4 ,-, L e �y-e,,, A Services or feeders installation, alteration, and/or relocation
11 r 200 amps or less 80.30 2
3 ; , y axr $ 201 amps to 400 amps 106.85 2
r x i t , t s� y xs ri f lt ivt^3(" i i`11i ``� 1Efi gg S r s d, i . .
.. r -� r r t`f : l'A t v - i t ..t 1. } fis t i_ . - ,., . 2.,1 , 401 amps to 600 amps 160.60 2 •
Name: gc i, L 601 amps to 1,000 amps 240.60 2
Name: � N r �^ 454.65 2
_Over 1 am or volts
Address: 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
, ,h j 1 T 5 t , z� 1 i, 1)xti , i oalo it, i 4 i >� i " acct F - i t d F 1 i r # A. Fee for branch circuits wi th
� ,. , , , ,.. -- •t: ,, yi,,,„ h it ,,,, h s 5 ,.. 3. =- y ....... ,. fLC RO" f ll:.,.Yc .h :Y. ;.fieik`� :•.i“:1.`i7'e:i i r, - rtid - service or feeder fee, each
6.65 2
Business name: branch circuit
• _
B. Fec for branch circuits 'l
Contact name: without. service or feeder fee, / A 46.85 y4 2
each branch circuit G t:' 2
Address: Each add'l branch circuit / 6.65
City /State!ZIP: Miscellaneous (service or feeder not Included)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax: : ( ) Sign or outline lighting 53.40 2
E-mail: Signal circuit(s) or limited -
5 x „ x z;� ei F ; :F: �j } I It;, :r. I energy Panel, alteration, or
,r` " 'mci' M 1 kR u's s 8. t 'r`",., v rI r� _> •c,.i 1�,s...' s 4,_, f#. it P e 2 2
k.`'v tC 8'. ;�nL extension. Describe: g
Business name: up y i it vi..vt ti � , ( •t ,,, 1 . 1 1, le tin AL -
Each additional inspection over allowable in any of the above
Address: r. C.) . z.. 0 .5 4 .1_ Per inspection 62.50
�, i , [�1 ? Z & I Investigation per hour (I to min) 62.50
City/State/ZIP: TtSyt- �..>!J 11 _/
J Industrial plant per hour � 3.75
Phone: (sQ�) G2� - 3 Lt ( I Fax: (57y3) (sYZ`� - Z°13 u , : ti r a .,ft•nam ,1: to : t �. ;: , ; ,, .. : , 4 , ; ..
CCB Lie.: 9- 5"q Electrical Lie.: . 76-3 C.I Suprv. Lie.: (4' G 5 Subtotal t 57) •
�
- n � Plan review (25% of permit fee)
Suprv. Electrician signature, required: y
State surcharge (8% of permit fee , L�
Print name: e Date: ` j '. 5 -, 73 I -
TOTAL PER FEE
Authorized signature: This permit application expires If a permit is not obtained within 1511
days after It has been accepted as complete
I Date: Fee methodology set by Tri�ounty Building Immustry Service Board
Print name: " Number of inspections pen permit allowed_
i,\ nui lding \Penn,ts.BLC•PerrnitApp.doc 12/03 440 4613T(1Lt02/COWWEa
CITY_ OF TIGARD - l .
BUILDING DIVISION ( PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: ELC2GCI5 -00615
Phone: (503) 639 -4171 Ai„,, l,,�i li 912/2005
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/28/2005 TIME: 7 :08AM PAGE:
SITE ADDRESS: 10300 SW GREENBURG RD 550 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER /ONE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: TRIAD INTERNATIONAL
DESCRIPTION: (2) branch circuits.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE # : 503- 293.2745
CONTRACTOR: WILLAMETTE ELECTRIC INC PHONE # : 503-624-3631
Inspection Request Scheduled For: Date: 9/21312005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 016846-01' 503 -624 -3631 N
Corrections /Comments /Instructions:
I
i
I
PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL I I/ LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
s
Inspector: / Date: f Go hcc Phone #: (503) 718 - 2. •