Permit 7
mi.- 0
III 3 ELECTRI AL RESTRICTED ENERGY PERMIT
. CITY OF TIGARD
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00080
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/19/2007
PARCEL: 1S135AB-01003
SITE ADDRESS: 10300 SW GREENBURG RD 100 ZONING: C -
SUBDIVISION: LINCOLN CENTER /ONE LINCOLN LOT: JURISDICTION: TIG
PROJECT: CHASE
Project Description: Low voltage T - stats.
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: OUTDOOR LANDSC LITE:
OTHER: HVAC: X PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
EQUITY OFFICE PROPERTIES TRUST AMERICAN HEATING
ONE SW COLUMBIA ST #300 1339 SW GIDEON ST
PORTLAND, OR 97258 PORTLAND, OR 97202
Phone: Contact #: PRI 503- 239 -4600
FAX 503 -239 -7038
Reg #: ELE 26- 993CRE
FEES LIC 33135
Description Date Amount
[ELPRMT] ELR Permit 3/19/2007 $75.00
[TAX] 8% State Surcha 3/19/2007 $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: ,X 4. � i G-----
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.
a • •
Electrical Permit Ay {f^`¢ � r - '1 . . FOR OFFICE USE ONLY ' _
City of Tigard `� pag ' (r Pemrit ea_cen —A k
13125 SW Hall Blvd., Tigard, OR 9 7223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 t ' ►1� O I %e % u r. �j l I '� DatE/g : Other Permit. Inspection Line: 503.639.4175 ?dzi\ 1 t.., �D a £' ,I Date Read /B Juris: 0 See Page 2 for
Internet: i �� W Notified/Method: Supplemental formation
Ready /By:
www.cl h gard.or.us , Supple Information
. �": "`f Tj � , a .. 'J��k 5�+� ,+s�'. -,� � � ,:a 7� �_ -�. r,,} <� -: "' s' �•Y_ .r,.r.�. •.,•. •p•.
L 'i'"� - • � c� :�. r a, `c: •B' , 3 a", ,, r`r iY '• „,,,. 2vrf- - - .+�. «.a •s ^••h,a .,:'- ;
❑ New construction ' 0 • e dltiorl/alieration/replace , Please check all that apply:
❑Service over 225 amps, comm'l ❑Hazardous location
❑ Demolition 0 Other:
r -� . � xa -M--1,-",-, • � ❑Service over 320 amps – rating ❑ Buildng over 10,000 sq. ft.,
R r s? • ., , E e 91 d. ..:11 ® g of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling [ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories OFeeders, 400 amps or more
❑ Multi family ❑ Master builder ❑ Other: _ _ DOccupant load over 99 persons ❑Manufactured structures or
n = 's``'f ,�, .r: ``' C ` i e , ' e�' a � / �+� l - � I + r r DEgress/lighting plan RV park
la 1030 S W a 00' &.uc Qc ❑Healthcarcfacility ❑above.
Job no.: J ob s ite address: Submit 2 sets of plans with any of the above.
City /State /ZIP: & , c) e_ The above are not applicable to temporary construction service.
■ Suite/bldg. /apt. no.: \0 0 Project name: _, .1t fi 1 !, ",I3+ , ` k::,. :.h %r .I .' ' ':':7 1 ) :604-i4 - : . ; :.: P! ,::.: ..
. ll•-1 111
Description M Qty. I Fee. I Total .._
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax ma /parcel no.: _ "�� Limited energy, non - residential 75.00 2
d o : o '� �! Each manufactured or modular
ql G ,, ,, c r - f , v dwelling, service and /or feeder 90.90 2
C ib U3 Vo l .T Ac ` .)t (i I' 1Q Services or feeders installation, alteration, and/or relocation
U J 200 amps or less 80.30 2
k a - ti w i s w w:1-1 `'r _ ;7„,74-.F Wa i 201 amps to 400 amps 106.85 2
f � .,�1 • x 4 -2 ''r`'- ,.G 401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
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
'"S" 'Q✓"'.v 3 c•t Wy'' i- M A' "����• giplini: `T' A - Fee for branch circuits with - .
k,:.k .,ZL • 1 + 8- service or feeder fee, each
Business name: p_ I ( �� 1 call branch circuit 6.65 2
�1 1 B. Fee for branch circuits
Contact name: 0 rr[��.1L.11 �J�tt without service or feeder fee, 46.85 2
. - G 3 L r 6 �� � t a
each branch cu
I
Address: 1 t Each dd'1 branch ch circuit 6.65 2
City/State/ZIP: 1 b \e4 Gin d, t 0 (2._ qi a 0 Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone:) ay _ q 6 I Fax: )aq 63 Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
r
£ ® te f energy panel, alteration, or 2
t ��s x extension. Describe: Page 2
Business name: AIM (i (°c a -t- not L f1C .
Address: ' -- cl SE a ci-. o r Each additional inspection over allowable in any of the above
Per, inspection 62.50
City/State/ZIP: ` L ' 4 qi a0a Investigation per hour (1 hr min) 62.50 -
Q Industrial plant per hour 73.75
Phone: ( ) 1–y. 0 I Fax ( ) � �� �3 D F M i 4 .V .1. tinaiia
CCB Lic.: 33 t 35 Electrical Lic.: , bQT3 (,LL Sup . Lic.: ).&-10 Subtotal / 5 -
Suprv. Electrician signature, required: _ i',W, Plan review (25% of permit fee) •
State surcharge (8% of permit fee) b —
Print name: `-"`�v� y n` Date: q.
"l / TOTAL PERMIT FEE g 1
Authorized signature: A „ ' ; A ` ` it, This permit application expires if a permit is not obtained within 180
days after It has been accepted as complete
Print name: e m m J a � ) o d n Date: 6 1-6 ` Fee methodology set by Tri- County Building Industry Service Board
J •• Number of inspections per permit allowed.
i:\ Building \Pcmits\ELC- PerrnitApp.doc . 12/03 440- 4615T(10 /02/COM/WEB