Permit - a� o g
CI TY OF T I GA R D ELECTRICAL RESTRICTED ENERGY PERMIT
DEVELOPMENT SERVICES PERMIT #: ELR2006 - 00234
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/27/2006
PARCEL: 1 S 135AB -01004
SITE ADDRESS: 10220 SW GREENBURG RD 410 ZONING: C -
SUBDIVISION: LINCOLN CENTER/TWO LINCOLN LOT: JURISDICTION: TIG
Project Description: Burglar Alarm.
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: PROTECTIVE SIGNAL: X
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
EQUITY OFFICE PROPERTIES TRUST SONITROL PACIFIC
ONE SW COLUMBIA #300 8220 N. INTERSTATE AVE.
PORTLAND, OR 97258 PORTLAND, OR 97217
Phone: Contact #: PRI 223 -5822
FAX 503- 973 -7773
FEES Reg #: ELE 26- 370CLE
LIC 53535
Description Date Amount SUP 3567LEA
[ELPRMT] ELR Permit 9/27/2006 $75.00
[TAX] 8% State Surcha 9/27/2006 $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.
Issued By: � Permittee Signature: <jy - C P�
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.
El ctrical Permit App " io� �rn - -- FOR OFFICE USE O •
�J /` n
City of Tigard Date : Received (' / V ` � , 1 /,Q ,„ Ay
13125 SW Hall Blvd., Tigard, OR 97223 D 9 vi ' Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 SE ,f (+ ' 4 %;ht ,116'\ Date/B : Other Permit:
Inspection Line: 503.639.4175 _AV. ' ,_W Notifie d/Method: Supplemental Date Ready/By: 0 See Page 2 for
Internet: www.ci.tigard.or.us y pp allnformation
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�( PLAN' rRE�?IEW
" Please check a ll that apply:
❑ Newtconstruction � Add / rep PP y
['Service over 225 amps, comm'l ❑ Hazardous location
❑ Demolition ❑ Other: .
<.: ; �. -.:. . �: -., 3..13....::1. ;:;: ..::. ....... . ...:...: .....:, :. _
❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
:':'.r rf ' =,: COI!(STRU.CTION' t.? ::: "` : "`'i »4i of 1 -and 2-family dwellings 4 or more new
.: -. .. << . teal
. .
❑ 1- and 2- family dwelling ,Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family ❑Master builder CI Other: ❑Buildin over three stories ['Feeders, 400 amps or more
7 •' � x:- t:; �;'.:....:..:...:.:.:. �;:, �;.:.;.;: .:. >::::, ;:.:.::• •= persons red structures or
Occupant load over 99 a Manufactured
''�' ; .:; JOB:!:S'ITE:�INF.ORMATION:''AND LOekiii' Y. �' - `'.'< '-` ` " '!; .
:.:...:::. ..:..::- :: ;,... ,.:.::.._ �:..:.:,.;.,..-;....: �::...:.:.•--:.: ... .:1::.:•..:'.: ;- .:'.- ;::.::.:_ gressighting RV park
Job no.
L ❑Health -care facility ❑Other:
6 7 Job site address: C 220 ( PI11X.1�q'
Q v d Submit 2 sets fa plans with any of the above.
City/State /ZIP: 11% C A (-)� 9 7 223 The above are not applicable to temporary construction service.
H , ^ I '4. ; % i ;.c; c. ; <%i,,FEE .$::00ED.LIL,'E:�': . •
Suite/bldg. /apt. no.:S yi l.Jt Project name: t f l 2 �ln �7 S� Q. Description Qty. I Fee. I Total I . Cross street/directions to jo site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
- _ .. a °: *< - _ : < ,5 ; .
Limited energy, non - residential 75.00 2
- ••< � - •:t ":• • a ' -• ... >:': . - Each manufactured or modular
< >. ;_. � :DESCRIP. ION ;UF= :�YORK� -'� ' . .
dwelling, service and /or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
yc:;'. : . : :.....:,r ::n..,.:.:.,; zr r 201 amps to 400 amps 106.85 2
...3...::3.3. :, ,:,.. , ; p
:..:_._,❑, ; ROPERI'Y'. ;.UWNER�:`'':• ' ❑'.�:TENAI\T' =` ;'
_
:, _..K... ,..:... >.._,... ; .:., .::.� •. :_: 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 1 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
. ...:. .,,. 3.3.: • -.:�
- .Av:• .:- - . ,, : _ A. Fee for branch circuits with
;:, :.: . :: 3. 74 ' ® . ®?CO1V'IAt T:V „..„ SON [ ;
::;•, :...,..�= ., ; : <�:,.:..::: • • : ;. < .. ;:,..,� � ? ::- • ..:.::... .: < .: - � :: ,,,..,:-.,:e.':-..:;:4';'' .- :. •: :
" service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
each branch circuit 46.85 2
Address:
Each add'I branch circuit 6.65 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax:: ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited -
? •i :. ? y energy panel, alteration or
- Y ,
�: • N . iT ... R .,:
g P
extension. Describe: 1 Page 2 2
Business name:
�3 1 Rotcl�•\c- 75
Address: R
_0 I UQt I ` c>..Ln, •i � �� Each additional inspection over allowable in any of the above
�� Per inspection 62.50
City/State /ZIP: 'o\ asl A I OZ t 9 7,R Investigation per hour (1 hr nun) 62.50
Phone: (r ) 223 - 5 R' 2 2 Fax: ( 5 3 3 ) 9 73 _ 777.3 Industrial plant per hour 73.75
.. .,.. - . 'ELE'CTRICAL PE'RM'IT..' FEES *, ,,,..:: .7:..: ;.
CCB Lic.: 535 Electrical Lic.: a6 3 7 .(j Suprv. Lic.: Subtotal 76 , 00
v
Suprv. Electrician signature, required: Plan review (25% of permit fee)
State surcharge (8% of permit fee) tr> • 00
Print name: Date:
TOTAL PERMIT FEE 31 . o6
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board
" Number of inspections per permit allowed.
i:\ Building \Perrnits'ELC- PerrnitApp.doc 12/03 440 -4615T(10102 /COM/WEB
r'
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL 00, 4∎I e
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:
�T°. m.' e! �- w:: ....- ?art-.me _
Fee for each commercial system $75.00
(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* •
7 i,_ 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 04/03