Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
kzt , ,r. DEVELOPMENT SERVICES PERMIT #: ELR2000 -00279
"��'� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/27/2000
SITE ADDRESS: 12123 SW 69TH AVE PARCEL: 2S101AA- 02900A
SUBDIVISION: TIGARD CORPORATE CENTER ZONING: MUE
BLOCK: LOT: OOA JURISDICTION: TIG
Project Description: 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:
TIGARD CORPORATE CENTER LTD CHRISTENSON ELECTRIC INC
15400 SW MILLIKAN WAY 111 SW COLUMBIA
BEAVERTON, OR 97006 STE 480
PORTLAND, OR 97201
Phone: 503 - 646 -2202 Phone: 241 -4812
Reg #: LIC 000458
SUP 3289S
PLM 2468S
ELE 26 -34C
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 11/27/200C $75.00 2720000000 Elect'I Final
5PCT CTR 11/27/200C $6.00 2720000000
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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
Issued by Permittee Signature au ,47 icy; 70j/ - A/9 L
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
•
Electrical PermitAppBt • Date received: 1/ 2/ Dz) Permit no.: EL/22oop 40!17•
r.0..., r„ ,
' .i�ii City of Tigard r`�y 2900 Project/appl.no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigart,0%/7 DI:VELOP�, ?Ef b ate issued: By2 # Receipt no.:
Phone: (503) 639 - 4171 , +'' IT
Fax: (503) 598 -1960 • Case file no.: Payment type:
CHUCK, CITY OF TIGARD INSPECTOR 639 -4171 EXT 356
Land use approval:
..' TYPE OF PERMIT'
0 1 & 2 family dwelling or accessory Nal Commercial/industrial 0 Multi- family 0 Tenant improvement
0 New construction 0 Addition/alteration /replacement 0 Other: 0 Partial
JOB SITE INFORMATION •
Job address: 12123 SW 6 9TH Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: I Block: I Subdivision:
Project name:RENINNANCE HOLDINGS I Description and location of work on premisesLOW VOLTAGE DATA /TELECOMMUNICATION
Estimated date of completion/inspection: Q UESTIONS? CONTACT CARL STENSRUD INSTALLATION .
- _ _. NI L Z 'P ; I.G.W .� s'rU�- , '�` }-c ti-- ._-j4 •. - .:..A- �;- !SCI�EI#-LL .4::::-.4;�..,....,14_,.,-:..k:......:_
Jobno: 119 -9070- Fee Max
Business name: CHRISTENSON ELECTRIC, INC. Description Qty. (ea) Total no. insp
New residential - shigle or multi- family per
Address: 111 SW COLUMBIA, SUITE 480 dwelling unit. Includes attached garage.
City: PORTLAND I State:OR I ZIP:97201 -5886 Service included:
Phone: 241 -4812 I Fax: 241 -0519 I E -mail: 1000 sq. ft. or less 4
CCB no.:
458 I Ele . bus. lic. no: 26 -34C Each additional 500 sq. ft. or portion thereof
Limited energy, residential 2
City /metro lic. ,o.: 5246 Limited energy, non- residential 2
Each manufactured home or modular dwelling
Signatu -, :'. • -mot'. Date 11/20/00 Service and/or feeder 2 ec
Sup. elect. name (print): License no: Services or feeders— installation; •
alteration or relocation:
........:.. OWNER : ,,...:.
200 amps or less • 2
Name (print): 7. /Gy2 b e'z et-,/ ,e_ G 77A 201 amps to 400 amps 2
401 amps to 600 amps • 2
Mailing address: / 5 yzi—� S'a /t.L/, e.„9, w r9Y 601 amps to 1000 amps 2
City: g E "27 / (State:6e_I ZIP: ?06 do Over 1000 amps or volts 2
Phone: - 6 y�, - ,2 Fax: (E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
•
which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocation:
200 amps or less 2
ORS 447, 455, 479, 670, 701.
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 am s 2
Branch circuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E -mail: Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
O Service over 225 amps- commercial 0 Health -care facility Each pump or irrigation circle 2
O Service over 320 amps- rating of 1 &2 0 Hazardous location Each sign or outline lighting 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
0 System over 600 volts nominal more residential units in one structure alteration, or extension* 1 75 . 2
0 Building over three stories 0 Feeders, 400 amps or more *Description: LV DATA/ TELECOMMUNICATION
O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lightingplan 0 Other. Per inspection 1 I I I
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ 7 5 .
0 Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ 6 ."
Expires accepted as complete. TOTAL $ 81 - 00 l
Name of cardholder as shown on credit card /
$
Cardholder signature Amount 440-0615 (6/00/COM)
•
Electrical'Permit Fees: • Limited Energy Fees:
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
P Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total 4, Check Type of Work Involved:
Residential - per unit
1000 sq. ft. or less . $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof _ $33.40 1 ❑ Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular . ❑ Garage Door Opener
Dwelling Service or Feeder $90.90 2
Services or Feeders ❑ Heating, Ventilation and Air Conditioning System*
Installation, alteration, or relocation
200 amps or less $80.30 2 ❑
201 amps to 400 amps $106.85 2 Vacuum Systems
401 amps to 600 amps $160.60 2 _
601 amps to 1000 amps $240.60 2 Other
Over 1000 amps or volts $454.65 2 _
Reconnect only $66.85 2 •
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation
200 amps or less $66.85 2 Fee for each system $75.00
201 amps to 400 amps $100.30 2 (SEE OAR 918 - 260 -260)
401 amps to 600 amps $133.75 2
Over 600 amps to 1000 volts, Check Type of Work Involved:
see "b" above.
Branch Circuits El Audio and Stereo Systems
New, alteration or extension per panel ❑
a) The fee for branch circuits Boiler Controls
with purchase of service or •
feeder fee. ❑ Clock Systems
Each branch circuit $6.65 2
b) The fee for branch circuits - ❑ Data Telecommunication Installation
without purchase of service
• or feeder fee. ❑ Fire Alarm Installation
. First branch circuit $46.85
Each additional branch circuit $6.65 ❑
HVAC
Miscellaneous
(Service or feeder not included) ❑ Instrumentation
Each pump or irrigation circle $53.40
Each sign or outline lighting $53.40 ❑
Signal circuit(s) or a limited energy Intercom and Paging Systems
panel, alteration or extension $75.00 ri Minor Labels (10) $125.00 I I Landscape Irrigation Control*
Each additional inspection over ❑ Medical
the allowable in any of the above
Per inspection $62.50
Per hour $62.50 ❑ Nurse Calls
In Plant $73.75 - - -- . -- - � _ --- - - - -
Outdoor Landscape Lighting
Fees:
❑ Protective Signaling
Enter total of above fees $
n Other
8% State Surcharge $
25% Plan Review Fee Number of Systems
See "Plan Review" section on $
front of application. * No licenses are required. Licenses are required for all other installations
Total Balance Due $ Fees:
❑ Trust Account # Enter total of above fees $
8% State. Surcharge $
Total Balance Due $
i:\dsts \forms \elc- fees.doc 10/09/00 •
CITYJOF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
/ BUP
Date Requested l / — ff - AM PM BLD
Location 1 Z 1 a 3 5 w l09 Suite MEC
Contact Person Ph PLM
Contractor C/YI 5'1 d jg41 $ -C- Ph ) _ `/ a SWR
BUILDING Tenant/Owner ELC n Q
Retaining Wall ELR 2a010 0003 7
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: r L �
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
• PASS PART FAIL —
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
• S PART FAIL
IT€
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk Date // _' i Ins �� Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.