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Permit iip CITY OF TIGARD ELECTRICAL PERMIT - RESTRICTED ENERGY ATI DEVELOPMENT SERVICES PERMIT #: ELR2003 -00378 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639. -4171 DATE ISSUED: 12/17/03 SITE ADDRESS: 12447 SW 69TH AVE PARCEL: 2S101AA- 09100C SUBDIVISION: TIGARD CORPORATE CENTER ZONING: MUE BLOCK: LOT: OOC JURISDICTION: TIG Project Description: Limited energy for data telecommunications. Job No. 37 -01127 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 PARTNER CHRISTENSON ELECTRIC INC 15400 SW MILLIKAN WAY 1631 NW THURMAN BEAVERTON, OR 97006 2ND FLOOR PORTLAND, OR 97209 Phone: Phone: 503- 419 -3608 permit la Reg #: L$O3- 341436 SUP 3289S ELE 26 -34C FEES Required Inspections Description Date Amount Low Voltage Inspection [ELPRMT] ELR Permit 12/17/03 $75.00 Elect Final [TAX] 8% State Surchart 12/17/03 $6.00 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 t ow rutt?s dopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 throuc Iss d by ..___, 1 k i l Permittee Signature j% �4,..il!'r: 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 i _ _; ' f ieZ. % DATE: LICENSE NO: r i Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day 16 -2003 TUE 10:26 AM CHRISTENSON CORPORATION FAX NO 503 419 3636 P. 01 Electrical Permi _ ' .ation Received Electrical Date ay: !X ! Cr C Permit E , 40 - o't08 — 0037 1 e City of Tigard Planning Approval ' St 13125 SW Hall Blvd. DEC 16 2003 ane Petrtlit No,: Tigard, Oregon 97223 Date/By Orr Permit No.: C( Phone: 503 - 639 -4171 Fax: S �98= '�,bRRU ; • Post-Review Land Use Internet: www.ci.ti ardor. � "�'�; ' } °' \� Date/By: L�seNo.: 24 -hour Inspection Request U I D9 4 D I I S I C` ., 4 . I contact ' �J ® See Page 2 for — -- - Name/Method: /' k Supplemental Informadon. i r l£C.Ztig.3ifl L: t•'r"S'tl4 is \J';1'�ti : i! . .�� t , �. .+t��D+�_ �-.^ r �. yn'•„' r ; • y a . . >' 4?: s?.. .tt�ti:,?S�a's:.::r�.!��.�..A'2� R1:Cec1�v.., t,�''� t'li :7,'3,', 't�' �' ��;�'=�.;� � r . , •,: II New construction ■ Demolition ■ Service over 225 arms- • Healt facility 1 Addition/alteration/r • lacemetlt 11. Other: commercial 0 Hazardous location i:- ; r ,- T ; .:,-'•.•_- ...-,. .,,,_ : ;,,� . , ❑ Service over 320 amps-rating of ❑ Building over 10,000 square feet. '" 11f -: Y: : ' . , :� : ^ 1 & 2 family dwellings tour or more residential units in r_■ 1 & 2 -Fami1 dwellln _ LL' Commercial/Industrial ❑ System over 600 volts nominal one structure '� ACCeS30 B1liIdin: ❑ Building over three stories ❑ Feeders, 400 amps or more — ri Occupant load over 99 persons' 0 Manufactured structures or RV park r Master Builder I. Other: ❑ Egress/lighting plan 1' f g.'.'a4Wtl 2 ‘ ;. t'S -.:1:';‘'-.1';.. b / . Y-t:" L ?.4 1 ❑ ih t an . --. � • � :..'. `° t � '' c'7 �"_`�ti.. : M' �� Submit vets of platy with y ores above. The above are not a fcable to Job site address: 12447 SW 69TH ST 97223 tern �re construction service. Suite #: Bid: ./A t.#: Number of ins . ctlons . er • trait allowed Pro - ect Name: : • ,o :�i.:. . :,: r fA.._.NL ,e-, -_ ..,..:.4.-.,-,- 7 ? __ -,-;:-,-..-,1-4,-,..--,:a x� _ t . ; • s - Desert , nom Qty Pee (ea.) Total 1111 Cross street/Directions to job site: New residential-single or multt -famQy per QUESTIONS ?CONTACT CLARENCE MARTIN(503)419 -334: dwelling Includes attached gsraga Il 1000 so. ft. or less 145.15 Each additional 500 ... R or •.n thereof 33.40 Subdivision: Lot #: I-imited energy, residential 75.00 p Tax ma • • arcel # Liuni[ed ea -, non residential 75.00 _ _ Each man borne or modular dwelling �© � tiy rr iu5 J t' , _ i ° ° !=1:a" °; t 7 ' :. ? c • ` 1 . n 17 ^ service atrd/or ftxder 90.90 f 7 ✓ SerNca or reederi • installs non, LOW VOLTAGE DATA TELECOMMUNIC� a N IN 4 � ahar ation or relocat PHASE 2 BUILDING C SECOND FLOOR zoo amps or less 80.30 201 amps to 400 antes 106115 _ r 401 .., to 600 am • 160.60 ,, i,i , :' X., ri , +y ;`)_ „_,1 'r , , 1.f ,a 't '',.17i' 60 1 am•� to 1000 Z ,l, t „ ...:: 7 �E.. 240.60 © over Name: 7 e ', 9 ,t,z D C'o�Po2/} rt err LT i • 2r/l)f QS// i ' Recon on' or volts 4546 66 . 8 5 �© .. 66.8s a Address: / 00 H ■ L L 1 K • eJ lt.) • Temporary services or feeders - Installation, Ci tbf RO�.11 -ro O' 9 7.0a0 200 action, le or relocation: amps or lose 66.85 Phone: Fax: 201 amps to 400 amps 100.30 i( L33.75 ". w.:.. __ +. `t' .'? ' -... i' Branch Circuits - new, alteration, or Name: euteuaton per panel: Address: A. Fee for branch circuits with purchase of service or feeder fee, each branch circuit 6.65 - City /State/Zip: a Fee forte circuits without purchase of Phone: service or feeder fee. first branch circuit .. 46.85 ( Fax: Each additional branch circuit 6.65 E -mail: Misc.(Serviee or weeder not included): s. .L ? . . ;'' 3n: ' j:;'r; ' i. :. ' . i ' `::" : , w, ;". Each • •. or' :ationcircle '.; :, , ' ,':.i. _ '- . .e ' ::. :' .,. , 2' ''''f , .,' . . . �. 53.40 JO N 0 Each aim or m honing 2 Job 3 7 -01127 Signal eircuit(s) or a limited energy panel, 75.00 75.00 Business Name:CHRISTENSON TECHNOLOGY SERVICES, 11. +, " atron,or exteasien P 5 2 2 Address: 1631 NW THURMAN ST 2ND FL DATA Ci /State/Zi • • PORTLAND, OR 97209 Each additional ins ection over the allowable in an of the above: Per inspection per how (min. 1 hour) 62.50 IIIIII. Phone :(503 419 -3600 Fax: 503 419 -3636 ievesti : anon fee: CCB Lic. #: 64137 Lic. #: 26 -1174C O � Supervising electricia -7 n Cie I .. :.. .: ; : � ..; Si _, . lure required: l�J ``�,�` Subtotal r �s . ' 12/16/0: Plan Review (25% of Permit Fee) $ Print Name:RODER . A. AXT Lic. #: 99 s State Surcharge (8% of Penult Fee $ 6. TOTAL PERMIT FEE $ 81.00 v Authorized Notice; Signature: Date: permit application *spires if a permit Is not obtained within 180 days after It has been accepted as complete *********VISA** *Fes methodology set by Tri- County Building Industry Service Board. (Please print name) i :\Dsts\Pertnit Formsk&1ePermitApp.doc 01/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST // // BUP Received / Date Requested (R — S�4` PM BUP Location /2-V47 Suite Contact Person - Ph ( ) LM Contractor Ph ( c � '7() 3 - 0 Pb5 SWR BUILDING OPOwner ' _ % ?d off' ELC Footing ELC Foundation Access: 3 Ftg Drain 3 3— I A? Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain �J � Shower Pan J / Other: CM Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL L ��,,�� .iou G j UG/Slab Low Voltage Fire Alarm Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE ❑ Please call for reinspection RE: 0 Unable to inspect — no access Fire Supply Line ADA r � 1 Approach/Sidewalk Date - 5 — 0 '(Inspector Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL