Permit CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
A DEVELOPMENT SERVICES PERMIT #: ELR2002 -00011
s=`" Ai' 13125 SW Hall Blvd., Tigar OR 97223 (503) 639 -4171 DATE ISSUED: 1/22/02
SITE ADDRESS: 15705 SW 72ND AVE PARCEL: 2S112DC -00100
SUBDIVISION: OREGON BUS. PARK 111 ZONING: I -L
BLOCK: LOT: 002 JURISDICTION: TIG
Project Description: Installation of paging system and additional wiring.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: X
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:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC REALTY ASSOCIATES CHRISTENSON ELECTRIC INC
15350 SW SEQUOIA PKWY #300 -WMI 111 SW COLUMBIA
PORTLAND, OR 97224 STE 480
PORTLAND, OR 97201
Phone: Phone: 241 -4812
Reg #: LIC 458
SUP 3289S
ELE 26 -34C
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 1/22/02 $75.00 2720020000 Elect'l Final
5PCT CTR 1/22/02 $6.00 2720020000
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 OA 52- 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
Issued by .4,12(7 CLIP Permittee Signature dam/ '9 °/' / , 9 - 7
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
Sent by: CHRISTENSON ELECTRIC 5032056721; 01/18/02 5:24PM; #564;Page 1/1
fr
Electrical Permit Application
Datereeeived: / / ( PAGEM Permit no.: &.,QZQp Z- Da/
, ` ., . City of Tigard d, gty2gD Project/appl. no.: Expire date:
Ciry of gard Address: 13125 SW Hall Blvd gar Date issued: By :A. U)
Receipt no.:
Phone: (503) 639 -4171 C ase File no.: Payment type:
Fax: (503) 598 -1960 JAN 1 R 2002
Land use approval: CITY OF TIGARD sue L2 0200/-00302 .
O 1 & 2 family dwelling or accessory 0 Commercial/ industrial CI Multi- family 0 Tenant improvement
0 New construction 0 Addition /alteration/replacement 0 Other - Q Partial
JOii 5111.: I,N10I01A11O`
Job address: 15705 SW 72ND AVE (T) ' Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot: Block: Subdivision: , _ A' 2 N :i_ /A/ -S S 7
Project name: Description and location of work on premises: LOW VOLTAGE DATA /TELECOMMUNICATION
Estimated date of completion /inspection: QUESTIONS ?CONTACT NICK GEORGE (503) 419 -3319
. (x)N'1•I1Ac'1OR Ai'1 ;1,1(',1f1ON r .. 1 FF S(•I11•;l)li1,1? - ; ,
Job no: , — i t a • Fee Max
Description Qty. (ea) Total no. rose
Business name: ELECTRIC, INC. � residential-single or maiti-fandly per
Address: 111 SW COLUMBIA, SUITE 480 aweFfstgunit .lndndrs attached prop.
• City: PORTLAND _ I State: OR [x:97201 -5886 4
Phone503 2414812 Fax503241051 'E -mail: I000sq ft, orlrss
Each additional Soo sq. ft. oroo thereof Mr
CC73 c. bus, lie. no: 26 - 34C Limited energy, residential MEM INN 2
City /metro . o.: 5 46 Eadt manufactured h o me o ml ..� 2
, � � Each home or modular dwelling
Date 14-1-8442 Service and/or fader 2
Signet ' oisupavisin Rl'=*c required) Services or feeders - installation,
Sup, diem name (primil: BRIAN CHRISTOPHER 8 73S
alteration orrelocation:
I'RO1'ERCI OWNER 200 arops or less 2
201 amps to 400 amps 2
Name • 'nt): 401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: State: ZIP: Over to00 amps or volts 2
j Fax: 1E Reconnect only I
Phone: Temporary services or feeders -
Owner installation: The installation is being is on proper I own Installation .atterarlon,orrehrwtioa:
which is not intended for stale, lease, rent, or exchange according to 200 amps or tees 2
ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 am. 2
I I N h: i'A t Branch circuits - new, alteration,
or extension per panel:
Name: .. F- for branch circuits with purchase cf
Address: service or feeder fee, each brands circuit 2
( B. Fee for branch circuits without purchase
City: [State: of service or feeder fez. first branch circuit: 2
Phone: Fax: E - mail: Each additional branch circuit:
1'1. ‘N REVIEW tl'k:se check all that apply) Misc. (Service or fader not tndaded): 2
O Service ova 22S amps.omermacial O Health-care frairy Each pump or irrigation circle _.
Each sign or outline lighting 2
13 Service over ngs amps -rating of 1422 O O Building O location 10,00psquare feet four or Signal circuit(s) or a limited energy panel.
familydwellin&s Building ova 1 75.01 2
O System ova 600 volts nominal mote residcmtial units in one structure alteration. or extension`
O Building over throe raories 0 Feeders, 400 amps or more •Demipt10J -0W VOLTAGE DATA/ TELECOMMUNICATION
0 Occupant Toad over 99 persons 0 Manufactured structures or RV park Each additional Inspection over the - Oowabie In any of the above:
F.t;trisAightingpinn
0 Other: - Per inspection 1 J 1 1
Submit _ sets of plans witb any of the above. Investigation fee _
The above are not applicable to temporary construction service. Other _ — •
Permit fee $
Na all jurisdierba a xon credit cards, pieta call junsdicti ter mat information. Notice: This permit application P er review (at _ %) $
O Visa 0 MGM expires if a permit is not obtained
aura' cans rumba: _ P xp'r R within 180 days aft 6 -
alter it has been TOTAL surcharge (8%) .... $ 9 _
aacepcodascomplcto * * * * ** *TRUST ACCOUNT DEDUCT * * * **
Name of cmdti01& as dawn 05 credit card S
Catdboldce avenue _____,Amount 44oasts (motcOM)
OCT.2000 +FEES ON BACK OF FORM
----- r ._. .. —t -. .. .
CITY OF TIIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested . 7/1 k AM PM BUP
Location LS 7 0,S 7e? Suite MEC
Contact Person Ph ( ) 1( 9-3&s t PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: ELR _ COO
Crawl Drain
slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing /3
Firewall L J ,
Fire Sprinkler �/ `;j / pli
Fire Alarm
Susp'd Ceiling
(.1
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
U
Wlta
ire Afarm
Ci11r Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SI Please call for reinspection RE: • Unable to inspect — no access
Fire Supply Line
ADA /6)-
A roach/Sidewalk Date 2— 0 2 Inspector -� .� / -� r Ext PP
Other:
Final DO NOT REMOVE this Inspection record from the job = - te.
PASS PART FAIL