Permit �_ 1 .. " - ---%"—t r"- - ' 1 " si t) r-Ac-;`‘A- s _
CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
, .,
' ,I,Jr. COMMUNITY DEVELOPMENT PERMIT #: ELR2006 - 00104
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/15/2006
PARCEL: 25101 BD - 00105
SITE ADDRESS: 12805 SW 77TH PL ZONING: I -
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: TEREX UTILITIES WEST
Project Description: Data /Telecommunications. EXPIRE 1
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:
B R + G CO LLC CHRISTENSON ELECTRIC, INC. 1) ./ z O �
PO BOX 23009 111 SW COLUMBIA STREET # 480
TIGARD, OR 97223 PORTLAND, OR 97201
'1 0
Phone: Contact #: PRI 503- 419 -3300
FAX 503- 419 -3728
Reg #: ELE 26 -34C
FEES LIC 458
Description Date Amount SUP 1994S
[ELPRMT] ELR Permit 5/15/2006 $75.00
[TAX] 8% State Surcha 5/15/2006 $6.00 REQUIRED ITEMS AND REPORTS
[HRELC] Hourly Elec 6/19/2008 $62.50
[HRTAX] Hourly 12% S 6/19/2008 $7.50
Total $151.00
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 yvork 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'�Ti esti ns to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: / / I/ Permittee Signat c1 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: 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.
4 ,
•
CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
PERMIT #: ELR2006 -00104
DEVELOPMENT SERVICES DATE ISSUED: 5/15/2006
"W 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S101 BD - 00105
SITE ADDRESS: 12805 SW 77TH PL ZONING: I -
SUBDIVISION: LOT: 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:
B R + G CO LLC CHRISTENSON ELECTRIC, INC.
PO BOX 23009 111 SW COLUMBIA STREET # 480
TIGARD, OR 97223 PORTLAND, OR 97201
Phone: Contact #: FAX 503- 419 -3695
PRI 503- 419 -3300
FEES Reg #: ELE 26 -34C
LIC 458
Description Date Amount
[ELPRMT] ELR Permit 5/15/2006 $75.00
[TAX] 8% State Surcha 5/15/2006 $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: 7 c ,, � T Permittee Signature: _Sx.„.P, C1
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.
MAY-11-2006 THU 02:33 PM CHRISTENSON VELAGIO FAX NO. 95034193695 P, 01
_..-.. e -.,. , � '[rO[i UhI'i('1_` OIVL1`. 'Electrical Permit Apfili-ca'tio�n; �� � Fr f ' r6 ti ' Cam- ' Received - / '/ � I Q
,,, Permit NO.. VIJ ` Ia. • t
city of Tigard Date /By
143125 SW Hall Blvd., Tigard, OR 97223 Plan Review other Permit:
i
Phone: 503. 639,4171. Fax: 503 - 598.1.960 MA ! 1 2uu eteard )14 � '' Date /ray: -
�1 ° °�1 Data Rcndyfl3y: : / t H Soo Page 2 rnr
basin tion line: 503.639 ,us a ' �l Notified/Method: (f Supptomcntnl intnrmanoo
hllernat: www,ci.tigrd.urus Vi V R pH d t 1 pLtW
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r:•:;:: ,::�:' .fir :.;
.::..:.. ....: ::: ...... ..... > please check all that apply:
0 New conslrllction ►mot ; . d•llion/alteralion /replacement ❑Service over 225 amps, cumm ❑ Hazardous location •
❑ Demolition ❑ Other: ❑Service over 320 amps - rating ['Bulldog over 10,000 sq, ft.,
•w residential
„�� .... .....�- + - ..!.:':. :,:.: ..... .. :. .::... .... . : ; ! 7 ' r: ? ;;i "i s : ::.:;:2 : ::Si ?3 iE: %y!r; r _ '1 5
or more n�
':sa:: >!: >:; :�::: : � f and 2 fahnlV dWelhl g 4
ai
....,.::.......:..: �:.�.... :,,. ::�:,:,:,;. •:. '. .,.:..::;: ::: .... . , unite in one structure
:;0.I- aIld 2- famil dwelling -'.....::.
❑ System over GUU volts nomina
❑ y ]' Cntrtatcrctal / atdusirial ❑Accessory building
Q Building over three stories ID Feeders. 400 amps or more
El .Multi lalnily ❑ Master builder ❑ Other: ❑Occupant Ivad over 99 pairops ❑Matutt;icl.uredstrucuires n1'
.. ice a ' s i2 v:,,o!!:;!::;:.:;::: : ,,.. art:
r
CS8 /l1 h[tn
] an
P
❑ g BP
Yir s;�ti .. x ,...
a�
c► :
.. > .. .............. , ta i ::. , ........
0 HcnlLh -ca1'c fac ility El other;
:lob no,:3 f - LI O Job site address: (ay( 5U) 1 PL&(ix. Submit 2 sets of plans with any of the above.
n 1 ' The above are not applicable to temporary construction service.
City/State/Za - 0 t . ■ . r: ,
t �
1 s. R? X41'alLir < ;<:> :;: »!<s: ::s;::: ...::::: >.:
Suite/bldg. /apt. no,: Project name: -MRI TX I 1`�i, II,C_ Douriptlan > @: ! :: =::C:. . 1 a � r J '1 -
� single- or multi-family dwelling unit.
Cross slreel/dircctions to job site: �,� S� � . l �jrn, New residential
attached garage.
3 - .S-4 - � 5� 1,000 sq. 1t. or less 145.1 4
— l" 1
Sll1)d1vlSlOr1: Lot no,: ga. add'1 500 aq. ft, or portion 33.40 1
_ 2 residential 75.00
_ Limited energy,
Tax map /parcel no -: Limited energy, non - residential 75.00 2
:
i%!:': :;8;2::i:?. > s: :.: mnnufw or mode ar
E:tclt
. ;:- .:....::.:..:::,., >:.. :..,.::.:..... ,.i ...........,,.:
dwelling, service and/or feeder 90, 2
i ,l 0 Diu. _ 0 t ' t `5-4 V 1 . Services or feeders installation, alteration, and /or relocation
i 200 amps or less 80.30 2
.r'.. : : ,;. s; : >; >: , .. ; : <;; 2a 1 amps to 400 amps 1OG.RS 2
.......::.:.:::::.•:: r r: :: ::o:<. ! !! .,. . • i s . . :: T %� Y.
..::-;:: . ...; :' : :.:.... ..:......;.: :!.::.: shk.!!�1 :....:..::.! ..,::...- 160.60
cr'.: i::.i ....: ,. •Op..tA$'k1'1�::i':: < ::;s e; ' :::..::.:..:..:: 0 amps to 600
e
Name; 601 amps to 1,000 amps 240,60
Over 1,000 amps or veils 454.65 2
Address: - Reconnect only 66.85 2
City /Statc/ZIP: Temporary services or feeders installation, a acrd /ur
- 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 4 00 amp 100 -30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 70 401 amps to 600 amps 133,75 2
B ntnch ciretdtx - new. alteration, or extension, iter panel
Owner signature: Date; —
❑ crar:t T r�
n re f branc circuits tvirh
AlCMW1€r F serv or f ee d er Pee, each 6.65 '-
` branch circuit _
Business name: _ _ - 13. Fee for branch circuits
Contact name: without service or feeder 16ec, 46,85 2
first branch circuit
Address: Eaoh add'1 branch circuit 6,65 2
City /Stat'JZ1-l': Mlscenaneolrs (service or feeder not included) -
Pump or irrigation circle
53.40 1 2
Phone: ( ) I Fax: : ( ) . — 2
_ Sign or outline lighting 53.40 _
Signal circuits) or limited -
E energy panel, alteration, or
gy p
' 2
Pa e
2
5
Page .:::; ...`.:'' ;.!:.: >;: � ! :i.1�rr`1i'`� ;
,. ,,..... _ a n cna i on Describe; C
J `
liusuicss name: Christenson Electric, 1[nc,
- -" Each additional inspection over allowable In any or the above
Address: 111 SW Columbia Street, Suite 480 per inspection 62.50
I nvestigation per hour (1 hr nun) 62.50
City/State/ZIP: )Portland, OR 97201
industrial plant per hour 73.75
1') -3695 � .,.,,
Pax (503) 4 °i;: Air p817`Nit.'1:::) :Lr »; ::�;:::::;:::::. : : :. . •>s ::::;:;•.:::::::,:
Phone: (503) 419.3300 _ ?J EtiC..1FE ,
laectricul Lie.; 26 -34C Si rv. Lic.: 199' Subtotal 7 5 (/D
COI Lic.: 458 _
Plan review (25% cil permil. rcc)
Suprv, iacclrician signature, required:
li:
SWie sut'charge (8% '�+ of permit e) �,
Print name: -- . Date: 5/ t t / (
i �i TOTAL TOTAL PERMIT rl ?F. R , CTQ
-
Thtx permit application expires Ira permit Is not obtained within YNn
Authorized Slg[]ahlrl': _ _ days after it Iran Wen acceptOiI IIA complule
]]ate: w F ' methodology net by Tti- County Building Indastry Service Board
!'' mane: - **Number of inspections per permit allowed.
440 •161 5'1(1e /02 /COMiW1:11 U'
r7HuildinglPuin 'list &LC- I'cnniU+pp.dac 1J0. b E