Permit I }' 1C I TY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2002 -00434
*l
°11il4 DEVELOPMENT SERVICES DATE ISSUED:, 8/30/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S113B0 -00600
SITE ADDRESS: 16060 SW 85TH AVE
SUBDIVISION: SEWER TREATMENT PLANT ZONING: I -P
BLOCK: • LOT : JURISDICTION: TIG
Project Description: Installation of service, (2) branch circuits and signal circuit/panel near filter building located between
outlet structures #1 and #2. Job No. 249 -0002.
RESIDENTIALUNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: .
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL: 1
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: 2 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor: •
UNIFIED SEWERAGE AGENCY CHRISTENSON ELECTRIC INC
150 N 1ST AVE 1631 NW THURMAN
HILLSBORO, OR 97123 2ND FLOOR
PORTLAND, OR 97209
Phone: Phone: 503 - 341 -3636
Reg #: LIC 458
SUP 3289S
ELE 26 -34C
FEES Required Inspections •
Type By Date Amount Receipt Rough -in
PRMT CTR 8/30/02 $168.60 2720020000( Elect Final
5PCT CTR 8/30/02 $13.49 2720020000(
•
Total $182.09
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable Taws.
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 -6699 or 1 -800- 332 -2344.
Permit Signature: dAi / Issued By:
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 639 -4175 by 7:00pm for an inspection the next business day
AUG -28 -2002 WED 08:32 AM FAX NO, P. 01/01
Electrical Permit Application
Date received: p7i Permit no -: e2G.200a -O y
Ci ty of Tigard L , ' Pro ect i a _
• '"l1' l I ppl. no.. Expire ate:
C.ityofTigard Address: 13125SW hall131v >�� i i i )L ' Date issued: By :, Receipt
Phone: (503) 639 -4171 r._._
Fax: (503) 598 -1960 A' 1 C 2 B 2OO� Case file no:: Payment type:
Land use approval: HUl7
CI 1 & 2 family dwelling or accessory kommcrcial/industrial 0 Muhi- family ❑ Tenant improvement
. ci New construction Cl Addition/alteration/replacement 0 Other: 0 Partial
Jolt Si I L INFOKtSl,1 10N
)oh address: 16060 , SW 85T11 (T) 97224 Bldg. no.: Suite no.: Tax map /tax lot/account no.: ge,>Zr^l
Lot: Block: Subdivision: DURHAM FACILITY A/EgR P;` •Bz.b6. P
Project name: a a . Elty] Description and location of work on premises: 60A PANEL (2) CKTS ( 1 ) L'V FOR , N,
Estimated date of completion/inspeeliun: 4 t a s • a: 1 1. - .. TR t 1 ��
. . I lIP UtA1,'A(IIt,<11' ) 1,1(.'Al IQN a s + -, ,, n, , , 4 4, , • 4 ('111-i1)IILE . - , , ,
Job no: 249 -0002 wee Max
Business name:CHRISTENSON ELECTRIC. INC. . Description Qty. (e:.) Toad no.Insp
Address:.. x631 NW THUt4NAN 2ND FLOOR New residential slltskormulti fartdly per
dwelling unit- Includes attached garage.
City: I'C)RTLAND I State: OR I ZIP: 97.209 Serviceincluded:
r — 1000 sq. ft or less 4
Phonc. 36U8 1 4193b3�? -mail: ,
CCB no.;45 8 - c. bus. lie. no: 26 -34 C Each additional 500 sq. tl or portion thereof
Limited energy, residential 2
City /metro o.: 5 46 Limited energy, non-residential -� 2
Each manufactured h ome or inn dwelling
Signet of suprvisin cc r et requited) p Service an fee _ • 2
Sup, elett. name (print):' BRIAN CHRISTOPHER t.icense 8735 Servtceaorleederts– irtsla ! lation •
alteration orrelocation: 60A 1 30.30
200 amps or leas 2
Name (print): 201 amps to 400 amps • . , . 2
401 am
Mailing address: amp to 600 amps 2
601 amps to 1000 amps 2
City; . Slate: ZIP: Over 1000 amps or volts 2
Phone: Fax: E-mail: Reconnect only 1
Owner installation: The installation is being made on property 1 own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to Installation, alteration, orrelOealion:
ORS 447 455, 479, 670, 701. 200 amps or less 2
701 amps to 400 amps 2
Owner's signaturc: • Date: -- 40 to600 a , 2
Branch circuits • new, alteration, •
. or extension per panel: -
Name: A, Fee ft:rbrarlch cixu9 with pw :hnso of •
Address: service or feeder fee. each branch circuit 2 1 2
City: State: • ZIP: B. Fee for branch circoita WithOUt purchase
of service or feeder fee, fall branch circuit: 2
Phone: Fax: E-mail: Each urlditional branch circuit:
PLAN REVIEW (Please chuck all That apply) Misc. (Service or feeder not included):
❑ Service over 225 atnps•conumercial 0 Health -care facility Each pump or irrigation circle 2
• 0 Service over 320 amps - rating of l&2 ❑ Harardous location Each sign or outline lighting • 2
family dwellings 0liuilding over 10 ,000 square feet four or Signal circuit (s)ora limited energy panel, •
0 Sy:4ctn over600 volts nominal more residential unilg in one structure • ` alteration, or extension* 1 1 5 . 0(L 2
G Building over three stories 0 Feeders, 400 amps or more *Description: TRANSDUCER , _
U ()ccupaut load over 99 Demons Q Manufactured structures or RV park Each additional Inspection over the allowable In any of the above:
0 Ligrr-•rs/lighting plan 0 Other. ,, • ,-- Per inspection , I
• Submit sets of plans with any or the above. Investigation fee - wawo.artaarmla•••••••-•.-..■—•-•
above are not applicable to temporary construction service. Other
—pr. it ee
f $ '1 $ . 60
�Nnt allJwirdicti
ons accept credit cards, please call Jurisdiction for more infcnnatioo Notice: This permit application
Q 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%) .... $ 13.
explrer TOTAL $ 182.09
A�ptedascomplete.
Filmic as shown oo credit card s * * * ** *TRUST ACCOUNT DEDUCT *i
..,_ T cardholder 'immure A m oun t - 440 -405 (6footCOM)
OCT.2000 +FEES ON BACK OF FORM '
CITY OF TIGAR® 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested / • AM PM BUP
Location
/ (0 " Suite MEC
Contact Person / Ph ( ) PLM
Contractor C/j r a t �, /L £eerk- Ph ( ) 2 6 w - l 6 SWR
BUILDING Tenant/Owner ase ELC -
Footing
Foundation ELC
Access:
Ftg Drain ELR
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
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In -
-
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm •
44P Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
= PART FAIL
SITE Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA �'� Ext
Approach/Sidewalk • D 4 i - - Inspector
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL -