Permit CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2001 -00619
1''' DEVELOPMENT SERVICES DATE ISSUED: 12/7/01
+L �' II 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S135DD-03300
SITE ADDRESS: 11555 SW 88TH AVE 23- 24(23- MANAGER)
SUBDIVISION: PARK PLACE GARDEN APT. ZONING: R -12
BLOCK: LOT : JURISDICTION: TIG
Project Description: Reconnect.
RESIDENTIAL UNIT 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:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: 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: 1 SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
PARKER, JEROME W TRUSTEE CHRISTENSON ELECTRIC INC
BY SUMMIT REAL ESTATE MANAGEME 111 SW COLUMBIA
5320 SW MACADAM AVE STE 480
PORTLAND, OR 97201 PORTLAND, OR 97201
Phone: Phone: 241 -4812
Reg #: LIC 458
SUP 3289S
ELE 26 -34C
FEES Required Inspections
Type By Date Amount Receipt Elect'l Final
PRMT CTR 12/7/01 $66.85 2720010000(
5PCT CTR 12/7/01 $5.35 2720010000(
Total $72.20
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Spedalty 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)
246-6699 or 1 -800- 332 -2344.
i
Permit Signature: ,J T Issued By: , 1-7
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: —Q�� � )/75�� DATE:
LICENSE NO: !? ) 3 S
Call 639 -4175 by 7:00pm for an inspection the next business day
Sent by: CHRISTENSON ELECTRIC 5032056721; 12/06/01 12:21PM;JJtfax #588;Page 1/1
Electrical Permit Application
D Datereceived: ; i C 1 Permit no.: C / — /�
'" `� ", ' of Tlgar CEIV E Projectiappl. no.: Expire date:
a II Ct
i
Add r ess: 13125 SW H vd, Tigard, OR 97223 Dace issued: By Receipt no.:
Cityof7igard 2001
Phone: (503) 639 -4171
Fax (503) 598 -1960 DEC 0 Case fife no.: Payment type:
Land use approval: a TY OFT iM
O 1 & 2 family dwelling or accessory U Commercial/industrial XUMulti- family 0 Tenant improvement
•
❑ New construction 0 Addition/alteration/replacement CI Other: Cl Partial
.11)11 Sill INI:OR 11ATlON
Joh address: 55 SW 88TH TIGARD 9 7223 Bldg. no.: ' 1 1lfiee no. ax map/tax lot/account no.:
Lot; Block: Subdivision: ,
Project name :PARK PLACE APARTMENT Z. P - scription and location of work on premises:RECONNECT ONLY
Estimated date of com•letion / inspection: QUESTIONS? CONTACT EDD. BURNS 503 701 - 7866
(:QN1iLA('TOR A rci11Cb177ON t _ , , . I' EL 5CI!I :01 . • '
Job not 62 -25119 Fee Mart
Business nae:CHRISTENSON ELECTRIC, INC. Description a!4 (ea) Total no
tn imp
Newrajlddrthl- single ormultt-falnily per
Address: 111 SW COLUMBIA, SUITE 480 dwetling unit. Indudes attached garage.
City: PORTLAND State: OR ZIP: • t — ; ; . Service included:
Phone503 2414812 Fax503241051 'rrmaii: 1000 ft or less 4
i Each additional S00 sq. ft- oryortion thereof
CCB no.:458 1 a C. bus, lie. no: 26 -34C united energy, residential IIIIII 2
City /metro ' 0.: 5 46 Limited ener- y,non-residential NMI 2
/Iir. Each manufactured home or modular dwelling
Signal ' of supervisin - ear + requited~ Date 1 2 / 6/n Service and/or feeder IIII 2
Sup. elect. name (print): BRIAN CHRISTO L icense n o: 87 ^Iees installation, ■
altermfon or relocation:
PRO Nit l'1' OWV NLR 200 amps or less 2
201 amps to 600 amps III Name •tint): 2
401 amps to 600 amps 2
w
Mailing address: 601 amps to 1000 amps - 2
City:
State: ZIP: Over 1000 amps or volts mimp 2
Reconnect ' ' - • ` 1
Phone: rte: Fax: E -mail: ,' _
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 11 os, nor'dOj1' artion:
200 amps or leas 2
ORS 447, 455, 479, 670, 701. 201 erteps to 400 amps 2
Owner's signature: Date: 401 to 600 am s '
1:N(;INI:F:It Branch drafts - or*, alteration,
or extension per passel:
Name: _ A. Fee for branch circuits with purchase of ,
Address: service or feeder fee. each branch circuit 2
City: j Slate: • i ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first Mauch circuit; 2
Phone: Fax: E -mail: Each additional branch circuit:
l'l.AN IttNIF: v(I'ieaw check all that apply) Mile. (Service or feeder not included):
O Service over 225 amps-commercial 0 Health-care facility Each pump or irrigation circle 2
a Service over 320 amps- rating of 18r2 0 Hazardous location Each sign or outline lighting 2
family dwellings O Building over 10,000 square feet four or Signal circuit(s) ora limited energy panel,
CI System over600 volts nominal more residential units in one structure alteration, or extension* 2
0 Building over three stories 3 Feeders. 400 amps or more `Description: .
❑ Occupant load over 99 persons 0 Manufactured strum: urns or RV park Each-additional inspection over the allowable In any of the above:
Cl Egress/lighting plan ❑ Other. _ perinspection _ I
Submit sets of plays with Any of the above. Investigation fee The above are not applicable to temporary construction service. other ,
Not all jwisdictitsa accept credit cads, passe call jurisdiction for mote information Notice: This permit application Permit fee fife R.5
O Visa O MasterCard expires if a permit is not obtained Plan review (at _ `Yo) $ 5..3
Qodit Cara number: _ / / within 180 days after it has been State surcharge (8%) .... $
e accepted as complete. TOTAL $ 72 . ?(1 7
Name of ea:dholderas shown on credit card TRUST ACCOUNT 1 EDUCT * *k*** '
S
Cardholder signature Amount , 440.4615 (6 )0/C0M)
OCT.2000 +FEES ON BACK OF FORM
CITY OF TIGARD BUIING INSPECTION DIVISION MST
24 -Hour Inspection Line: 63931-k , '5 Business Line: 639-41
BUP
Date Requested l — / 3 AM PM BLD
Location C/ 5.5 5 8 (J`2 Suite - 1 MEC
Contact Person <i Ph '70 / PLM
Contractor I f7.^LSIPizs3 ., ,/c 7 Ph L './ 1 L / '/ 2. SWR
BUILDING Tenant/Owner ELC P CO lo/
Retaining Wall ELR
Footing Acces ` ,, - , = ,cam
Foundation '�1� / OO FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: / /
Slab _L J AJ° � °•"' SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling Rf C' (*)/'� j
`�`°V_
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
ELECTRICAL
Servic
ugh In
UG /Slab
Low Voltage s l
Fire Alarm
PART FAIL
SITE
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 `e2 — f 2 — 0/ Inspector FLvcl y . Ext
Other CJ
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.