Permit ,l
N .. t ITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00480
TIGARD DATE ISSUED: 12/27/2007
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1 S126DB 02800
SITE ADDRESS: 09370 SW GREENBURG RD 311 ZONING: C -
SUBDIVISION: PP1991 - 018 LOT: 001 JURISDICTION: TIG
PROJECT: DAVID BILSTROM MD
Project Description: Install low voltage for data telecommunications. Job No. 99 -38- 01189.
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:
FRANKLIN COMMONS ASSOCIATES CHRISTENSON ELECTRIC, INC.
BY NORRIS + STEVENS 111 SW COLUMBIA STREET #480
520 SW 6TH STE 400 PORTLAND, OR 97201
PORTLAND, OR 97204
Phone: Contact #: PR1 503- 419 -3300
FAX 503- 419 -3695
•
Reg #: ELE 26 -34C
FEES LIC 458
Description Date Amount SUP 1994S
[ELPRMT] ELR Permit 12/27/2007 $75.00
[TAX] 8% State Surchar£ 12/27/2007 $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 00.33 - 44.
Issued By: 1 0 A Permittee Signatur=�` 1 _ I1 J ' f .� ( --
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.
11111inw
DEC-27- 10:42 AN CHRISTENSONELE_OTRIL, INC FAX NO. 95034193695
LK:0.mm rental. li 1 Eeti Ei P ' °
City of Tigard Received /,21ZERNMS‘f permit N..: i. fe
1:aitc/B ;
13125 SW 14431 Blvd, Tigard, OR 97223 DEC 2 7 200. Plan Review Other Permit:
Phone: 503,639,4171 Fax: 503.598.1960 . k .1. I3ate/B ; ,
inspection Line: 503.639417 GUY a II . "Al. 'Li, Dom Rendy/By; lag Ed SEM Poo 2 thr
Internet: www.ci.li pitied-ma .::. . V't: , ' qt t`, Noted/Method: Supplemental Information
#P..*1101,.#0*.i;!i':;q;:1::015ii::q:;;::::.,i'illi:.!,::Ti:':i':',..::;;:':'.ii 1*:.':.:4i:;;I::E;::1::::;,::i..:::::::::::::'AiA
0 New constfuction C:4 Addition/alteration/replaceinent Viaase check all that apply:
OService over 225 amps, comml °Hazardous location
0 Demolition 0 Other; 0 Service over 320 amps - rating 011uildng over 10,000 sq. ll„.
:47440.94:';:::!*'g01g1,01P.1011:j':::::!,;',::: of 1- and 2-family dwollings 4 or more new residential
0 1 and I dwelling 7 -- .4 Commercial/industrial 0 Accessory building °System over 600 volts nominal units in one sinicture
°Building over three stories OVecders, 400 amps or more
0 Multi-family 0 Master builder D Other:
. - .. , , , , . , . , , ... , ,,,:•,.,„ °Occupant toad over 99 persona pManufacturod structures or
';::::;';::'.;1:::::!:.::'::':':','::'.0:::::::;:r.;'':;':::.;:::',,49,lt:.;,#A',:ig0P.W.M.`;.(10.:OP:4.M.V.4.7.0(1;0,:i.t:.',:;',:;;::;•;;':',::::i:',:;:;,:::!g,'.::;i;;;;;L: 0 Egress/lighting plan RV park
DHealth-carc facility 00thar: — .,—
Job site address: 113 k.,•-- eireeNct,vr '. Submit 2 sets of plans with any of the above,
City/State/ZIP: - N - \ arc ), Oa- al aa 3 The above are not applicable to temporary construction service.
Suite/bldg./apt. no: Si Project name: Ociu;c1 6 .E., litA '..1$4•1'"91G.13)iiiii .
Cross street/directions to job site: 0 'oh .. al , _-....inc ‘ e 4 - r n or Inulti4amily dwelling unit.
t. Deludes attached garage.
. ,
.i ,-1.: 30 A 1..02., . 3 '' - - it
- 0 1,000 so. , or iesS 111111031 '
Subdivision: Lot no.: 'EA. add'l 500 sq. 1 or . onion 11111 33.40 mg
Tax map/parcel no.: IIIM 75.00 Imre
75.00
Limited energy, non-residential In
,:.:..: :,:::. ' .'":.:::::: ::.: ''.; ;':':': i';:::., ; .:,: ',:,; ':!:: •;:i :::::;':.:1::1: '.'l::Fill',.4001119.1'....f.j.':'.09Y948::;:j.::: ::::: ;:':::':: '..i.::'.::1; g;',:g:.:', .:;::':'.'::::': i0.: i'];'::',1:.: Each numufactured or modular 1.1 III
dwellini service and/or feeder NM 90.90
r. INA " e.. s • - ..... 7...... N._ ..., ,....-. 1 .,- - ' -.,:.... Services or feeders installation, alteration, and/or relocation
• - g 200 amps or less MI 80.30 IMES
am
11- P
201 am a to 400 s'
::i..:i.,:,,:;.':;,;',.;,..:gi:',:::::1Ti'::::.,04:10#C00,0i$;:::;:e''.'':::'::::;':g:3 l''::':,;•111:'''''".:P',..:;•.:;:;:04*!'"W.:.1r.::.:':!'.q,'::::!':'0:::;::'::::. 1111 106.85 /MUER
401 amps to 600 amps III, 160.60 NIEMEN
Name: /-", NJKLI Or rfrie k)b f).e____- 601 amps to 1,000 amps In 240,60 nom
Address: Over 1,000 ;imps or volts 11111 454.65 Min
1E11 ' 66.85 IMMO
Temporary services or feeders installation. alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 'AMPS Or 1065 11111113311111.113
Owner installation: TitiS inStallatiOn is being made on property that I own which is not 201 aMps1.0 400 arrio MI ' 10030 NIMBI
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 2
amps to 600 amps
Owner signature: pat: - Branch circuits - new, alteration, or extension, .1. , unei
a';.c1:0:::t.i‘Ot,:400,i,';';'N'I':';'.1:0,]. A, Fseevfor boraineccdhic:rirfceueits.awcibrh
Business name: ' branch circuit
.. B. Fee for branch circuits
Contact name: without servico or feeder fee,
Address: first branch circuit
6.65 2
Miscellaneous (service or feeder not included)
CIISIIIIIMIIIIIIMIIIIIZSMMIIIIIIIMIIIII P or irri8ati°1 I II ' 53.40 111111111111
E-mail: sgal circuit(S) lillii4d-
Page 2 ri
extonsio Descrbe:
Business name: Christenson Electric, Inc,
Addres Each additional Illa action over allowable in an of the Above
s: 111 SW Columbia Street, Suite 490 11111111SEI 111
Cily/State/ZIP: Portland, Ott 9121)1 Investigation per hour (1 he min) 11111 62.50 MI
Phone: (503) 419 Fax: (503) 4194695 Industrial plant per hour 11111118n1111111111
: ', : :,: ; . :ii: : • :: :',,,':: : '; , ::::;;.', 1 ',1141,:t',..E r tRiC :40i.P.,11141F.g:',01:;FP.t::',.i:::;:';:•,::::';';:;:;:';:::;':.!..':::
CCB Lie.: 458 Electrical Lie.: 26-31.....0 IMICMIli 11111.101.1111111:13 -7,5".e..0
AV/ A . Ailli
Suprv. liaectncian signature, required: Plan review (25% of permit fee)
State surcharge ( of permit fee) tf
Print name: P • ' • A Date: t a. .
_ .-- ' TOTAL PERMIT E'EiL
Authorized signature; This permit, ePP1icatian expires if a permit is not Assailed within 180
days after it has been accepted as comp
Print name: , ' 1311111111111111111 , Fee methodology get by II-IA:aunty Building 'Industry Service Board
• Nurnbcr of impectionx per permit allowed
rilanibluie\ Puimioslz-PeninutaReue 11/03 4411-lo 1 YIT totrarcomm2B —
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, ... _ .
CITY OF TIGARD
BUILDING DIVISION
PE IRMUD: 2 0 ITE #:
13125 SW Hall Blvd., Tigard, OR 97223 DA TE S
I S
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 jW' IL
•
INSPECTION WORKSHEET FOR DATE: 1/31/2008 TIME: 7:00Alvl PAGE: 37
SITE ADDRESS: 09370 SW GREENBURG RD 311 CLASS OF WORK:
SUBDIVISION: PP1991 LOT #: 001 TYPE OF USE:
PROJECT NAME: DAVID aLsTRom MD
DESCRIPTION: Install low voltage for data telecommunications. Job No. 99-3B-01189.
OWNER: FRANKLIN COMMONS ASSOCIATES, PHONE #:
CONTRACTOR: C',HRISTENSON ELECTRIC;, INC. PHONE #: 503419-3300
Inspection Request Scheduled For: Date: 1/31/2000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 064269.01 503-806-9341 N
J°1°1 ivAL, .
Corrections/Comments/Instructions:
,\(
( /
L/I
PASS 0 PARTIAL APPROVAL LI CANCEL fl NO ACCESS
FAIL 0 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: • f
Date: II af) Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007-004t30
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12127/2007
Phone: (503) 639-4171 avAliabOl&
Inspection Requests (24 Hrs.): (503) 639-4175 ,44-
INSPECTION WORKSHEET FOR DATE: 1/24/2008 TIME: 7: 02AM PAGE: 74
SITE ADDRESS: 09370 SW GREENBURG RD 311 CLASS OF WORK:
SUBDIVISION: PP1991 LOT #: 001 TYPE OF USE:
PROJECT NAME: DAVID BILSTROM MD
DESCRIPTION: install low voltage for data telecommunications. Job No. 9938-01189.
OWNER: FRANKLIN COMMONS ASSOCIATES, PHONE #:
CONTRACTOR: cHRISTFNSON ELECTRIC, INC. PHONE #: 603 419-3300
Inspection Request Scheduled For: Date: 1/24/2008 Pour Time:
Code # Inspection Description Confir - Contact # Message
13 ..; Low voltage 06378101 503-806-9341
Corrections /Comments/ Instructions:
PASS PARTIAL APPROVAL 0 CANCEL fl NO ACCESS
LII F- IL [7 CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Cr • N 46 Date: t • 1-.4 • O1 Phone #: (503) 718- I-Ab