Permit n CITY OF T I G A R D ELECTRICAL PERMIT
a I PERMIT #: ELC1999 -00397
fi �l� DEVELOPMENT SERVICES DATE ISSUED: 7/1/99
— 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S135AB-01004
SITE ADDRESS: 10220 SW GREENBURG RD 610
SUBDIVISION: TWO LINCOLN - TOWN OF METZGER ZONING: C -P
BLOCK: LOT : JURISDICTION: TIG
Project Description: Add three (3) branch circuits to a commercial tenant space.
• 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: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 3 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:
KNICKERBOCKER PROP, INC XXIV CHRISTENSON ELECTRIC INC
BY NORRIS, BEGGS + SIMPSON 111 SW COLUMBIA
10300 SW GREENBURG RD STE 200 STE 480
PORTLAND, OR 97223 PORTLAND, OR 97201
Phone: Phone: 241 -4812
Reg #: LIC 000458
SUP 3289S
PLM 2468S
ELE 26 -34C
FEES Required Inspections
Type By Date Amount Receipt Wall Cover
5PCT GEO 7/1/99 $2.41 5782 Elect'I Final
PRMT GEO 7/1/99 $48.20 5782
ORI G/Hlkt°
Total $50.61
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 -0080. You may obtain copies of these rules or direct •�estions • OUNC at (503)
246 -1987.
Permit Signature: _ 9 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: 0 - 73 - 5 ®' DATE: / 9- 9
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
T ' F TIGARD RECEIVED'
CITY
Electrical Permit Application Plan Check #
13 SW HALL BLVD. 1 1999 Recd By
TIGARD OR 97223 JUL Date Recd
Date to P.E.
Phone (503) 639 -4171, x
nlUN1rY DEVELOPMENT
Print or Type Date to DST
Inspection (503) 639L4175 Incomplete or illegible will not be accepted Permit #� C ( ` 3
Fax (503) 684 -7297 Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development LINCOLN II Number of Inspections per permit allowed
Name (or name of business) COMBINED INSURANCE Service included: Items Cost Sum
Address 10220 SW GREENBURG RD . SUITE 610 4a. Residential - per unit
Each additional it or less $110.00 4
City /State /Zip PORTLAND OR
Each additional 500 sq. ft. or
Commercial El Residential ❑ Li portion thereof $25.00 1
Limited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all current licenses) 4b. Services or Feeders
Electrical Contractor CHRISTENSON ELECTRIC, INC. Installation, alteration, or relocation
Address 111 SW COLUMBIA, SUITE 480 200 amps or less $60.00 2
PORTLAND State OR Zip 9 7201 -5886
201 amps to 400 amps $80.00 2
Cit p 401 amps to 600 amps $120.00 2
Phone No. 503 241 -4812 601 amps to 1000 amps $180.00 2
Job No. 62 -04045 Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. 26 -34C Exp.Date 10/99 Reconnect only $50.00 2
OR State CCB Reg. No. 0045 Exp.Date 5/03 4c. Temporary Services or Feeders
COT Business Tax or Metro No. 5246 Exp.Date 12/99 Installation, alteration, or relocation
-- 200 amps or less $50.00 2
- 201 amps to 400 amps $75.00 2
Signature of Sub El-c' - -. �1le•■■ . -.1. IVr !a
T 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. 873S Exp.Date 10/01 see "b" above.
Phone No. 503 241 -4812
4d. Branch Circuits •
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address Each branch circuit $5.00 2
b) The fee for branch circuits
City State Zip without purchase of
37.50
Phone No. First r der fee.
branch circuit 1 37.50 2
The installation is being made on property I own which is not Each additional branch circuit 2 Ma 5.35 10.70 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required): * Signal circuit(s) or a limited energy
panel, alteration or extension $40.00 2
Minor Labels (10) $100.00
Please check appropriate item and enter fee in section 5B.
4 or more residential units in one structure 4f. Each additional inspection over
Service and feeder 225 amps or more the allowable in any of the above
System over 600 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00
as described in N.E.C. Chapter 5 In Plant $55.00
* Submit 2 sets of plans with application where any of the above apply. 5. Fees: 48.20
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ 2 . /11
NOTICE Subtotal $ 50.61
5b. Enter 25% of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $ 50.61
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account #
Total balance Due $ 50.61
I: \DSTS \ELC96.APP Rev 9/96
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested —711', ° C t AM PM BLD
Location /02--2 COrNeD1 Y✓ Suite (P1( MEC
Contact Person S S Ph g o -{, VD PLM
Contractor Ph SWR
BUILDING r swner Corn % ELC)9q
' ;cr)
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing •
Insulation
Drywall Nailing
Firewall
Fire Sprinkler :7-/A--
Fire Alarm
Susp'd Ceiling
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
CELT
Service
Rough In
UG /Slab •
Low Voltage
Fire Alarm
a'c
PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: • _ [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Other Date ,� ifi rli°/°r/.
Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.