Permit CITY OF TIGARD ELECTRICAL PERMIT-
RESTRICTED ENERGY
' 'l DEVELOPMENT SERVICES PERMIT #: ELR2002 -00149
` - -- ' 13125 SW Hall Blvd.. Tigard, OR 97,223 (503) 639 -4171 DATE ISSUED: 8/5/02
SITE ADDRESS: 08015 SW HUNZIKER ST PARCEL: 2S101BD 00300
SUBDIVISION: ZONING: I -L
BLOCK: LOT: JURISDICTION: TIG
Project Description: Install Data /Telecommunication.
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:
PERFORMANCE CONTRACTING INC CHRISTENSON ELECTRIC INC
8015 SW HUNZIKER ST 1631 NW THURMAN
TIGARD, OR 97223 2ND FLOOR
PORTLAND, OR 97209
Phone: 503 - 684 -5533 Phone: 503 - 341 -3636
Reg #: LAC 458
SUP 3289S
ELE 26 -34C
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 8/5/02 $75.00 2720020000 Elect'I Final
5PCT CTR 8/5/02 $6.00 2720020000
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
Issued by Permittee Signature
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale. lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: 0 DATE:
LICENSE NO: 7 3 5
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
JUL 4 )02 TUE 11:39 AM FAX NO, P. 01/01
•
Electrical Permit Application •
Date received; 041/ Permit no.:,! ` ,., '0.,..- -ea
ma EWE rt��ii, City of ` igard t. 1'rojcet/appl,no.: Expire date:
Cityof'1'igard Address: 13125 SW Hall Blvd, l�tgard OR 97223 Date issued: lanq Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 JUL 3 ( 2002 Case file no.: Payment type:
. Land use approval: x,3.1. Y fi11$' i•gkiita.
T , v Mel nrirmniq
o 1 & 2 family dwelling or accessory a Commercial/industrial El Multi - family ❑Tenant improvement
El New construction 0 Addition/alteration/replacement 0 Other 0 Partial
job address: 8015 SW_ HUNZ1I(R RD (T) Bldg. no Suite no.: Tax map/tax lot/account no.:
Lot: • — J 'Subdivision: _
Project name: p C I 'Description and location or work on premises: LOW VOLTAGE DATA /TELFCOMMUNICATIOI
Estimated date of completion/ins ction: QUESTIONS ( 503) 806 -9340 GARY
I„ . , it VI:11.N "i' )R AP ',;,I('A l'ION 0 „ ,i , , „•11:#: St 1 lvDit1 , . ,
Job niot • --0 U3 Cee 1,6x _ Description Qty, (est.) Total no, limp
Business naml:CITRISTENSON ELECTRIC, INC- New residential- sin* ormultldnmilyper
Address: .. 1631,. NW THURMAN 2ND FLOOR dwelling twit. Includes athtchedgtune•
City; PORTLAND State: 0 • ZIP: 97209 , l 000 sq, fr, or less � Service included: 4
_
Phon03 41 3608 Fax503 4193'636E ?1✓ nchadditional500sq .fr- orportion
110
CC 5 w - F C, hus.lic. n0: 26 34C , \ - Limited energy, residential 2
J City /metro o.: 5 46 " Limited energy, non- residential 2
Each in *nuractured home or modular dwelling
7 30 02 Servico and/orfeeder 2
Sij�nat' of supervisin • Derr c required) Dale Serviccsotrfeedrrs- lnslallalton,
Sup +lecrname (print): HRIAN CHRISTOPHER tic ensena: 87 alleratlonorrelocation:
200 amps or less 2
201 an1p5 to 40 amps - ■ 2 •
Name (prink): - 401 amps to 600 amps 2
Mailing address: ,_, - 601 amps to 1000 amps . , 2
City: _ —, Slate: ZIP: J Over 1000 amps or volts 2
Phone: lam: E-mail: Reconnect only - l
Ownitr installation: The installation is being made on property t own Temporary wervices or recurs -
irudallation, alteration, or relocation:
which is not intended for sale, lease, rent, or exchange according to 200 amps or less 2
ORS 447, 455, 479, 670, 701. 261 amps to 400 amps 2
Owner's signature: __ _ _ • Date: 401401 to 600 amps } - 2
Branch circuits - new, alteration,
or extension per panel:
Name: _ _ P.. Fee for branch circuits with purchnee of
Address: �� service or feexler fee, each brunch circuit 2
Cit : - I State: J ZIP: - ; 1I• Fee for branch circuits without purchase
Y of service or feeder fee, first branch circuit: 2
Phone: Fax: B "
Each additional branch circuit.
Mist, (Service or feeder not tncloded)t
f ach pump or irrigation cin It 2
❑ Service over 225 amps-commercial U Health-care facility 2
0 Service otcr320 amps - rating of 15:2 Q Each sign Or outline lighting Hazardous location i ticirc r s i ng panel, family dwellings 0l3uildinp,,ove S
10,000 square feet four or g ' �) or light gyp 1 75 -00 2
0 Systim over 600 voila nominal more residential unit in onesutrcture alteration, or extension'" - -
0 Building over three sturles 0 Fettle's, 400 amps or mole *pcscriplion: PA.A / T ELE.C.OMMLU.N LC AT TON ,.,, _. ..
11 Occupant load over 99 persons 0 Manufactured stnictures or CV park ' Fzch additional Inspection over the allowable In any of the above:
0 Egress/lightingplan ❑ Other:. - _ Per inspection MINII♦
submit sets of plans with any of the above. Investigation fee _
The above are not applicable to temporary construction service. Other .
Permit fee $ 75 • -
Not all juriulleliona accept ciedir coats, please call juriadicli n roe mote ipfomuNton, Notice: 'this permit application Plan review (at %) $ —
❑ Vita, 0 MasterCard expires if a permit is not Obtained
cradle card number: _",,,, .,. _ .. / / within 180 days after it has been State surcharge (8%) .... $ 6_, __ /
t accepted as complete. TOTAL $ , R 1 _ 011._
— Nome of cardnolckr tot ri+own on credit C �r� "-- S * ** *TRUST ACCOUNT DEDUCT * * **
Cuniboldcr signature &meant 4aua4615 (Ntuico
OCT.2000 +ZEES ON BACK OF FORM