Permit i
:CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2002 -00198
�Il, DEVELOPMENT SERVICES DATE ISSUED: 5/3/02
`�" `--' 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 •
PARCEL: 25101 BD -00300
SITE ADDRESS: 08015 SW HUNZIKER ST
SUBDIVISION: ZONING: I -L
BLOCK: LOT : JURISDICTION: TIG
Project Description: Electrical tenant improvement - (1) 200 amp service and (24) branch circuits.
Job No. 142 - 0005 -001
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: 1 W /SERVICE OR FEEDER: 24 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:
PERFORMANCE CONTRACTING INC CHRISTENSON ELECTRIC INC
8015 SW HUNZIKER RD 111 SW COLUMBIA
TIGARD, OR 97223 STE 480
PORTLAND, OR 97201
Phone: 503 - 684 -5533 Phone: 241 -4812
•
Reg #: LIC 458
SUP 3289S
ELE 26 -34C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT CTR 5/3/02 $239.90 2720020000( Rough -in
Elect'I Final
5PCT CTR 5/3/02 $19.19 2720020000(
Total $259.09
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 youto 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 thes -Jules or direct questions to
Permit Signature: x Issued By: "I �i 1/
,.......-,--- - -1- .._. (
,
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: , C.. / '' 'G DATE:
LICENSE NO: g7a5
Call 639 -4175 by 7:00pm for an inspection the next business day
x'k ,
I "
- Electrical Permit Application _
C _ Tigard Date received: 61 Permit no.: e - G�' //�'V
4 .- 1'��� Ci of lad ;." ' ' Project/appl. no.: Expire date: -
City of Tigard Address: 13125 SW HaIl.Blvd, Tigard, OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 - 4171 -
Fax: (503) 598 -1960 Case file no.: Payment type: .
Land use approval: ENT APR 3 0 2002
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family CI Tenant improvement
❑ New construction 5( Addition/alteration /replacement ❑ Other: ❑ Partial
JOB SITE INFORMATION
Job address: 8015 SW HUNZIKER RD Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: Block: Subdivision:
Project name: P C I Description and location of work on premises: REMODEL OF EX
Estimated date of completion /inspection: 7/02 QUESTIONS? CONTACT DAVE HUNT (503)419 -3617
,.h;," .9. 1 TOR P,' _ICATION I ,:A r-' - :' a . ; - ..,;' 'r. , _RE .S€IW -, # 4 : , ,? -a • -I .
Job no: 142 - 0005 -001 Fee Max
Business name:CHRISTENSON ELECTRIC, INC. Description Qty. (ea.) Total no.insp
New residential - single or multi- family per
Address: _. 1<• ►t f = l t dwelling unit. Includes attached garage.
City: PORTLAND - State: OR ZIP:. 9 72_09 Service included:
Phone503 41'9 3608 Fax503 419363CE-mail: 1000 sq. ft. or less 4
CCB no.:45 8 Ler c. bus. lic. no: 26-34 C Each additional 500 sq. ft. or portion thereof __ _—
Limited energy, residential ___ 2
City /metro ' o.: 5 46 ' Limited energy, non- residential __� 2
/// j,�� Each manufactured home or modular dwelling
Signat .' ofsupervisin_ " ectrici.' (required) Date 4 / .iU /U2 Service and/or feeder ■■� 2
Sup. elect. name (print): BRIAN CHRISTOPHER License no: 873S Services or feeders — installation, '
all
alteration or relocation:
"!, :, PROPERTY OWNER - - 200 amps or less 80 • 0 2
Name (print): PERFORMANCE CONTRACTING INC 201 amps to 400 amps MEMO 2
Mailing address: I SW HUNZIKER RD 401 amps to 600 amps ___ 2
g 601 amps to 1000 amps ___ 2
!s}�1M[lfGld1 R •
State: ZIP: Over 1000 amps or volts ___ 2
Phone: Fax: E -mail: Reconnect only ___ 1
Owner installation: The installation is being made on property I own Temporary services or feeders - . --
which is not intended for sale, lease, rent, or exchange according to htstallation ,alteration IIII
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps ___ 2
Owner's signature: Date: 401 to 600 amp$ MEM_ 2
ENGINEER Branch circuits - new, alteration,
CHRISTENSON ELECTRIC, INC. A. Fee e bra 159. �0
Name: A. Fee fc: branch circuits w i t h purchase of
Address: service or feeder fee, each branch circuit 24 6 • 6 2
City: State: • ZIP: B. Fee for branch circuits without purchase ■111 .
of service or feeder fee, first branch circuit: 2
Phone: Fax: E-mail: Each additional branch circuit: __ _—
PLAN REVIEW.(Please check all that apply) Misc. (Service or feeder not included):
❑ Service over 225 amps - commercial ❑ Health -care facility Each pump or irrigation circle 111111 2
❑ Service over 320 amps- rating of 1&2 ❑ Hazardous location Each sign or outline lighting MOM 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, ME
❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2
❑ Building over three stories ❑ Feeders, 400 amps or more *Description:
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egress/lightingplan ❑ Other. Per inspection __
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Permit fee $ 39.90
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application $
❑ Visa O MasterCard expires if a permit is not obtained Plan review (at _ %)
' Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ 19. 19
Expires TOTAL as complete. TOTAL $ 259.09 /
Na of cardholder as shown on credit card
$
Cardholder signature Amount 440 -4615 (6/00 /COM)
•
OCT.2000 . I • +FEES ON BACK OF FORM
Electrical Permit Fees: Limited Energy Fees:
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS) .
. Service included: - - ' Items Cost Total `► Check Type of Work Involved: •
' Residential - per unit • - -
1000 sq. ft. or less $145.15 4 Ti Audio and Stereo Systems
Each additional 500 sq. ft. or
:• portion thereof $33.40 ,. 1 0 . - Burglar Alarm, ..
. Limited Energy . $25.00
Each Manufd Home a' Modular n Garage Door Opener"
Dwelling Service or Feeder • $90.90 2 ' +.
Services or Feeders n Heating, Ventilation and Air Conditioning System*
Installation, alteration, or relocation
200•amps or less' .• $80.30 2 Ti Vacuum Systems*
201 amps to 400 amps • $106.85 2 •
401 amps to 600 amps $160.60 2 ❑
601 amps to 1000 amps $240.60 2 Other
Over 1000 amps or volts $454.65 2
Reconnect only $66.85 2
•
Temporary Services or Feeders. -
. • .- N
TYPE OF WORK I VOLVED - COMMERCIAL
Installation, alteration, or relocation Fee for "each system ' $75.00
200 amps or less $66.85 2 (SEE OAR•918- 260 -260).
201 amps to 400 amps $100.30 2
401 amps to 600 amps - $133.75 2 Check Type of Work Involved:
Over 600 amps to 1000 volts,
see "b "• above. Audio and Stereo Systems
Branch Circuits n Boiler Controls
New, alteration or extension per panel
a) The fee for branch circuits Ti •
with purchase of service or l l Clock Systems
feeder fee. .
Each branch circuit : $6.65 2 Ti • Data Telecommunication Installation
b) The fee for branch circuits
without purchase of service Ti . Fire Alarm Installation
or feeder fee.
First branch circuit $46.85 Ti HVAC
Each additional branch circuit $6.65
Miscellaneous n Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40 Ti Intercom and Paging Systems
Each sign or outline lighting $53.40
Signal circuit(s) or a limited energy -
panel, alteration or extension $75.00 Landscape Irrigation Control •
Minor Labels (10) $125.00 Ti
Medical
Each additional inspection over
the allowable in any of the above Calls
Per inspection $62.50
Per hour $62.50
In Plant $73.75 n Outdoor Landscape Lighting
Fees: n Protective Signaling
Enter total of above fees $ n Other •
•
8% State Surcharge $ Number of Systems
25% Plan Review Fee * No licenses are required. Licenses are required for all other installations
See "Plan Review" section on $
front of application.
Fees:
Total Balance Due $
Enter total of above fees • $
0 Trust Account # 8% State Surcharge $
•
TotalBalance Due $
•
i:\dsts \forms \elc- fees.doc 10/09/00 ++OVER FOR PERMIT FORM
CITY OFARD 24 -Hour JUMP.
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
/
BUP
Received Received Date Request d ` ' - AM PM BUP
Location D D 1 Suite MEC
Contact Person (O74 l - Ph ( ) le- M
Contractor r r7sni7 . 1 ftG Ph (
BUILDING Tenant/Owner P VT ELC , e , c f g
Footing
Foundation ELC
Access: / .— , 4
Ftg Drain / l.C� -✓ 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 / I '�
Rough -In
•
Water Service
Sanitary Sewer
Rain Drains -
Catch Basin / Manhole
Storm Drain
Shower Pan
Other: -
Final
PASS PART FAIL
MECHANICAL _
Post& Beam
o Rough -In
' Gas Line •
Smoke Dampers
Final•
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
❑ Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd.
R ' PART FAIL
S ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
- Approach /Sidewalk Date lc) —0 -l2- Inspector c c Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
•