Permit •C !TY OF T; CARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00153
< I DEVELOPMENT SERVICES DATE ISSUED: 3/15/2005
1 ��I I 1 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1 S 136CD -00101
SITE ADDRESS: 11675 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: LOT : JURISDICTION: TIG
Project Description: 2 circuits, ATM and lighting.
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: 1 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:
MILLAR, TED LTRUSTEE CHRISTENSON TECHNOLOGY SERVICES
BY WILLIAM C FLOBERG 1631 NW THURMAN ST. STE 200
834 SW ST CLAIR PORTLAND, OR 97209
PORTLAND, OR 97205
Phone: Phone: 503 - 419 -3600
FEES Reg #: LIC 64137
ELE 26 -1174C
Description Date Amount SUP 1994S
[ELPRMT] ELC Permit 3/15/2005 $53.50
[TAX] 8% State Surcharge 3/15/2005 $4.28 REQUIRED ITEMS AND REPORTS
Total $57.78
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 or 1,00 -33 -2344.
Issued By: Permittee Signature: j
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.
W AR -14 -05 tION 05:10 PM CHRISTENSON ELECTRIC FAX NO, 5034193695 P. 01
j pical Permit ,� a,, 1)
e -
' FOR OF'F'ICE USE ONLY
' City of T igard Relved
13125 S W Hall Blvd., Tigard, OR 97223 ' NOS Dat ie / `� O5 A, Pemrit Na. - • 1 -
Phone: 503.639:4171 Fax: 503.598.1960!- i Plan Revie
Inspection Llne: 503.639.4175 1 +'. l ' ' pare/By: Other Permit; Internet: LIne: .tisar C1 lY O F Ti GAR � � . - _ � �� tau Reedy/By: AIM. 10 Notified/method: 121 See Pegs a mt � -
�F Y oka #�, aZ7 ' .�, U • w !rr� ��a . - a 1� / • Supplemental Information
❑ Ncw cOnstruclion g Addition /alterati Please check •. �' ' c k all that rd : a ply: N�1. RE{tYY?�Y
on replacement - ca I
I:3 Demolition Other: pp Y
:r, - /,• tr Mr nn tt ❑ � AA,��
OService over 225 amps, corrun'i El Hazardous location
'.waY "sd,Q,;.i aa;: , *�I� ,;DIx` r r N �, :�. �:,• ❑Service over 320 amps - rating ❑Buildngover10,000sq.ft.,
r+ h •�;; .• , ;.•; : of 1- and 2- family dwellings 4 or more new residential
❑ 1 - and 2- family dwelling x Commcrcial/industriai
❑ Accessory building ❑System over 600 vole nominal units in one structure
❑ Multi family 0 Master builder [] Other; ❑Building over three stories ❑Feeders, 400 amps or more
A , `' r' as �� ❑Occu ant load over 99
11111 ' „�11, P IC !: 1l'l /: r :1 ' f,. SIR ''r"• tr '" a , P persons ❑Manufactured structures or
yirsr3,Fi s 1� ' ��- •I� ,,,'`" a i ❑Egress/lighting plan RV park
Job no.67 - 46808 Job site address:11675 SW PACIFIC HWY [Wealth facility ❑Other _ T
City /State/ZIP: TIGARD, OR 97 223 Submit 2 sets of plans with any of the above.
The above are not applicable to temporary construction service
SuitefbldgJapt. no.: _ I Project natne:WEST COAST BANK P' ; 1 • i::1 '- '�� P>tkf • • --- --
Cross street/directions to job site: ter '" twlD" r Qty. I FM I rout I --
QUESTIONS ?CONTACT EUGENE WONG (503) 720 -6287 New residenuatsingle - or tnuiti- family dwelling unit, -
Includes attached garage.
1,000 sq. ft or less il 145,15 4
Subdivision; Ea. add'I 500 s . !t or
Lot no.: q portion 33.40 1
Tax map/parcel no.: Limited energy, residential 75.00 2
1. n �i,�tiH�i1t tw it r i nn i r Limited energy, non - residential 75.00 2
J '
��:t�F!' =+ � , r�� . s�±� '�! Each manufactured or modular
(2)CKTS FOR DEDICATED CIRCUIT FOR ATM AND FIGHTING dwellin;, service and/or feeder 90.90n 2
Services or feeders Installation, alteration, and/or relocatio
71 ^e!i.i ?1,p,Yt' -�H�; n."R'' 200 amps or less 80.30 2
x. -. ''' c'.y .r_ ... 1 i ,;, o i:` ' l i,'Ir >,,,'i"'li { ;i;•= r.. t itan' 201 amps to 400 amps 106 85
Name: WEST COAST BANK 40i amps to 600 amps _ 160. z "
601 amps to 1.000 amps _ 240.60 2
Address: 11675 SW PACIFIC HWY Over 1,000 amps or volts 454.65
z
City/State./ZIP: TIGARD, OR 97223 Reconnect only 46.85 2
Temporary services or feeders Installation, alteration, and/or
Phone: (503 )598 -7482 I Fax: ( ) _relocation
Owner installation: This installation is being made on ro not 200 amps or less amps 46.85 I
intended for sale, lease, rent, or exchange, according to ORS 447 449, 670, and 701. 201 amps to 4 00 amps 100.30 z
Owner signature: 401 amps to 600 amps 133.75
Date: Branch ?
i1- I+'��•irS�'r'• +��',:,:�• '''�r`�( ?-� ' " +'�. a•T, . r.• _ dcircaits -•hew alteration, , ' " �� y ^ i.. 'i �•�� h' -�' 'wr.,•rrr.� : ,r; hew, Ion, or extension, per panel
.. + ,._ Vii _.� .t.,l:• .." r ��j-• J n�3�°,'�',,�C !1.::ir::.��1
A
.• . . •. .rr s .,'0',' . t••" :,. ..t . ,_ ;' "c , ;1 , A. Fee for branch circuits c h
r « =4 . service or feeder fee, each
Business tattle:
branch circuit 6.65
2
Contact name: B. Fee for branch circuits
without service or feeder fee,
Address: each branch circuit 1 46:85 +6.85
City/State/ZJp Each add') branch circuit j 6.65 6.65 z
• ` Miscellaneous (service or feeder not Included)
Phone: ( ) Fes:: ( ) Pump or irrigation circl 53.40 2
gn or outline lighting 53.40 2
E a il: p� •� ,.� , Signal circuit(s) or limited
. -
tt gry ?3 .MA TZ :'1�?.i7: . � _ e nettk. scal ri
Business name: CHRISTENSON TECHNOLOGY SERVICES, INC.
�u. e be
li on, or 75.00
Page 2 2
Each additional inspection over allowable In any of the above
Address:1631 NW THURMAN ST 2ND FL
City/State/ZIP: PORTLAND, OR 97209-2558 - Per inspection 62.50
Investiga
Phone' Investigation per hour (t ru mini 62.50
419-3600 1 Pax: ( 503) 419 -3636 industrial plant perllour 73.75
CCB Lie.: 64137 Electrical I.ic.. 174C ► Su 1 4c ^ ��•dyAlti)�3ittac i ,t', 1 7 : ` .=.3 ; _ 7 .: '
Suprv. Etc , ,
Subtotal 53.50
Suprv. Electrician signature, required: / r �
' / _ Plan review (25 °4 of permit fee)
Pratt name: ROBERT AXT Date: /14/05 14/ 05 State surcharge (844; of permit fee) 4.28
Authorized si gnature: TOTAL PERMIT FEE 5 1. 78 .,/
This permit appl cadoo expires WA permit Is not obtained within ISO
Print game; days after It has bean accepted as complete
I Date: • Fee methodology set by Tri - Co uhry Building Industry Service Board
•• Number of hoc
c\ 8wlei°t+lPemritslQ.Lt Pcmiiuppdec ILO3 inspections perpetmitallowed. * ** *VISA * * **
440- 4613700/02/COM/WE9
,
CITY OF TIGARD
BUILDING DIVISION 4, PERMIT #02OO6 -0/.6
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 ta 4, 0 1
Inspection Requests (24 Hrs.): (503) 639 -4175 % :44— � II 120/2, k "
INSPECTION WORKSHEET FOR DATE: 141, — D TIME: �'I r PAGE:
1.,
SITE ADDRESS: //(Q75� S(J �RG/7�'t/ y CLASS OF WORK:
SUBDIVISION: / � LOT #: TYPE OF USE:
PROJECT NAME: 10-e � 1
T/r
DESCRIPTION: l 7 .54-R # 1 r ZCf� -S
OWNER: PHONE #:
CONTRACTOR: afrifrikiilapl PC PHONE #:
Inspection Request Scheduled For: Date: i ftfeya. 10 Pour Time:
Code # Inspection Description Confirm # Contact # Message
!fig f i hd 9) - 7 O- 1
C G��4
Corrections/Comments/Instructions:
•
X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ C L OR INSPECT' • N ❑ ADDITIONAL FEES ASSESSED
Inspector: A Date: 7 / 4O Phone #: (503) 718 - 1-41/h