Permit CITY TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2007 - 00299
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/26/2007
PARCEL: 1 S135DD -03301
SITE ADDRESS: 11945 SW PACIFIC HWY 208 ZONING: C -G
SUBDIVISION: TIGARD PLAZA LOT: 002 JURISDICTION: TIG
PROJECT: DOLLAR TREE
Project Description: Low voltage for data and 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:
TIGARD PLAZA LLC CHRISTENSON ELECTRIC, INC.
8320 NE HWY 99 111 SW COLUMBIA STREET # 480
VANCOUVER, WA 98665 PORTLAND, OR 97201
Phone: 360 -566 -8102 Contact #: PRI 503- 419 -3300
FAX 503- 419 -3695
FEES Reg #: ELE 26 -34C
LIC 458
Description Date Amount SUP 1994S
[ELPRMT] ELR Permit 7/26/2007 $75.00
[TAX] 8% State Surcha 7/26/2007 $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 • -stions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: / / j/ � Permiftee Signature: S 40/dielther4
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.
07/25/2007 14:07 5032275987 CHRIST NSON PAGE 01
City of Tigard - Received • •
Dete/By: /09 S Permit No.: E .III t0 < < 131 -vo Hall Blvd., Tigard, OR 9722 RErtr- �*r, p 7 - .. Plan Review
Phone: 503:639.4171 Fax: 503.598,1960 " -.- 0, '"..' ,' ), I
Date/By: Other Permit:
Line: 503.639.4175 — !1,. J pate Readyn3y: kris: B See Page 2 for •
Internet: www.ci.tigard.or.us JUL 2 5 , i Ptotified/Adethed
_ _ � Sapplementallnfermagon
x.:. :¢x< •."e 'y: � . <x :Y .. „�:"� 'd'ais,.<f >: :c;:fii` ;� ':`t.9e;K•:x >s:z: ' ,sr. >.r,<. .V. :vre.<o.
.; y �. :1 -
,. :..,- i:,::s, : >. f«<isv':i 0 :z> ....sRa ,s , , .. % n $,; . • •/ �:.,
;.x<G:- <;,,:::: «r.R'` J ', w s: >;>•. * '�: �< (es�.a`n >y°F•a> s;><. Lev' •' ;�:« eL, � :+
.c• us�:c . .,Y ,: . x .. ::l:, � �?�. :;• .r'.E;f >!'� r' z�.s r;.''siF9< N<- �:;:> �x�:.;n >s>a a ;� . ^!u!s : � ' � .:a,*e`.M x s �ep?e�°3� . < ; C;fa , •f1b
•" .' `.. . >.< K >..o. . -. , . � .. ear.;" ZY" n„,}:e:<: }f:KY, %3. ^::<R%t;! %,.. �..:, � "" �, $...fR.xQ,i,C '^fa <:`L�.,<
�∎ ew construction • J Additi t 99i K °fioAtlt`8pl .
p> I Please check all that apply: n "
❑Service over 225 amps, comni'I •`'pHazardoua location
[] Demolition ❑ Other
'i? 3. K =:ezig.,: a'> ws :,e.m , .. > • A < ,. .;. : ny:x : r`wxL'° 4. '.. e:"e`i<owe ` ['Service over 320 dugs -rating 5 �]Htttldng over 10,000 3q, R.,
`'" ," ■> ' ' .' ' '• � ` �.��,�:,. ,;,>�r;x;�r � of l- and 2-family dwellings • 4 or more new residential
❑ 1- and 2- family dwelling !' Commercial/industrial ❑ Accessory building El System over 600 volts nominal units in one structure
❑ Multi family ❑ Master builder ❑ Other; El Building over three stories ❑ Feeders, 400 amps or more
:' : ^; , • < :.•:n:. <:::<; »;; . " „. ; . 00oatpant load over 99 persons ❑Manufactured structures of
a :. < • : axe: . n
<s - .,s x .. > I � Y @ ; , '
sc
. vs :? „ : : «N.4 N ❑ Egres&lightingplan RV Park
•
Job no. 3g-010114 Job'site address: ‘V11.1.5 sw lv` (7R c a, ►r r• t `,� j, t w , I y ! ❑ I•lealtb -are facility ❑Other -
Submit 2 sets of plans with any of the above.
cit /State/ZIP '� r i piciri � above ate not applicable to temporary con
� ` t1` 3 The .—�^ abov ar no a swcion seree. tvr Suite/bl . /apt_ n : Project T/1 I A i - Y •, ;::.:.,
f t [lame ::� 3•M ” :. _ ;:� ;; : ,.< ' Sa^.,e`:�.:. ;c, "a�e�4:;�:a ��•
Cross street/directions to job site; k y - ,i km 5 ; Mil S Ggt ''ln/tg..►��. New residential single- or multi-family dwelling unit.
+' v Include% Attached garage.
•
.50344 ' 3352- 1,000 sq. ft. or leas - 4
Subdivision: 1 Lot no.: Fa add'1500 sq. ft. or portion 33.40 1
Tax map/parcel no.: •
Limited energy. residential 75.00 2
« }, •.t r.> e o ..a ` > ' r " r ;w ":.w ".,: - y ., , y ... .; ka: t �:, . , x , .. Limited energy, non-residential 75.00 ' • 2
:,J;k::/ - . x ., f:e5` ,,••:, gy p. y` )o�,i n ... " > • A •
>.:.... . - >: : :.:e•an*:•&.,::;,f :14; .:.... •;SX ,�� .., °: P::M,•. 's91 •Nac :;roo:eti<a>•."
>... >:ii`,`.s; > -t•' r+:rysA > > %;, s� %� �; "�a'k a Each manufactured or modular
n ���,C r 4 r? �, - I 1 , "A �� , , `` - � n (} ' dwelling, service and/or feeder 90.90 2
, fit V T{`} (Odic v1 6 �Vilkisui— V� t&11S. Services or feeders instailation, alteration, and /or relocation
1 200 amps or less 80.30 2
,''•e 7 ::, . • >,,•: : ; .5.1 ;9:F x, >. :: ? >;:Mtx, sH, x�c :��:p• >- :;,::;•:: « 106,85 2
:sHr�: 201 s to 400 am .. < >:: • is <' :: • ...ow.. . 'f', } :e r fb ‘:........:•'. •r. >W.,,A < snip F3
... •k :s:;:�: «:, e•r ;. , h: \"^ . . :.:,:9r'. . � 0"o , {�j�^ ..+....,' �., �� ..'.'>�L`.: ^ti
401 amps to 600 amps 160.60 2
Name:
6_01. .. 21,..._, 000 amp
arttp 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2 '
City/State/VP: Temporary services or feeders Uwtaliation, alteration, and/or
Phone: ( ) I F ax: ( ) relocation .-
200 amps or less 66.85 I
Owner Installation; This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 _ 2
Owner signature:, Date: • Branch circuits— new, alteration, or extension, per panel
aiA . k' i Y: ; "' • ,•� ark. t ;:Z •' :W > : Z:5,4, �: y.�,� .•.:, t :, :'.v : {x: � A. Fee Car branch circuits with t
^`>9 ..i. 01 - • ± ! !; ..>;`•o..N: . ...T i wR>. v ,,, , ,6 J`foe' ; ,cM �{�� '�++j, > . , ,,-; Y S
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: . wit/tour service or feeder fee, 46.85 2
•
Address: fast branch circuit
Each add'l branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( )
I. F ax:: ( Pump or irri circle 53,40 2 -
L Sign or outline lighting 5340 2
E-mail: Signal circuits) or limited- '
.: .i: : 0'. is i' i <is..'7 vC`>`• :� . ` :ii i `y i e. � .
.....:.......<..._.. c:, �;,>:,»>. sF,« �>< �r< i�.' RFCS. tb' �'.' �, �IAG;. y,,. G�'.,& k. zx z' S< �. �: L: t�. :>< >::<•':< c,r e ll e l'ayP a n el . alter
Business name: Electric, Inc e� st j"�esb ` Page 2 'C . 2 TOL
Address: Ill SW Columbia Street, Suite 480 Each additional Inspection over allowable 1st Any of the above
Per inspection 62.50
City /State/ZIP: Portland, OR 97201 Investigation per hour (1 hr min) 62.50 •
Phone: (503) 419-3300 1 Fax; (503) 419 - 3695 Industrial plant per hour 73.75
CCB Lic.: 458 1 Electrical Lic.: 26 S rv Lic.: ]99 ; < „� -:.: : > <�'
Subtotal I I ,
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print name: Rp1P-t‘ Date: I I a te Di State surcharge (8% of permit fee) 4 0
Authorized signature: TOTAL PERMIT FEE I it[m
gnature. This permit application .spires I a permit Is not obtained within ISO
days .n.r It bats been accepted ■,.ontplete
Print Warne: _ I Date: ' . . • Fee methodology set by Tn- County Building [MOW Service Board
•• Number of utspecNoes per permit allowed.
1'< 13 'g\PermUaaELC- PeennAppdoe 17/03 440.101 ST(tarpb'COM/WEb
•
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00299
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/26/2007
Phone: (503) 639 -4171 ICI
Inspection Requests (24 Hrs.): (503) 639 -4175 F. _..
INSPECTION WORKSHEET FOR DATE: 7/30/2007 TIME: 7:02AM PAGE: 34
SITE ADDRESS: 11945 SW PACIFIC HWY 208 CLASS OF WORK:
SUBDIVISION: TIGARD PLAZA LOT #: 002 TYPE OF USE:
PROJECT NAME: DOLLAR TREE
DESCRIPTION: Low voltage for data and telecommunication.
OWNER: TIGARD PLAZA LLC, PHONE #: 360. 566.8102
CONTRACTOR: CHRISTENSON ELECTRIC, INC. PHONE #: 503-419-3300
Inspection Request Scheduled For: Date: 7/30/2007 Pour Time:
Code # Inspection Description on # Contact # Message
199 Electrical final 052966 -01 03-702 -9346 N
Corrections /Comments /Instructions:
c 4 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: v ' 0 6 Date: � ��I be) Phone #: (503) 718- x--17