Permit CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
mr DEVELOPMENT SERVICES
PERMIT #: ELR2005 -00259
N
l i 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/31/2005
PARCEL: 1S135DD-03301
SITE ADDRESS: 11945 SW PACIFIC HWY 250 ZONING: C -G
SUBDIVISION: HOFFARBER TRACTS NO.1 LOT: 002 JURISDICTION: TIG
Project Description: Voice /Data.
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 PROPERTIES INC CHRISTENSON VELAGIO, INC.
8320 NE HWY 99 1631 NW THURMAN ST. STE 200
VANCOUVER, WA 98668 PORTLAND, OR 97209
Phone: 360 -574 -6255 Phone: 503- 419 -3600
Reg #: LIC 64137
ELE 26 -1174C
FEES SUP 1994S
Description Date Amount
REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 8/31/2005 $75.00
[TAX] 8% State Surcha 8/31/2005 $6.00
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 questions to OUNC at 503 - 246 -6699.
Issued By: ��' Permittee Signature: c.; sQ ,(;
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.
•
AUG -30 -2005 TUE 12:04 PM CHRISTENSON VELAGIO FAX NO. 95034193695 P. 01/02
'ti r
Electrical Permit Application 1.01: O 111(• f, I , t.. ( "' I.1
City of Tigard RECEIV • ;� Re . , - r �I ._- •
13125 SW Hall Blvd., Tigard, OR 97223 Plan Revieiw Other Pent*: Phone: 503.639.4171 Fax: 503.598.1960 a ..',
(� ry I • DateB
Inspection Line: 503.639.4175 ' AU D r--114 , ' I � „ Date Ready/By: !Nita . Sc Page Z far
Internet: www.ci.tigard.or.us Nati(ied/Methad:' LL Suppletaentallnformadon
a xe 3 s �',I - 4 : ' :ix
.,hF;7^r.S0' Za OI4" s9 a �Ii { [ N� l r W o' "rC*. 'EK , .M''fi"4 .
❑ New construction Ut Addition/al :, 11 ;i "1 1 .:'cement Please check all that apply:
['Service over 225 amps, comm'I El Hazardous location
O Demolition ❑ Other: ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. tt,
y r 7.1" yip;, �X W . a',. ', :' ; 4 l � ii . k),_'":"7 • g u ',' :. of 1 • and 2- family dwellings 4 or more new residential
.:hl"� ;' F .Rrk A�'d '� 1.�1!T!' .. . •. :�.;4 ' �� •. ,:
❑System over 600 volts nominal units in one structure
❑ 1 - and 2 - family dwelling Comltlercial /industrial ❑Accessory building ❑Building over three stories ❑Feeders, 400 amps or more
❑ Multi - family ❑ Master builder ❑ Other: DOccupant load over 99 persons ❑Manufactured structures or jp
ll. °.' Vic; , r; • �,. w.° t'. ` 4. ! +.s91+v,:.:.` 150.44 ' f c- " ❑ Egress/lighting plan RV park
��:�>~,.. .,
Job no.: 39 -00954 Job site address: 11945 SW PACIFIC HWY ['Health-care -care facility ❑Other:
Submit 2 sets of plans with any of the above.
City/State/ZIP: TIGARD, OR 97223 -6478 The above are not applicable to temporary construction service.
..4..,' \ k„ ., .1:1' ' j' : rL�N, -;,1 ,)ll ,.,? ti : ' , IM 4.i.: i • l• �YS,+ y ' . :ii � .: I•:,,�ic'•,'s"`•;:
Suite/bldg. /apt. no.: 250 I Project name: JO -ANN FABRICS#2120-TIGAR) ' d aa Qty. I Fes. 1 rota( (•-
Cross street/directions to job site: QUESTIONS ?CHRIS G . (503) 419 -3352 New residential single- or multi- family dwelling unit.
- - Includes attached garage.
1,000 sq. f(. or less 145.15 _ 4
Subdivision: - I Lot no.: Ea. add'l 500 sq. R. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map/pitied no.: Limited energy, non-residential 75.00 2
Y r _v,". r., :` " " '•' r, ` ';° " Each m anufactured or m odular
,:- , ...,.. A . ,. • ,. ��;D�6�, �t�r�. 411�1ft':,�'_, w+�',
ky d •`•'.,��S% `" ie. ^•i - ..f . , �,.. .y �'.t! K l r .- . .,��r. . r »•
dwelling, service and/or feeder 90.9 0 2
' LOW VOLTAGE DATA/ TELECOMMUNICATION Services or feeders Installation. alteration, and/or relocation ,
200 amps or less 80.30 2
, . ,. � � r ry_� • r . .- \k ..,,.-, • •„ ,.•. rr,: ' 201 amps to 400 amps 106.85 2
• . 4;g Ps �dL :1�:Q,+! +,ZTr:k_:r ^ ,J • ' :��r::.;r0ia \I . �PIWZ r,.. sf.tre,-• 401 amps to 600 amps 160.60 z
Name: 601 amps to 1,000 amps • 240,60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/5tate/ZIP: Temporary s ervices or feeders Installation, a lteration, and/or
r- relocation
Phone: ( ) _ Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that 1 own which is not Y01 amps to 400 amps 100.30 .„ 2
intended for sale, least, 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
�- e.. v i.('i:• ,: r�;�: ' I p• ) e!::`(•, 3 j; •4: ''.,k A. Fee for branch circuits with
�• �. •h��!$- :� � .. ; ApitC�•r�lf,r tltrer: : ,5'•'r1�S �!k y a;l;- t•:':�,Q rr . :;e >;•rr
....... �• �'', � .., .�: ... � 1�.17:[i`RER9QN ^ " ser or feeder fea each I
6.65 2 ,
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee. 46.85 2
each branch circuit
Address: • Each add'I branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included) _
Pump or irrigation circle _ 53.40 2
Phone: ( ) I Fax: : ( ) I Sign or outline lighting 53.40 2
E -mail: I Signal circuit(s) or limited 75.00
M . , ::ax r ener panel alteration, or
y,.. ,R:�. 1-14 \. \ . 1 t �� j� G 'i•N�•;J"� �•�: �i'�:• _. .la
�C+ „;il..:vrr�•�k >4i;? '' ;�.,i.S; GQSAC�'t+�l \r? r'•a ... ,. S•r�a.. ., s._:., 2 2
• • t extension- Describe: P age
Business name: CHRISTENSON VELAGIO, INC. i DATA /TELECOM _ 75.00
1631 NW THURMAN ST 2ND FL Each additional inspection aver allowable in any of the above
Address: Per inspection 62.50
City/State/ZIP: PORTLAND, OR 97209 -2558 i
I investigation per hour (1 hr min) 62.50
419-3300 I Fax: (503 ) 419 -3333 Industrial plant per hour 73.75
Phone: (503) 419 -3 _ .~ ;.$:. ' : :•e ;s41 ItIC.411 01(4 - 1 ' ;"' rsi;
CCB Lic.: 64137 I Electrical Lic.: - 174C 15uprv. Liei 1994S Subtotal 75.00
Suprv. Electrician signature, require Plan review (25% of permit fee)
State surcharge (8% of permit fee) 6.00
Print name: ROBERT AXT • Date: 8- 130 -05 TOTAI. PERMIT FEE 81.00 ,/
Authorized signature: I Thl, permtli applicadue aspires If a permit Is not obtained within ISO
days after It bas been accepted ae complete * ** 1,
Print name:
Pri Date: • pee met odology set by 7r(- County Building Industry Service B m
•• Number of inspections per permit allowed
i:Atui dint\ n litABLC.PcmutApp.doe 1:/m 44a1 6I ST(Ilva /COM/WBB
•
r
CITY OF TIGARD r
BUILDING DIVISION PERMIT #: ELR2005-00259
13125 SW Hall Blvd., Tigard, OR 97223 • DATE ISSUED: 8/31/2005
Phone: (503) 639 -4171 ��hili�ll
Inspection Requests (24 Hrs.): (503) 639 -4175 `:_..
INSPECTION WORKSHEET FOR DATE: 9/2/2005 TIME: 7 :07AM PAGE: 68
SITE ADDRESS: 11945 SW PACIFIC HWY 250 CLASS OF WORK:
SUBDIVISION: HOFFARBER TRACTS NO.1 LOT #: 002 TYPE OF USE:
PROJECT NAME: JO -ANN FABRICS
DESCRIPTION: Voice/Data.
OWNER: TIGARD PROPERTIES INC, PHONE #: 360 -574 -6255
CONTRACTOR: CHRISTENSON VELAGIO, INC. PHONE #: 503-419-3600
Inspection Request Scheduled For: Date: 8/22005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 014865 -01 503 - 702 -9346 N
Corrections /Comments /Instructions:
/1 Cry d2/1.1./
•
❑ PASS ZTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL II CA OR INSPECTION ❑ ADDITIONAL FEES ASSESSED
2 — Ur
Inspector: 9 Date: Phone #: (503) 718-
CITY, OF TIGARD
BUILDING DIVISION c ' PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: ELR200& 00259
, r� 8/31/2005
Phone: (503) 639- 4171 p I�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/29/2005 TIME: 7:08AM PAGE: 93
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: 11945 SW PACIFIC HWY 250 LOT #: TYPE OF USE:
PROJECT NAME: HOFFARBER TRACTS NO.1 002
DESCRIPTION: `O -ANN FABRICS
Voice/Data.
OWNER: PHONE #:
CONTRACTOR: TIGARD PROPERTIES INC PHONE #: 360- 574 -6255
CHRISTENSON VELAGIO, INC. 503 - 419 -3600
Inspection Request Scheduled For: Date: 9/29/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
13 ow vo - • = 016968 -01 503. 702 -9346 Y
l e Al
Cor actions /Comme!s"1' --
tru ions:
F;NaL�' 12c
/ Q3 -
J
PA C _
El PARTIAL APPROVAL ❑ CANCE ❑ NO ACCESS
❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G (t - N 6 8 Date: 2-9 a Phone #: (503) 718- ,.LI
' CITY OF TIGARD
BUILDING DIVISION "' PERMIT #: ELR2005 -00259
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: B/31/7005
Phone: (503) 639 -4171 4 7 1 111
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9J812005 TIME: 7:09AM PAGE: 64
SITE ADDRESS: 1.1945 SW PACIFIC HWY 250 CLASS OF WORK:
SUBDIVISION: HOFFARBER TRACTS NO.1 LOT #: 002 TYPE OF USE:
PROJECT NAME: JO - ANN FABRICS
DESCRIPTION: Voice/Data.
OWNER: TIGARD PROPERTIES INC, PHONE #: 360.5746255
CONTRACTOR: CHRISTENSON VELAGIO, INC. PHONE #: 503 -419 -3600
Inspection Request Scheduled For: Date: 9/8 /2005 Pour Time:
Code # Inspection Description C. • irm # Contact # Message
135 Low voltage 1 aii 1-0 503-702-9346 Y
Corrections /Comments /Instruction
•
---- PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: c Y k Date: C I • e • O.T Phone #: (503) 718 - V\ \ 6 •