Permit •
A.. CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004-00750
/*Apo& DEVELOPMENT SERVICES DATE ISSUED: 11/24/2004
- " 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 110A6 -00200
SITE ADDRESS: 14355 SW PACIFIC HWY
SUBDIVISION: CANTERBURY PLACE ZONING: C -G
BLOCK: LOT : 1 -3 JURISDICTION: TIG
Project Description: 2 branch circuits. Reconnect rooftop AC.
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:
KOLVE, G C CHRISTENSON TECHNOLOGY SERVICES
14389 SW PACIFIC HWY 1631 NW THURMAN ST. STE 200
TIGARD, OR 97224 PORTLAND, OR 97209
• Phone: Phone: 503 - 419 -3600
Reg #: LIC 64137
ELE 26 -I174C
FEES SUP 1994S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 11/24/200' $53.50
[TAX] 8% State Surcharge 11/24/200' $4.28 Rough -in
Elect'l Final
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 -800- 332 -2344. ,—
Issued By: fedt J , , ttjt4 4 , /11.4 j Permit Signature: d) a-1•24
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: q -. t/ DATE:
LICENSE NO: (— 1 7Y 19 C.. I T S
Call 639 -4175 by 7:00pm for an inspection the next business day
•
NOV -23 -2004 TUE 10:29 AM CHRISTENSON CORPORATION FAX NO. 503 419 3636 P. 01/02
. le.�„ cfrica1 P @ Y m it pplicat I,u t►
. ol fit( t•'. ii ',
, t.: oNI. •
City of Tigard r JRECEIVE ? Re..r.d P
13125 SW Hall Blvd., Tigard, OR 972 D° ° D I C OQ'� - 007 ■
Plan Review
Phone: 503.639.4171 Fax: 503,598.1960 m ' • r Datc/B . Other Permit:
Inspection Line: 503.639.4175 •� I 1 Due Ready/By: . .. 0 See Pegs 2 far • •
Internet: www.ci.tigard.or.us NOV tY 2 3 2 . - :.� - . Nocfed/Method. .
Supplemental lnformadon
M4Y v�,p �, }: ?k Y' ya s vl y� �i + t r w,.k r t;• sHS i 1 .f'7b,�Ku •
�., _,':r3. 2.151 ,• Li ,. ?•f l5 < i r s {. i ` ' f 0.1)714.-''.: r JJ .,A`- (5 rf• I ;d; , +. � ,�. / ?S�
�1 vl.. L -�. r�d� C � .V • it�,:��., X 1 . 41, 1. � :`��;¢�r •.+1 +3'�!!� -
❑ New construction Ad •'' I. r ni - rep Please check all that • . • • •
QService over 225 amps, eomm'1 ❑Hazardous location
❑ Demolition ❑ Other:
� r� 'y v %1 �`1�'�° c ,,' , ' r ' C M :; . "111.4...k171 ,iw�,. ❑Service over 320 amps - rating QBuildng ova 10,000 sq. ft., 'r` , �=' 1,4 , " " ' •+�u 12 1 �'��K^•.•. r ,,K u!. :e. re r,?4'• , yln 1 , of I - and 2 family dwellings 4 or more new residential
❑ 1 - and 2 family dwelling AI Comniercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ y , Master builder t r t. :.. s [ fiil. 5417:121 ❑Building over three stories ❑Feeders. 400 amps or more
Multi -family
} < ti� ❑Other •
5 z .., QOccupans load over 99 persons ❑Manufactured
t l � r � • w. a �i , r ". ��! af`.'g3 r � L 'Lim•; •.� r f structures or
1,: ;;V IdN .t: r )� ,�I F > iir ^ri '�. b �J�+.�'�. 1e'tit '4 ❑EMss/lighting .RV park
Job no.: 67 - 44582 Job site address: 14355 PACIFIC HIGHWAY ❑Health- care facility !]Other.
Submit _I sets of plans with any of the above.
CitY /StaterZIP: TIGARD, OR 9 7 223 The above are not applicable to temporary construction service.
Suite/bldg./apt. no.: Project name MARTIAL ARTS '.. �j ' � , °a , -..- "'r:;.. ..
STUDIO
ascrlpune Qtr. Fes Taal „
Cross street/directions to job site: New residential single or multi family dwelling unit. •
Includes attached garage.
•
1,000 sq. tt. or less 145.15 . . 4
Subdivision: Lot no.: Ea. add't SOO sq. R or portion 33,40 1
Tax map/parcel no.: Limited energy, residential 75.00 2
Limited energy non•residerttial 75.00 2
r ;} tt d : t r .:.r '.:41 1r .'. }�._ `t) ryr, , ( zM r
`', IS ' �, 3 -r � ••:� .1>•n i ,. ..,,, s 4..,.� sue' F � .. Y.l 'il j n 1 i
N Each manufactured or modular
RECONNECT A/C UNIT ON ROOF dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocatio
IUESTIONS ?CONTACT:BOB AXT (503)419 -3607 200amps 80.30 2
:io'•, '',;:,,:_17.1,.,,-- ir , ', ^ x , , . J M rn-� ir, 4� i. ,{ 201 amps to 400 amps 106,85 2
,..'. e . - •.v�, .. + u :4,.._1_,,.. ' '�, �'.,a....`. rt l. I ..x �� r 1 J , �kr N� s�'rf ".� 401 amps to 600 amps 160.60 2
Name: CC KOI,VE 601 amps to 1,000 amps 240.60 2
Address: 14389 SW PACIFIC . HWY Over 1,000 amps or volts 454 :65 2
Reconnect only - 66.85 2
City/State/ZIP: TIGARD, OR 97224 Temporary services or feeders installation, aheratioa, and/or
Pi ( ) Fax: ( ) relocation
200 amps or less 66.85 1
Owner Installation: This installation is being made on property that I awn which is not 201 amps to 400 amps 100.30
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 am to 600 amps t 33.75 2
Owner signature: - Date
Branch circuits - new, alteration, or extension, panel
Ir .7 r , , ? .,I r Y ' r / ,f r A. Fee for branch circuits with service or feeder fee, each
Business name: branch a ircuit 6.65 2
i
B. Fee for branch circuits
Contact name: ww ohut novice or fader fee,
each branch circuit 1 46.85 6.85 2
• Address: • Each add'l branch circuit f 1 6.65 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not Included)
Phone: ( ) Fax: : ( ) Pump or irrigation Circle 53.40 2
Sign or outline lighting 53.40 .. 2
E-MI • .; f .57:1'.1.-;; �> Signal circuit(s) or limited -
'iiy, ..: ,S:` t 1 I -, A r Iir Tr t .r^�- ri ', k','::12.''f2 ,P_Z�ir'r.`iR energy panel' alteration. or 75.0C ._ ',3,.N _:1,��_ ,.• ..T may ,
Business name: CHRISTENSON TECHNOLOGY SERVICES, INC. extension, Describe: Page 2' 2
Address: 1631 NW T1;URMAN ST 2ND FL Each additional Inspection over allowable in any of the above
Per inspection 62.50
City /State/ZIP: PORTLAND, OR 97209 - 2558 Investigation per hour (i ba ron) 62.50
Phone ( ( 503)
Industrial plant • hour 7175
503) 419 -3600 Fax: 419 -3636
CCB Lic.: n« ��xj,'' �?il''■�fi-,•.�_�}y-v %a- f:iin�, .; )• .j.;<t ;' ��r::- :..�a` :..
64137 �� _ • Subtotal 53.50
Supr v. Electrician signature, required . • 1 f Plan review (25% of permit fcc) •
Print name: ROBERT AXT Date: 11/23/04 State surcharge (8% of permit fee) 4 , 28
Authorized signature: TOTAL PERMIT FEE 57 . 7 8 %/
��' This permit appllcadonezplree Ins permit Is not obtained within too
Print name: days after It hat been accepted Si complete * *VI **
Da te: • Fee methodology set by Tri- County Building Industry Service Board
. •• Number ofinspeetioas per permit allowed
anultcy)porma jLGPwAtA,p.doe 1Z 1 440.46IST( OKWCaM/WBH
CITY OF TIGARD 24 -Hour
BUILDING Inspection ; (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Reques d 1 1 y AM PM BUP
Location 1 r f 3 S< i Suite MEC
Sll� — lb!
Contact Person Ph ( ) g PLM
Contractor _ Ph ( ) SWR
BUILDING Tenant/Owner ELC DO (f - Q n 7,5
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Note . SIT
Post & Beam r C;� / /� "'�'
Shear Anchors p� , V
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: C
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers •
Final
PSAS___pART FAIL
_ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
F•� larm
final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
'BOSS PART FAIL
SITE Please call for reinspec ion RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA Date �� G Inspector Ext
Approach/Sidewalk
Other:
Final DO NOT REMOVE this Inspection recur from th4ob site.
PASS PART FAIL