Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT •
t• „it" . = -- COMMUNITY DEVELOPMENT Permit #: ELR2012 -00088
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/09/2012
T . ..FiD g Parcel: 2S112AC00600
Jurisdiction: Tigard
Site address: 7440 SW BONITA RD
Project: Associated Business Systems Subdivision: GARDEN TRACT ADDITION Lot: PT 24 - 21
Project Description: data telecommunications cabling
Contractor: CHRISTENSON ELECTRIC INC Owner: BEALES, ALAN K & SUSAN R TRUST
111 SW COLUMBIA ST, STE 480 BY BEALES, ALAN K & SUSAN R TRS
PORTLAND, OR 97201 2126 MAGELLAN DR
• OAKLAND, CA 94611
PHONE: 503 -419 -3300 PHONE:
FAX: 503 -419 -3695
FEES
Description Date Amount
Specifics: Restricted Energy Permit 05/09/2012 $75.00
12% State Surcharge - Electrical 05/09/2012 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: Y Fire Alarm: N
HVAC: N Instrumentation: N
. Intercom /Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N •
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N Total $84.00
Other Desc: Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained In the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. j
Issued By: Permittee Signature: ON �,G /07
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' Date:
LICENSE NO.
Call 503.639.4176 by 7:00 a.m. for the next available Inspection date.
This penult 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.
MAY -07 -2012 MON 03;04 PM CHRISTENSON ELECTRIC, INC FAX NO. 95034193695 P. 01/02
Electrical Permit A lication 1:01;t ot'-IICE USE ONLY
. City Tigard v:
lig
" 13125 SW w Hall Dlvd., Tigard, OR 97223 Plan Review
Phone: 5113.7) .2439 Fax: 503.596.1960 f f. — 8 RECEIV �Lk,te/B �,a ed ....57f , z , Permit No. ECA O/2 — �ooP�
Other Permit: •";. sue raget fur •
inspection Line: 503.630.4175 L 'Date Ready /lay:
TI GAILD tt
Internet: www.tigard ur,(lov ,/Method mental Information iTy.OF
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k all t hat W n
::.. • • .:: . .' • . .: • • , � . •.... .... , . '= � - _ d y (submit acts of �l ans w /iws checked below); m
Please chec I itppl
• ❑ New construction 5 •ddition /alteration /replacement ❑ Service or feeder 400ampsormore ❑ Building over three stories.
❑ Demolition ❑ Other: _ where the available fault current ❑ Marinas and boatyards-
:`:CA GORY.'11F: • C01Y TRiIC UN ,... exceeds 14,000 or CI 0 Floating buildings.
Commercial-use agricultural
; ; exceeds 10 000 amps • . „ , • ... less to g or cx
❑ i - and 2- family dwelling Commercial /industrial ❑ Accessory building snips for ell titherinsrllations, buildings,
❑ Multi-family ❑ M • i r- b 0 Other: 0 lZIF ire pump. Emergency system, p larger la separrtely derived system.
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•• . tar loaf of • .. B 5l'J:E''�PiF.ORMA , , ., ...... ..
T40N.`ANip - i
OCATIOIV:. ❑ A
,. � • , , Addition o new motor '
.... .... occupancy. - - Q � t00HP ur m re,
Job no.(0Q 4' I Job site address: LIL( NA/ A [ _ ea ❑ Six or more residential units, ❑ Recreational vehicle packs.
❑ Healthcare facilities. ❑ Supply voltage for more than
City / State/ZIP: k 1: 2 if , O Hazardous locations. 000 volts nominal
,.
Service r 6 MIS or more•
or feeder Suite/bldg. /apt. no.: Project name r —1-- . • r. EE .';SCH1ED[ILE
Cross street/directions to job site: �ttegemptlam I Og'• I Fee. I rvt.t -1
n Now residential single- or multi - family dwelling unit.
r
41.a. , , At _.. •—e'1. _ Includes attached garage.
1,000 sq. ft. or less 168.54 4
Subdivision: Lot no.: Ea. add'I 500 sq. R or portion 33.92 1
Tax map /parcel no.: Limited energy, residential 79 00 2
- ............. • .. s q ( U — • . • -., ,^ .. . - . . . . , , . multi-family
•.,,.,.. .:. . : ;.�. : ,':.:�:,•:;�:, .;,;;;:'�
" '.. ' - Limited enerby. ilY
I. , 2
` r �ti , ! J C a - 5 residential (with above sq. (tl _
MA, — .Services or feeder I tallatin , and/or relocation
2
I amps orI
1 i .. .1b ., . 201 v pam4 0 133.56 2
..,
200 ps C99 s ns n, alteration,
::i@ ; 'PROI!ERCY• -- 200,34
;dVY ER.
;
.::.,. ; • :,. ' • - 401 amps to G00 amps
Name; —
Got amps to 1.01!0 amp 301,04 2
Over 1,000 amps or volts 552.26 2
Address: Temporary services or feeders installation, alteration, and/or
City / State/ZIP: _ relocation
200 amps or less 59.3(1
Phone:. ( ) I Fax: ( ) 201 amps lo 400 amps _ 125.08 2
Owner installation: This installation is being made on property that 1 own w is not 4 01 am l0 5 09 amp 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits— new, alteration, or extension, per panel A. Fee for
Owner signature: - hov branch or f 7 2 2
., ;, ; ;, . ' . . . ... branch circuit .
.,...,„ Q: C F h
..':��� •�, �: ••.
B. Fee for branch circuits without
m
Business na service or feeder fee, first 56.18 2
branch circuit
Contact name: —
add') brunch circuit 7.42 2
Address: Miscellaneous (service or feeder not included) _
Fach manufactured or modular 67.84 2
City /State/ZIP: dwelling, service and/or feeder
Reconnect only 67.84 2
Phone: ( ) Fax: : ( _ ) Pump or irrigation circ 67.84 2
E -mail:
67R
,..,,.... .: Q CI ,,. , ..,
� Sign or nut Ina lighting
.. , , . ,., . �'� � � OR ,�: ' : •; • si t:ircuit(s) or limited-energy
r ... :; .. '.. '. alteration or extension. Page 2 5
Business name: GM
AAA .. io . . 1_ 16 �' .
_panel. h additional inspection over allowable in any of the above
A dditional inspection ( h r min) �
Address: "l� i i , A A .
` 66.35 / hr
- _ .. d Investigation (I hr min) - G 6.25 /hr
7 8.18/ hr
City/State/ZIP: - i, • us. _ Tnduatri dl plant (i hr min) -
` nspecligtts for which no fee i9 90,00 / hr
one:. 0 11 ! _ l� . /1J s p r <ifirally listed ('h h min)
- t 1 CCB Lie.: Electrical Lie. of .l J1 _ of E I :,)3_ T.RICp1; "YEti.MIT':F •'•-' „
'r _ Subtotal: 5 � lb
• /�`
Suprv. Electrician signature, required:
Plan review (25 %, permit fee): mom Stat surcharge (l2`%of permit fee): /
Print name; 1Q��`�, ,. d,�- ~ Date: 1/
9'� /f �J �.:�1 TOTAL PERMIT FEE: to
Authorized signature: This permit oppiiention expires It a permit Is Pot obtained within 150
days atter it has been accepted as eamptete.
Date: • Number of
Print name: w u inspections allowed per permit.
- 440-01 ST( � J
clauiidingWe ,miis,et.C- Pcm,INpp.dou o7 /at /IO �.�
P. 02/p2
AUTOMATIC COVER SHEET
DATE: MAY -07 -2012 MON 03:04 PM
T0.
FAX #: 95035981960
FROM: CHRISTENSON ELECTRIC,INC
FAX #: 95034193695
02 PAGES WERE SENT
(INCLUDING THIS COVER PAGE)