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Permit CITY OF TIGARD ELECTRICAL PERMIT - RESTRICTED ENERGY �i� DEVELOPMENT SERVICES Tigard, (503) 639 -4171 DATEISSUED: I 3/3 04 04 -00053 - 13125 SITE ADDRESS: 15570 SW PACIFIC HY PARCEL: 2S110DC -02200 W SUBDIVISION: WILLOW BROOK FARM ZONING: C -G BLOCK: LOT: 011 JURISDICTION: TIG Project Description: Job No. 53 -03012 Data/Telecommunication paging A. RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: X 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: 2 Owner: Contractor: TIGARD, CENTER LP CHRISTENSON TECHNOLOGY SERVICES 9777 WILSHIRE BLVD #609 1631 NW THURMAN ST. 2ND. FL. BEVERLY HILL, CA 90212 PORTLAND, OR 97209 Phone: Phone: 503 419 - 3600 Reg #: LIC 64137 ELE 26 -1174C SUP 1994S FEES Required Inspections Description Date Amount Ceiling Cover [ELPRMT] ELR Permit 3/3/04 $150.00 Wall Cover Elect'I Final [TAX] 8% State Surchart 3/3/04 $12.00 Total $162.00 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 throuc Issued by Permittee Signature Am I Zji _ _ ��JL 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 639 -4175 by 7:00 P.M. for an inspection needed the next business day MAR -02 -2004 TUE 11:46 AN CHRISTENSON CORPORATION FAX NO. 503 419 3636 P. 01 Electrical Permit A 1'cation FtiK (li•iluE list ONl• R E C E I Received ` • Electrical . Lf// aaD7' - r 23 3 - Date/By: he Permit No• • Ci}� of Tigard Plaanir18 'val sign `J g Date/By: Permit No.: 13125 SW Hall Blvd. MAR 2 '2004 MUM Review Other Tigard, Oregon 97223 Date/By: Permit No.: Phone: 503- 639 -4171 MAW J 5f Post•Review Land Use +nr alr;k4 � Date/By: Case No.: Internet: �'t' '.ci.tigu bs elEDING DIVISION a i;; i f i a _ dw;s.: E3 See Page 2 for 24 -hour Inspection Request: 503 - 639 -4175 �""- -- Name/Method: _ Supplemental Information. f . ,'v _�: 6 ' r' a a - • i y9 � �� -, =.,.> �t.'', +' f S r 3•� T, lg 2 ' 1. + � ��:4;.�?£1� � •�' � i ' l_e J �: y ^7..�'� � ,(�, t� ��(,� �1 r1 `!• •J W, �, .N� �!�• "' � �I� �_' ; 1 1 + ... .3r.Rt! � .�. a... ,�9t .... . Ye:, w 1 'f� � .. � `�r" C1tSe�ll ..ti'.e.:�L�.O it P.�i6'�Y'r^w�.ao... .J �m , .. AJ��.C.. :a.ue_�i �' r'�' .r.�M •' � "'3.�. ` ,fir' -..1. • New construction l Demolition © Service over 225 amps- • health -care facility commercial ❑ Hazardous location •• Al Addition/alteration /replacement IM Other: ❑ Service over 320 amps rating of ❑ Building over 10.000 square feet, 7.1 •• 1".. -`•; : ° ,,-;„ •' r - "..,r ,- VietagrZcZ,X I & 2 family dwellings four or more residential units in & 2 -Famil dwellin :t t!1 Commercial/Industrial ❑ System over 600 volts nominal one structure ❑ Building over three stones ❑ Feeders, 400 amps or more ■ Accessory Building I Multi - Family ❑ Occupant load over 99 persons' ❑ Manufactured structures or RN park • Master Builder • I . Other: ❑ Egress/lighting plan ❑ Other: ;1 ,, ::; , • a •�,� J o . r „� , r , 72 <- �:, p Submit _ acts of plans with any of the above - '".� L,!id, �� s� 1 �:� 4 � � A , � � �� r.X 1 l' � _. 4.` / a � � q H�, k:'• 'N.1 The above are not a licable to tern ore construction service Job site address 15570 SW PACIFIC H 97233 , ` FJ 4*1rL. qi, , r" ; L - ; t -744 �i a _ ' " �' a •.,.... f' ... am ^i'4§ S uite #: I Bldg./Apt.##: Number of In • aliens • er • ermit allowed Proj Name: SAFEWAY 111478 Deeeri'don Qty Fee (ea.) Total 111 e� nsk New residential- aiaalo or mulct- fomi>y per ���NT�CT 1 KAAR(503) 419 -3348 dwelling unit includes attached garage. Service Included: 1000 s • R or less 145.1S Each additional 500 ft or • •rtion thereof 33.40 In Subdivision: 1 Lot #: Limited 61=3 residential MI Limited �' 75.00 � © ited en ::, nonresidential 75.00 - in Tax mail. reel #: ) ) path manufactured home or modular dwelling III �' tbi ~..(+ t1i1 ^ 9. �ir e3F:' 3'` "'t`1:9� ,,II.c !, , r .... 4JfLf.'ti , � scsvicc feeder 90.90 ;1F , : _ ....x,,. .. .. , _. rr,r�_.. ,i � 1 . . v.46. . .1:: fJ.•L,� 1,. „u ws.::t:�5� Services or feeders - installation. LOW VOLTAGE DATALTELECOMMUNICATION alteration or relocation: LOW VOLTAGE PAGING 200 am.- or lea, II 80.30 II 201 am... to 400 am • . M. 100.85 ICI ; C i )� ? T- 401 • to 600 • ..: I♦ 160.60 - - •(,i; k�';L(�a /� i. rii', ). �: „: :,, ,' " r . r, lCr3 S" :1i.,�. ���t � "^ r�;_. 601 am•.. to 1°°° . • . 240.60 EV Over 1000: • •- orvolts . 454.65 1E1 Name: SAFEWAYi'i 1478 JON WITTE (503) 657 -6336 Reconnect o. NM 86.05 © Address: Temporary services or feeders - Installation, alteration, or relocation: City /State/Zip: 200 am •• or leas 66.85 Phone Fax 201 am to 400 am .. MI 100.30 iii r 401 to600 am- . 133.75 � ,T. { s '__ .�r� .i i.`;.1;.%- :r1..li _ :.e'�LrVi d is 1•.' 1�P.1 :fiL•Z:7�y , ; ., °?'_.re.: Breneb circuits - new, dtsratlon, or Name: extension per panel: A. Fee for breach circuits with purchase of Address: service or feeder f -- each branch circuit 6.65 City /Stet@ /zip: • B. Fee ibr branch circuits widout purchase of . Phone: Fa Each �© service or feeder , first branch circuit 46.85 ch additional branch circuit r 6.65 E -mail 53.40 MIN �'.?1, : `� •r....vi _�L r f - 1 I r ;ir J r in r�lily r 1,5 'P�, f: ri .::. t: ... .. , } t y ? Each al .. or outline li : : • : 53.40 Ell Job No: 53 -03012 Signal circuit(,) or a limited energy panel, liggig 150.0 t • A / Business Nailie:CHRISTENSON TECHNOLOGY SERVICES, ' • °;.:� ; DAT DATA /TELECOMM()NICAT ON . • Address: 1631 NW THURMAN ST 2ND FL .. Cit /State/Zl tM . OR 97209 Each addition ns • ectioa over the allowable In an of the above: y p Per • • • etion .er hour min 1 hour iM 62.50 11111111.1l♦ Phone:(503) 419 -3600 Fax:(503)419 -3636 Invited: tionkee: MN MI CCB Lic. #: 64137 Lic. #: 26- 1174C 1 r Illl� .r .'s ii i. { .., , 24:i :.r.. .'.''1 ., {..: p, J�.r ,I. '.1; i Supervising electrici 1� Subtotal $ 50. signature required: r (� ` 3 / 2 / 04 Plan Review 25% of Permit Fee $ Print Name:ROBERT.. AXT Lic. #: 1 994S State Surch::0 8% of Permit Fee S 12. TOTAL PERMIT FEE IfinirarriErAl Authorized Notice: This permit application expires if a permit is not obtained within Signature: Date : 180 days after it has been accepted as complete. * * * ** *VI * * * * ** *Fee methodology set. by Tri -County Building Industry Service Board. (Please print name) i :\DatslPermit kerns 01/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received 777 - Date Requested q 2 _ AM PM BUP Location /5 5 7 , � Suite MEC Contact Person Ph ( �� 4z <Z9O PLM Contractor c Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC ?/ Ftg Drain Access: ' yq � 3 Crawl Drain ' L Slab Inspection Notes: SIT Post & Beam • Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole V7e Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final S� PART FAIL ELECTRIC Service Rough -In UG /Slab w Volta 4, ire Alarm PART FAIL 111 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE Please call for reinspection RE: 111 Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date �� Inspector � I� Ext Other: Final DO NOT REMOVE this Inspection record om the , ob site. PASS PART FAIL