Permit CITY OF T' G A R D ELECTRICAL PERMIT
PERMIT #: ELC2001 -00219
� r.w5ll`� ' DEVELOPMENT SERVICES DATE ISSUED: 05/01/2001
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S1 12 DA -01400
SITE ADDRESS: 06650 SW REDWOOD LN 370
SUBDIVISION: PP1996 -048 ZONING: I -P
BLOCK: LOT : 002 JURISDICTION: TIG
Proiect Description: Installation of (8) branch circuits in TI. Job #61 -20414
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: 7 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:
PACIFIC REALTY ASSOCIATES CHRISTENSON ELECTRIC INC
15350 SW SEQUOIA PKWY #300 -WMI 111 SW COLUMBIA
PORTLAND, OR 97224 STE 480
PORTLAND, OR 97201
Phone: Phone: 241 -4812
Reg #: LIC 000458
SUP 3289S
PLM 2468S
ELE 26 -34C
FEES Required Inspections
Type By Date Amount Receipt Wall Cover
PRMT CTR 05/01/2001 $93.40 2720010000( Elect'I Final
5PCT CTR 05/01/2001 $7.47 2720010000(
Total $100.87
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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 - 6699 or 1 - 800 - 332 - 2344.
Permit Signature: _. 1 Issued By: ,
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: X a 4(111/1( ,4i /Y1 — }'Y)ra nJ DATE:
LICENSE NO: ��j
Call 639 -4175 by 7:00pm for an inspection the next business day
0
, .
Electrical Permit Application
F Date received: i Q 1 Permitno.:t• ,cj
•/ .v/,�9
+ ' oc
-. i f l City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: [Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 RECEIVED Case file no.: Payment type:
Land use approval:
v" r,'. X0.0,'
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory %Corr tc( idEii • O Multi- family 0 Tenant improvement
O New construction 0 Addition/alteration /replacement 0 Other. _ 0 Partial
JOB M - -- SITE INFORMATION_ . - _ , - - - -- - - - _ _ - ___. - _ - - -- --
Job address: '4 9° °Jw - 't4OO9 t"ire- f+ooz- Bldg. no.: Suite no.:310 Tax map/tax lot/account no.:
Lot: I Block: Subdivision:
Project name: C*.t.rry e4 11JE.v1- . I Description and location of work on premises: TENANT IMPROVEMENT
Estimated date of completion/inspection: SUESTIONS ?CONTACT JON WIMBER
-- .;= :,�___- ;„_-- GONTIL. T01:LtPP -c.. TION- 4,.: - -- _..-< �•:_;� . � _- .- _�F.EE-SCHEDUEE -f-- - - -. --- - 5 - :
Job no: Cy I - 204 l4 Fee Max
Business name: CHRISTENSON ELECTRIC, INC. Description Qty. (en.) Total no.insp
New Address: 111 SW COLUMBIA SUITE 480 dwelling COLUMBIA, dwelling unit. includes attached garage.
City: PORTLAND I State: OR I ZIP: 97201 -5886 Service included:
Phone:503 241 4814Fax241 -0519 IE -mail: 1000 sq. ft. or less 4
CCB no.: 45 8 E c. bus. lic. no: 2 6 -34 C Each additional 500 sq. ft. or portion thereof
Limited energy, residential 2
City /metro • o.: 5246 Limited energy, non- residential 2
Eah manufactured home or modulo dwelling
Signatu of supervisin t required■ Date 4/27/01 Service and/or feeder 2
Sup. elect. name (print): BRIAN CHRI STOPHER License no: 873 Services or feeders — Installation,
alteration or relocation:
__ .� _ --, _, _.P O.W.N.ER._.:, -- ,- - - - - °- ,- -_- - .200 amps or less 2
Name (print): 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: I Fax: I E -mail: Reconnect only l
Owner installation: The installation is being made on property I own Temporary services or feeders - . --
which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocation:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
• 201 amps to 400 amps 2
Owner's signature: Date: ' 401 to 600am.s 2
ENGINEER Branch circuits - new, alteration,
or extension per panel:
Name: — A. Fee fcr branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: • I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 1 46 . 85 2
Phone: Fax: E -mail: Each additional branch circuit: 7 4 6.55
PLAN REVIEW (Please check all that apply) Misc. (Service or feedernot included):
❑ Service over 225 amps- commercial 0 Health -care facility Each pump or irrigation circle 2
❑ Service over 320 amps- rating of 1&2 ❑ Hazardous location Each signor outline lighting 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
O System over 600 volts nominal more residential units in one structure alteration, or extension' 2
O Building over three stories ❑ Feeders. 400 amps or more *Description:
O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egress/lightingplan ❑ Other. Per inspection f 1 i 1
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application
Permit fee $ 93.4O
❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $ .
' Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ 7 •47
Expires accepted as complete. TOTAL $100 7
Name of cardholder as shown on credit card •
_$
Cardholder signature Amount 440-4615 (&N0 /COM)
OCTOBER 2000 ++FEES ON BACK OF FORM
t
•
Electrical Permit Fees: Limited Energy Fees: •, I
• TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
• Com Fee Schedule Belo Restricted Energy Fee '$75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total 4. Check Type of Work Involved:
Residential - per unit
1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or • • -. _ . -
portion thereof . $33.40 1 ❑ Burglar Alarm ...
Limited Energy $75.00
Each Manufd Home or Modula . Garage Door Opener'
Dwelling Service or Feeder $90.90 2 El
Services or Feeders ❑ . Heating, Ventilation and Air Conditioning System'
Installation, alteration, or relocation
200 amps or less $80.30 2. •
- Vacuum Systems'
201 amps to 400 amps $106.85 2
401 amps to 600 amps $160.60 2 Other
601 amps to 1000 amps $240.60 2 ❑
Over 1000 amps or volts $454.65 2
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each system $75.00
200 amps or less $66.85 2 (SEE OAR 918 -260 -260) ,
201 amps to 400 amps . $100.30 2
401 amps to 600 amps $133.75 2 Check Type of Work Involved:
Over 600 amps to 1000 volts, ❑
see "b" above. ..Audio and Stereo Systems
Branch Circuits 0 Boiler Controls
New, alteration or extension per panel
a) The fee for branch circuits ,
with purchase of service or ❑ Clock Systems
feeder fee. '
Each branch circuit $6.65 2 0 Data Telecommunication.Iristallation . • - •
b) The fee for branch circuits
without purchase of service ❑ Fire Alarm Installation
or feeder fee. . •
First branch circuit $46.85 4(e1:6 HVAC
Each additional branch circuit T $6.65 4b95 Li
Miscellaneous ❑ Instrumentation
(Service or feeder not included) •
Each pump or irrigation circle $53.40 1:1:1 Intercom and Paging Systems •
Each sign or outline lighting $53.40
Signal circuit(s) or a limited energy Landscape Irrigation Control'
panel, alteration or extension $75.00 El
Minor Labels (10) $125.00 ❑
Medical
Each additional Inspection over
the allowable in any of the above .
Nurse C alls
Per inspection -
$62.50
Per hour $62.50 ❑ •
— In Plant $73.75 Outdoor Landscape Lighting , •
Fees: ❑ Protective Signaling
Enter total of above fees $ '0 ❑ Other
8% State Surcharge $ 7 .47 Number of Systems
25% Plan Review Fee
See "Plan Review" section on $ * No licenses are required. Licenses are required for all other installations
front of application.
Fees: -
Total Balance Due $ /00.87
Enter total of above fees • $
❑ Trust Account # 8% State Surcharge $
Total Balance Due $
•
•
i:\dsts \forms \elc- fees.doc 10 /09/00 OVER FOR APPLICATION
_CITY OF TIGARD BUILDING INSPECTION DIVISION
MST'
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 0 ' � AM PM BLD
Location 6 ( .SZ 5 w AJ ki e c d L-,.--- Suite MEC
Contact Person Ph 9)a G 3, 7 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC 2 / G b 2 /
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final F--in / A mss
PASS PART FAIL - �
PLUMBING
Post & Beam .
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRIC 0
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
S PART FAIL
S
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach/Sidewalk `�
Other Date V� '.).4 O / Inspecto lat. 4Atl Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
OF TIGARD BUILDING INSPECTION DIVISION msos --�
111 1Firour Ins Inspection Line: 639 -4175 Busines Lin
p � , e 639 -4171
• BUP
Date Requested s- 7 AM PM BLD
Location 6�.c Suite 37 MEC
Contact Person Ph ?7"-- PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC "OP/-60 -Z f f
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire wall 11-/e? /1 `� 4.5-s
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out n
Water Service / Y C' 7-E ,' /- Form ¢ 1
/ O /1
Sanitary Sewer
Rain Drains LS I roc- # re) c) S O v A/P d 5 l S
Final JJ ' � n /
PASS PART FAIL be / h (_', r G� a )ih (JCh —
MECHANICAL Cl / v h nvb mop, P
Post & Beam l )"Q /�1 C T� ✓✓ ����''II
Gas Line l g �( ' ?' �� C - 3 7 O ' / - 0
Smoke Dampers
Final
PASS PART FAIL
L
Service a •u
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA 6 Approach /Sidewalk Date 2 0/ Inspector E xt
Other P
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.