Permit ELECTRICAL PERMIT -
CITYOFTIGARD RESTRICTED ENERGY
*�y, DEVELOPMENT SERVICES PERMIT #: ELR2001 -00128
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 05/02/2001
SITE ADDRESS: 06650 SW REDWOOD LN 370 PARCEL: 2S112DA -01400
SUBDIVISION: PP1996 -048 ZONING: I -P
BLOCK: LOT: 002 JURISDICTION: TIG
Project Description: Installation of low voltage for data /telecommunication. Job #50 -03919
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:
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 Low Voltage Inspection
PRMT CTR 05/02/2001 $75.00 2720010000 Elect'l Final
5PCT CTR 05/02/2001 $6.00 2720010000
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 thr-,.gh OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987. — /
Issued by AVel, / /� , i t 1 Permittee Signature 1 Ce O,Q,ilil e))//
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: C1) apia.lafi h - DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
L. Jijiir .
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Electrical P Application
• � . Date received:5 y �- / • Permit no.:/' / —00 /z V
' A` `•1 City of Tigard Project/appl. no Expire date: - .
City o} Bard Address: 13125 SW Hall Blvd, Ti lV Date issued: By: - 1 Receipt no.:
Phone: (503) 639 -4171
•
Fax: (503) 598 -1960 MAY 9 2 2001 Case file no.: -- - -- Payment type:. - -• ... : _ _,
Land use approval: - -
I _. 4 I 1 1'u 1 .
.. TYPE OF PERMIT
Cl 1 & 2 family dwelling or accessory ` ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement . "„ '' '
❑ New construction , . , , •. , tz .. , ,,,❑ Addition/alteration/replacement ❑ Other.' - ❑ Partial
JOB SITE INFOR\IATION - . - - -
Job address: 6650 SW REDWOOD 'LANE 3RD EL_ Bldg. no.: Suite no.: Tax map /tax lot/account no.:.%.6":„' .;
. Lot: IBlock: (Subdivision: - 97223 - _-
Project name: CENTURY WEST I Description•and location of work on premises :LOW VOLTAGE DATA /TELECOMMUNICAT =ON
Estimated date of completion/inspection: QUESTIONS ?CONTACT JIM HARDISON . . _ . _ . —
.., CON"J.IL\C7;OR.AP1'.LICA7ION ..' _, FEE ..SCHEDULE -r
Job no: 50 -03919 . • Fee Max
Business name:CHRISTENSON ELECTRIC, INC. Description Qty. (ea.) Total no.lnsp
Address: l l l SW COLUMBIA, SUITE 480
New residential -single or multi-family per •
dweillogunit. Includes attached gamge.
City: State: ZIP: Service ittcloded •
ty: PORTLAND OR 97201 -5886
Phone503 2414812 IFax503241051tE -mail: 1000 sq. ft. or less 4
CCB no.:458 I c. bus. lic. no: 26 -34C Each additional 500 sq. ft. or portion thereof
City/metro /metro 0.: 5 46
Limited energy, residential 2
ty Limited energy, non- residential 2
Each manufactured home or modular dwelling
Signa of supervisin ci required) Date 5/1/01 Service and/or feeder . 2
Sup. elect. name (print): BRIAN CHRISTOPHER License no: 8735 Services or feeders— installation, .
PROPER O11'NER
alteration or relocation: ..
_ 200 amps or less 2
Name (print): 201 amps to 400 amps 2
Mailing address: 401 amps to 600 amps 2
601 amps to 1000 amps 2
City: 'State: I ZIP: . Over 1000 amps or volts 2
Phone: I Fax: I E-mail: Reconnect only 1
- 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 ,altetnttlon,orrelocat
ORS 447, 455, 479, 670, 701. 200 amps or teas 2
• 201 amps to 400 amps 2 .
Owner's signature: • Date: 401 to 600 am. s 2
ENGINEER Branch circuits - new, alteration,
.i Name. or extension per panel:
• A. Fee for branch circuits with purchase of .
Address: service or feeder fee, each branch circuit • 2
t Cit I S - 'ZIP: B. Fee for branch circuits without purchase
Phone: Fax: E -mail: of service or feeder fee, first branch circuit: 2
Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included): .
O Service over 225 amps-commercial O Health -care facility Each pump or irrigation circle 2
O Service over 320 amps - rating of 18t2 0 Hazardous location Each sign or outline lighting 2
family dwellings O 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* 1 75. 2
0 Building over three stories O Feeders, 400 amps or more *Description: DATA /TELECOMMUNICATION
0 Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egress/lightingplan O Other: Per inspection I I I
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 $ 75.00
. O Visa O MasterCard expires if a permit is not obtained Plan review (at _ %) $
• Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ 6 .
• • Expires accepted as complete. TOTAL $ 81.00
Name of cardholder as shown on credit card •
$
Cardholder signature Amount
440 -4615 (6100 /COM)
OCT.2000 +FEES ON BACK OF FORM
Electrical Permit Fees: F Limited Energy Fees: • _ •
•
Complete Fee Schedule Below: : TYPE OF WOR I - RESIDENTIAL ONLY
l� Restricted Energy Fee $75.00
. . - .- - Number of Inspections per permit allowed v . (FOR ALL SYSTEMS) -
Service Inclu -- - - Items - Cost - -Total • Check Type of Work Involved:
Residential- per unit ------ -} ._ ..- -' '
1000 sq. ft. or less $145.15 -� 4 ❑ Audio and Stereo Systems
Each additional 500 sq. R or -- - - -. ---.- _ -. - - - -- - - -- -- • • . _r ::7!.: .::_.;1
portion thereof • ..... ... _ . $33.40 -. - _ . - 1 .., ,� ; - ,Burglar Alarm , - . - _ .. •
Li mited Energy : ' • ••• ; ..: , $75.00`' c:: .: k. “ -- .. •.;4' e., 'V ^ 'a r• ° *•,,.r :.4: ^ '. : -.: z -_ 4 .
' Each Manufd Home Or Modular : _ - _ .. _ . - . ..1--: i _,-, . •
Dwelling Service or Feeder r =� '' i $90.90 . 2 !: =- ...Li _. Garage Door Opener*
' Services or Feeders " ❑ Heating, Ventilation and Air Conditioning System i
Installation. alteration, or relocation _ ;,�;. • • • -
200 amps or less 4-75"-r- y 'i • . $80.30 ._ • • 2 .
201 amps to amps ' r_• - x't 7.7 ' • ' $106.85 2 — Vacuum Systems'
401 amps to 600 amps $160.60 2
601 amps to 1000 amps __ " $240.60 - - -. 2 — - El _Other • -- Over 1000 amps or volts - ----.--- - -• -• ---- $454.65 2 ' .
, Reconnect only ,, 2 . . •
e -;r ..:Li.r• - :-,Q> -•" =:_ .; ..•..• - -. _ TYPE OF WORK INVOLVED - COMMERCIAL ONLY -
Temporary Services or Feeders .. • - `-r • • • - Fee for each system '• - - V V V - - • $75.00
Installation, alteration, or relocation
200 amps or less • • $66.85 2 ( SEE OAR•918 -260 -260)
201 amps to 400 amps v $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 El 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 ❑ Data Telecommunication Installation
b) The fee for branch circuits V " •
without purchase of service ❑ Fire Alarm Installation •••
_' or feeder fee. • V .
First branch circuit $46.85
Each additional branch circuit $6.65 ❑ HVAC
Miscellaneous ❑ Instrumentation
(Service or feeder not included)
Each pump or imgation circle $53.40 ❑ Intercom and Paging Systems
Each sign or outline lighting $53.40
Signal circuit(s) or a limited energy ' .
panel, alteration or extension $75.00 ❑ Landscape Irrigation Control'
•
Minor Labels (10) $125.00 _ ❑
Medical
Each additional inspection over .. ' •
the allowable in any of the above • ❑ Nurse Calls
Per inspection ' $62.50 •
• Per hour - $62.50 - ❑
In Plant $73.75 Outdoor Landscape Lighting*
Fees: ❑ Protective Signaling
Enter total of above fees - $ ❑ Other V • 8% State Surcharge - $ . Number of Systems
25% Plan Review Fee * No licenses are required. Licenses are required for all other installations
See - Plan Review" section on $ •
front of application.
Fees:
Total Balance Due $
. Enter total of above fees • $
❑ Trust Account # 8% State Surcharge • $
' Total Balance Due $
•
i:\dsts\forms\elc•fees.doc 10/09/00 +I FOR PERMIT FORM