Permit CITY OF TIGARD ‘. , r ELECTRICAL PERMIT
° PERMIT #: ELC2007 -00820
COMMUNITY DEVELOPMENT DATE ISSUED: 12/5/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25101 DC - 03700
SITE ADDRESS: 07095 SW SANDBURG ST ZONING: C -P
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: UNITED FOOD LOCAL 555
Project Description: 2nd. Floor: 5 branch circuits.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0.00 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAUPANEL:
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: 4 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:
UNITED FOOD + COMMERICAL WORKERS CHRISTENSON ELECTRIC, INC.
UNION LOCAL #555 111 SW COLUMBIA STREET # 480
PO BOX 23555 PORTLAND, OR 97201
TIGARD, OR 97281
Phone: Contact #: PRI 503 -419 -3300
FAX 503 - 419 -3695
FEES
Description Date Amount Reg #: ELE 26 -34C
[ELPRMT] ELC Permit 12/5/2007 $73.45 LIC 458
[TAX] 8% State Surcharge 12/5/2007 $5.88 SUP 19945
Total $79.33 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for
more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 through OAR 952- 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: /6.1,441 Permittee Signature: 9'i da /l lC/.GC
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
�; ‘DEC-05-2007 WED 10:11 AM CHRISTENSON ELECTRIC, INC , 4 FAX NO. 95034193695 P. 01/03
T
City of Ti and �� R?L i �SW hall Blvd., Tigar, OR ;; RECEIVE Plaview
Phone: 503.639.4171 Face: 503.598.1 %0 '""'4' 'a3!s,{ .• p Other Permit:
Inspection Line: 503.639.4175 t 14. ' 'T R Jura: ei See Page z ror
Internet www.ci.tigard.or.us DEC. 0 5 20i Nmifia • . supptemeotallnrormadan
....,. . .. < ::... .r.: .. : : :• r :.w >..vr .. .:: ref . :_ : :: :r „i, >.... ; '. .s.:n,,.s : :::: ..
r< �` i �t�
. „ „,i. :., :.,. :.,. :,,. :: ;;. :Y�4o :i., :..,..,u..Sk9.{.... ...: ko... P.l.`.�E11'..,,�:.. : :J.�. k..: .. : ::F.ar :et�rs: : :i? :fh<��33� I G:foq.,
❑ New construction tYL DP$Pa1•C7tkt't Please check all that apply:
❑Smice over 225 amps, comm'I ❑Hazardous location
❑ Demolition ❑ Other
,.; ❑Service aver 320 amps — rating ❑ Buildng over 10,000 sq. R
s�•���r.'ry ti •x
Y''
, .. ., r E`.lr+� .�. � :xh io', - 2-family dwell
:.��.... :. € >.....,, . •;,:;, :. , ,,,, :.t:;,,,,..., of l and IIY togs 4 or more new residential
❑ 1- and 2 - family dwelling N' Commercia1industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders, 400 amps or more
El Multi - Gamily El Master builder ❑Other
s <a a s {: : :• >i ”; —.... 1:10m-opera load over 99 persons ❑Manufactured structures or
r:
r:,s ` ?I.4 RV "del ,I� '�r��:
, ' ,.. � ' :,` :.<•.. ,. ..�... :�sSE•iz: .>.'i .F ',f,�;'�`ii. []Egreas!{ightingplan park
•
Job no &[.8 J 1k Job site address: Dot 5 Su) ❑Health -care facility ['Other: t� Submit 2 sets of plans with any of the above.
City /State/ZIP: pm -4.t t &R s' i r � 0 « J The above are not applialble to temporary construction servitx.
Suite/bldg /apt. no.: t$ C ([ I .P roject n ame: ( F� L (J (4•.Q SS :,.5! .4 :t q +•: - :. < . 3. ,. -.i •
D esaipdou : < :< <: I Qa• 1 Pee. r•.•
Cross strecUdircctions to job site: ¢� u15-11`6%/1, Pia 1/ 6371 lrei New resddentlal single- or multi -family dwelling unit. .
IL Q Includes attached garage.
, S) 3- O p p� tr� - 709 Q 1.000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea add'! 500 sq. R. or portion 33.40 1
^ Tax map /parcel no, .
Limited energy, residential 75.00 2
�3s;
„ 2 �� Limited energy. non - residential 75,00 2
::i :� : Nil;: ' :':'2::2.: : :k�
rk., :
e :d ppy!�p�pr�� ��} p�
... :., .. : : <., :. <.,. > :.. :..,..�,..:.;, Each dui
,:. :. : : :; : :;.. :. > :;;,: ,: >,... manufactured or m ar
( � V' v�.t 1 dwelling, service and/or feeder 90.90 a
Services or feeders installation, alteration, and /or relocation
. 200 amps or lass 80,30 2
%'i
201 o400am
'• "h� ?lit 2
�P Ps
,.s :: : !�. ..14 . :.. : ,.'�'.' !' :' :! : ?, :. :; !` :� :;: v!,
:,,. .: :'a:.. 401 amp to 600 amps 160.60 _ 2
Name: 601 amps to 1.000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only '66.85 2
City /State/ %[P: Temporary setvvkes or feeders Installation, alteration, and/or
Phone: ( ) I F aX: ( ) relocation
200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps, '100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133,75 2
Owner signature: _ • Date: Branch circuits — new, alteration, or ertenslon, per panel •
Pt
arch C I
:; A Fee for br rcuits with
,... :.::, . ::: ,.,:.. ... .:.:.:...::,::. '' �' sery or feeder fee, tech
ice
Business name: • branch circuit 6.63 2
B. Fee for branch circuits —
Contact name: — without service or feeder fee. ' 46,85 iftSY 2
Address: first branch circuit
o. Q 2
City / State/ZIP: • Miscellaneous (service Included)
feeder not Inclu d)
Phone: ( ) 1 Fax:: ( ) Pump or irrigation circle 53.40 2
1 Sign or outline lighting 53.40 2
' E - mail: _ • . Signal circuits) or limited. .
r:', .ah M p S e! alteralie
._ , >�rr� :. , ... ... ..f "r< °•�,. .Z�'r....ite ?' ;';tip, iJ %2''. % >x ener
4 or
extension. Describe: Paget 2
Business name: Christenson Electric, lnc.
Address: 111 SW Columbia Street, Suite 480 Each additional Inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: Portland, OR 97201 Investigation per hour (I hr min) 62.50
Phone: (503) 419 - 3300 I Fax: (503) 419 - 3695 industrial plant per hour 73.75
i; 1F ,CTit1GAf.'PF.01 rl,$',,: : : <i;«:<` :i',i[ :. , :a< > ::
CCB Lic.: 458 Electrical Lic.: 26 34C I S rv. Lic.: 199 . 71.
Subtotal 45
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print �, C O State surcharge (8% of permit fec) q . g q*
i rintname: R - Date: J TOTAL PERMIT FEE _ , 33
�U �(Q
Authorized signature: • This permit app anion capires It a permit ie oat obrainad within teo
d . a tt bas teen acce pted ue ctlmplete
Print name: Date:' • F.c m .. dology • DI-County Building Industry Sr,viee Board
•• N • • r of inspeatin• s • r pemsit alinwed.
Iish1dinewermiteleLC resmIApp 17/03 44 a.4617T(Ialmvr.:oM/v a
..., . 1 C li U5 .
CITY OF TIGARD r '
BUILDING DIVISION PERMIT #: C2007 -00820
A 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 12/5/2007
Phone: (503) 639 -4171 .114j41 EL
l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1/17/2008 TIME: 7 :00AM PAGE: 70
SITE ADDRESS: 07095 SW SANDBURG ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: UNITED FOOD LOCAL 556
DESCRIPTION: 2nd. Floor: 5 branch circuit::.
OWNER: UNITED FOOD + COMMERICAL WORKERS, PHONE #:
CONTRACTOR: CHRISTENSON ELECTRIC, INC. PHONE #: 503-419.3300
Inspection Request Scheduled For: Date: 1/1712408 Pour Time:
Code # Inspection Description on ' Contact # Message
199 Electrical final 063363 -01 503703 -7143 Y
Corrections /Comments /Instructions:
" y
•
•
\
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
El FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N 6a Date: I' 11' 6 11 Phone #: (503) 718- 1.- "1t'