Permit ^J/ CITY O F T I G A R D ELECTRICAL PERMIT
RESTRICTED ENERGY
aiIA DEVELOPMENT H BMENQ Tigard, SERVICES 1 639 -4171 DATE PERMIT #: ISSUED: E �R�0 -00351
SITE ADDRESS: 10108 SW WASHINGTON SQUARE RD A -3- PARCEL: 1S135BA 00102
SUBDIVISION: OAKBURG ZONING: C -G
BLOCK: LOT: 001 JURISDICTION: TIG
Project Description: Low voltage: Data/Telecommunications.
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:
PPR SQUARE TOO LLC CHRISTENSON ELECTRIC INC
BY MACERICH COMPANY 1631 NW THURMAN
ATTN• JANET FISHER, ASSET MGMT 2ND FLOOR
SANTA MONICA, CA 90407 PORTLAND, OR 97209
Phone: Phone: 503- 419 -3608 permit
Reg #: L103-34143E6
SUP 3289S
ELE 26 -34C
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 11/17/03 $75.00 Elect'! Final
[TAX] 8% State 11/17/03 $6.00
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 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -6699.
Issued by _j, LQAA, L. Permittee Signature Oh I Q
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
NOV -gip -2003 FRI 05:37 PM CHRISTENSON CORPORATION FAX NO. 503 419 3636 P. 02/02
Eh c rical Permit Application
ltecaived ' Date/By: No.: / Electrical g
4 - f Da. : : �� O ? A P • PenvitNo.: �. _,.s -fX��15
City of Tigar4 Planning A.. .vat Sign
13125 SW Hall Blvd. �{ECEIV Plan Review Other
Tigard, Oregon 97223 DatelBy: Permit No.:
Phone: 503- 639 -4171, Fax: 503 j19� 21 !; ? „ r \ Post-Review Land e
Internet: www.ci.tigard.or.us 1���� `"' I ` ;f'`' I 'I Y
r, l •� J Contact Juris.: See Page 2 for
�
24 -hour Inspection Request: 503tny1 Tie' Name/Methed: t/G . Snpplemeatal information.
BUILDING DIVISION
Y' fi:�, ri, y C� .4 �r rl , a 3'cri; ;i 7. ,[ o "',�:� •`li : . y , l 1C / yt 1 '11 1 "; 11 I
r�+,r r 115 y �. nr� � c..�l u�k y L 7 � , 7 d1n �' , r�r� , ... � , i "�', '� S
��..r'r' 's. a�� . r_. . �:� ..s.. :la � •, ... L . .. �! I ...�� 1:- t :1r11� x1..1 > f....,- _._ :.c+. �.�`�v H l v . ` 1 + ..- lt�..`"� � �. :
II New construction r Demolition r Service over 225 amps- U Health-care facility
commercial ❑ Hazardous location
• 17. Addition /alteration/re • lacement IN Other. g of ❑ S ervice over 320 amps -ratio o ❑ Building over 10,000 square feet,
.:r ] .w r � Jd' - .4,..,,r' i 1 a . f 01 [ :,E1 , rf : �!._. ', :!9 n .'.,i ,C Yf - .,�£ , 1 & 2 family dwellings font Or 2110x0 residential Ut11t9 in
• 1 & 2- Family dwelling Ea.' Commercial/Industrial ❑ System over 600 volts nominal one structure
Accessory Building 0 Building over three stories ❑ Feeders, 400 amps or more
• g 1� Multi-Family . ❑ Occupant load over 99 persons 0 Manufactured structures or 1W park
■ Master Builder 1• Other: ❑ Egress/lighting plan ❑ Other
l f i i' ,`. " -I' r - vl , : N C ICS 11 ,! r � r , r l l ^ J', ..► . .a (. y � j,� " r `
}4 '• Submit _ sets of plans with any of the above.
The above are not ble to tem ra • construction service.
Job site address: t t • r. • NG a Q ' u ) 1 r , ;- : � :, ,. , lica � ;u..
."..... y t sn .� ∎?1 , . .. •
' k' �! ; :','.'2_::','‘,.',74.`', �. r n. : :i f ' �.. ;. ti.. . ,
1.,- .,..,>�.Cr_ is
Suite #: I BldgJApt. #: Number of inspections perpermit allowed
Project Name: COST PLUSt'1 121416 TIGARD, OR Description Qty Fee(ea.) Total
Cross street/Directions to job New residential- single or multi- family per
1 dwelling unit. Includes attached garage.
QUESTIONS? CONTACT CHRIS GORMAN (503) 419-3352 Service included:
1000 s • . ft. or less 145.15 4
Each additional 500 sq. ft. or portion thetnof 33.40
Subdivision: T Lot #: Limited eneria residential 75.00 2
Limited energy, non residential 75.00 2
Tax ma • / r arcel # Each manufactured home or modular dwelling
° t< r %r' 1 yJ m 1� a ` J9� °' 7 , � v -' ' 1 19: p. .t c d ` P , � +� . t � , ' service and/or feeder 90.90 2
de+. ...�a �`t,k r _ _ "z ._ _.: :.�� , au ... _ :rh� :..x f r_ K,., Services or feeders - installation,
LOW VOLTAGE DATA /TELECOMMUNICATION alteration or relocation:
200 amps or less 80.30 2
201 amps to 400 amps 106.85 _ 2
401 amps to 600 amps 160.60 2
' a'�.tT'.5';f. ,W , 1 wt1a;A lvl "i! 1'r •fill` , Z � 31;' , 52 . - ,i i 601 am12sto1000amps 240.60 2
Over 1000 amps or votes 454.65 2
Name: Reconnect only 66.85 2
•
Address: Temporary services or feeders - installation,
alteration, or relocation:
City /State/Zip: 200 amiss or less 66.85 1
Phone: Fax: 201 em is to 400 amps 100.30 2
t� ,. `??._, i '.r � � \- :; . li e. } - . ,. >r %l-M. -; .1-hd — J 1 - ? $! Q5';' , ., eb . .. n'. ?, Branch c ircuits -sew, alteration, or amps 133.75 2
Branch circuits
Name: extension per panel:
A Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 6.65 2
City /State/Zip: B. Fee for branch circuits without purchase of
service or feeder fee, first branch circuit 46.85 2
Phone: I Fax: Each additional branch circuit 6.65 - 2
E-mail: Misc,(Service or feeder not included):
` , , q -, . i I r 1 l,n ,� , i r ` I �._ 1. e " 1 � _ ,, k ^: : : - Each Own or i gat on circle 53.40 2
Each s „. or outline ' :. ti • ; 53.40 2
Job No: 39 -00501 SiWlaI circuit(s) or a l energy panel,
Business Name: CHRISTENSON ELECTRIC, INC. D101 peaec ip>i ion,
t i °` "i °a 7 00 ' 2
oa.
Address: NW TH1IRMAN ST 2ND FL
Each additional inspection over the allowable in any of the above:
City /State/Zip: PORTLAND, OR 97209 -2558 Per n ape hour(min.lhOUr) 62.50
I
Phone: (503) 419 -3600 Fax: (503) 419 -3 36 Investigation fee:
CCB Lic. #: 458 Lic. #: 26— . .. 1 +.:, . ` _ :, , . I ., . r ' _ ., -.' , e e . .' , l L' �.. � :1. 'gr ;
Supervising electrician , Subtotal $ l _
' signature required: _ 11 / 14 / 0 _' — Plan Review U37.7.1 Permit Fee) $
Print N e / c. #. Stare Surcharge (8% of Permit Fee) $ 6 .
s1Z CH>ZIST�lHE i73S
am
TOTAL PERMIT FEE $ 81.00 /
Authorized Notice: This permit application expires if a permit is not obtained within
•
Signature: Date: 1S0 days after It has been accepted as complete. * *VIS/
"Fee methodology set by TrI- County Building Industry Service Board -
(Please print name) -
1:1DststPermit Forms lcPerttritApp.doc 01/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 6394175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested /2-3 AM PM BUP
Location / 010 N va 6i S• Suite — MEC
Contact Person �% � Ph ( ) eV 6 140 PLM
•
Contractor Ph ( ) SWR
BUILDING Tenant/Owner CJOS PA, S ELC
Footing
Foundation � ELC
Access: Drain ccess: 3 — 0 O SC/
Crawl Drain
Slab Inspection Notes: ( SIT
Post & Beam S -1
Shear Anchors
Ext Sheath/Shear ,
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler C F -
Fire Alarm
Susp'd Ceiling
Roof
Other:
• Final
147
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
P IL
E ECTRICA
Service ,
Rough -In 11/U C 1 3 , 4 (( r ;Jae-10 ,
UG/Slab
o. olt.•_ ,W d, p
e m
0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SIT 0 Please call for reinspection RE: 0 Unable to inspect — no access
ire Supply Line
ADA 'Z,
Approach/Sidewalk Date ` (2... 5 0 3 Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL