Permit 7i v CITY OF TIGARD ELECTRICAL PERMIT
% COMMUNITY DEVELOPMENT Permit #: ELC2013 00067
-TIGARD' 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/29/2013
Parcel: 151 36DA00101
Jurisdiction: Tigard
Site address: 11410 SW 68TH PKWY
Project: Oregon Pers Subdivision: PFAFFLE PLAZA CONDO Lot: 2
Project Description: (1) 200 amps or less to replace UPS at test lab
Contractor: CHRISTENSON ELECTRIC INC Owner: OREGON, STATE OF PUBLIC
111 SW COLUMBIA ST, STE 480 EMPLOYEES' RETIREMENT FUND
PORTLAND, OR 97201 11410 SW 68TH PKWY
TIGARD, OR 97223
PHONE: 503 - 419 -3300 PHONE:
FAX: 503 -419 -3695
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 01/29/2013 $100.70
Specifics: amps or less
1 ea 12% State Surcharge - 01/29/2013 $12.08 -
Type of Use: COM Electrical
Class of Work: ALT
l Type of Const:
Occupancy Grp:
Total $112.78
Required Items and Reports (Conditions)
•
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 95 -001-00 0. You ma obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 �-r or 1.800.332.2344.
Issued By: )1 A l" Permittee Signature: 0, / / � YL -le o , /
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' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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. .
JAN-28-2013 MON 11:12 AM CHRISTENSON ELECTRIC, INC FAX NO. 95034193695 P. 01/02
Electrical Permit Application RE FOR OFFICE USE ONLY
City of Tigard Received , p_q (3
Pate/13y: '
/ -- ' 13125 SW Hall Blvd., Tigard, OR 97223
1011 ItOv.e w '
• . Phone: 503.718.2439 Fax; 503.598,1960 JAN 2 8 20 t teisy: i
Other Permit;
T1 Gimp Internet: Line: 501639.4175
CITY OF TIG ' 1 7i . 111 1 7 ae dRCIy c /By: : JIMA: El See PageTror
internet: www.tiprd•orgov
& Supplemental Information
. ., • • ' , .. ,......,.. ,... • ..... !".....;,..; . 1.:. r ‘ ...::: :'7 l '% tflAN *EW . . .
: -•
.. .. •
. • _
CI New Construction ITSI Addition/alteration/replacement Please check all that apply (submit 1 sets of plans wfiterns checked below);
0 Service or feeder 400 amps of more 0 Building over three marks.
• 0 Demolition Cl Other:
where the available fault cuirent ['Marinas and boatyards.
• - ' ;•• ' ' . ' ' ' ' I " ••• . ' ik'NqfjitYWPStAittilVft .-.1 exceeds 10,000 amps at ISO volts or 13 Floating buildings.
cm to ground, or exceeds 14,000 D Commercial-use agrkuluirol
ID I - and 2-family dwelling al Commercial/induStrial 0 Accessory building amps for all other installations. building:
• 1:1 Multi-family 0 Master builder 0 Other: 0 Fire pump. LI Installation of 75 KVA or
,i, ., . , • At.,., 4.6;4 ,.., . t.r... ... ,.. ...,. .. • • . 2...; ., 1 ... .. , • F. .. ,. ... ... .. ['Emergency system. larger sepamtely derived system.
..li B i q..101; atlemtvo'.4 ..,,: NA; : 1 1 . ;1 7 .. ''•:•' ":,. 1:I Addition of new motor load of El "A", '1?", "I "14
. .
or occupancy.
Job no. 25982 Job site address: 11410 SW 68TH PICWY I 00Fir more.
LI six or mare residential units LI Recreational vehicle parks.
Cit ------------- 0 Health-rare facilities 0 Supply voltage for more than
y/StateJZIP: TIGARD, OR 9 722 3
. CI 1 locations, 600 volts nominal.
Suite/bldg./apt. no.: Project name: OREGON PERS 0 Service or feeder 600 amps or more.
44.;. 4t ' ' . ClEritlijK.;;:i;L ... - ; •••••:.. . .:".,:.. ... . .
Cross street/directions to job site: BOB BRUENE 5 0 3 - 4 1 9 64 6 .
DescrtptIOO I Qty. 1 - 1 Total 1 •_—_
------ New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision:
I Lot no.: 1,000 sq. ft. or less 168.54 4
. Ea. add'I 500 sq. 11. or portion 33.92 I
Tax map/parcel no.:
_ Limited energy, residential
. i .".....:.......: .. .. :hr.: : iir,. ,31:i#00014 A- ilig,.....4,..,4,,,......,.,;;..,!r,1177-. _Iwith above scLft.) . 75.00 2
Limited energy. multi
75 2
REPLACE UPS AT TEST LAB
residential (with above sq. ( t.)
Services or feeders Installetion, alteration, and/or relocation
200 amps or less 1 100_70 — 1 °O• if 2
... 201 MPS to 400 amps 13156 2
Name:
401 amps to 600 amps --- 200.34 2
— — 601 amps to 1,000 amps 301.04 2
Address:
Over I,000 =pa or volts 552.26 _ 2
Temporary services or feeden installation, alteration, and/or
City/State/Z1P:
•
relocation
— _
Phone: ( ) Fax: ( ) 200 amps or less _ 59.36
_
Owner installation: This installation is being made on property that 1 own which is — 201 amps to 400 amps 125.08 2 not —____—________
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168,54 2
Branch decoke - new, alteration, or extension, per panel
Owner signature:
— Date: A Fee for branch circuits with
_.
1: ■•;.;:.!.; 13 0: 40004.ti"ili r e: i't'..t';, I hlike6;':41: No 00 '7' 5.70 'Rk! 3ti1IL`1. :7.P.; above service or feeder fee,
each branch circuit 7.42 2
Business name:CHRISTENSON ELECTRIC " . B. Fee for chjrcu r
— service or feeder fee, first
Contact name:
.
branch circuit 56.18 2
• -- Each addl branch circuit 7.42 I 2
—
Address:
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
67,84 2
dwelling, service and/or feeder
.
Phone: ( ) I Fax: : ( ) Reconnect only • 67.84 - , 2
E — Pump or irrigation circle 67,84 2
Sign or outline lighting 67.84 2
.'"?.'` 3. .;;::0'17::il.'11i?.;r• 'biMOOT.OAtit;CM.".3i."414.7iN■lfrol:ialri.;.".4!.::.4'..11:1:1:=1!k Signal circuit(s) or limited
Business name: CHRISTENSON ELECTRIC panel, alteration, or extension. Page 2 2 -
—
Erich additional inaevIion over allowable in an elfin above
Additional inspcktion (I hr min) 66.25/ hr
Addre55: 1 1 1 SW COLUMBIA, SUITE 48 0
City/State/ZIP: poRTLAND
OR 972 0 1 Investigation (I lir min) 66_25/ hr
Industrial plant (1 hr min) 78.18/ hr .
Phone: (503 ) d 1 9 -3 3 54 1 F ) 419-3695 Inspections for which no fee is
90.00/
—
speciflizi11 listed(d hr min) hr
CCB Lic.:458 Electrical Lie.: 26- .M Su . • Lic.: 52155$ ;:"..g!-!:?-Y*1'-.'''..t.4i:..4;Eci____2:10EamieFEEa.:::; l'...1. ....- .., ,....r;'
Suprv. Electrician signature, required: Mr 1117 . . ?
Plan review (25% of permit fee)!
Subto_tab 100 . 70 _
—
..
•
Print name: ROBERT BRUENE Date: 1/28/13 State surcharge (12% of permit fee): 12 . 08
_
orized signature:
TOTAL PERMIT FEE:
Auth
. 2 . 78
'
- — This permit anplienilon expires Ira permit Is net obtained within too
i
days after It bat been accepted as complete.
Print name: l Date:
• Number of inspections allowed per pcnnic
Baulking \Perinimmr-PmnitApp,dee 57/01/1 0
440.1615711 1 /133/COMAYEkt
1111•1=1•1111•1111111=1•11•1•111111111■1011101ORIPIIMmm2111111111.mto
P. 02/02
AUTOMATIC COVER SHEET
DATE: 1AN -28 -2013 MON 11:13 AM
TO:
FAX #: 95035981960
FROM: CHRISTENSON EL @CTRIC,INC
FAX #: 95034193695
02 PAGES WERE SENT
(INCLUDING THIS COVER PAGE)
P. En2
AUTOMATIC COVER SHEET
DATE JAN -29 -2013 TUE 10:38 AM
T0.
FAX #: 95035981960
FROM: CHRISTENSON ELECTRIC,INC
FAX #: 95034193695
02 PAGES WERE SENT
(INCLUDING THIS COVER PAGE)