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Permit ELECTRICAL PERMIT „ CITY OF TIGARD COMMUNITY DEVELOPMENT Permit#: ELC2014-00114 Date Issued: 1/2 03/1014 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 3/11/2 A00200 Jurisdiction: Tigard Site address: 7904 SW HUNZIKER RD Project: AGILYX Subdivision: 1994-025 PARTITION PLAT Lot: 2 Project Description: (3)FEEDERS 200AMPS OR LESS FOR PANEL 4/3/2014: REPRINT permit to correct scope of work to(3)branch circuits and(1)low voltage for data telecommunications. DLH Contractor: CHRISTENSON ELECTRIC INC Owner: WALL STREET INDUSTRIAL LLC 111 SW COLUMBIA ST, STE 480 A RICHARD VIAL EXECUTIVE CENTER LLC PORTLAND, OR 97201 7000 SW VARNS ST PORTLAND, OR 97223 PHONE: 503-419-3300 PHONE: FAX: 503-419-3695 FEES Quantity Description Date Amount 3 crt Branch Circuits wo/Purchase 04/03/2014 $71.02 Specifics: Service or Feeder 1 ea Signal circuit or Limited 04/03/2014 $75.00 Type of Use: COM Energy Panel Class of Work: ALT 1 ea 12%State Surcharge- 04/03/2014 $17.52 Electrical Type of Const: Occupancy Grp: Total $163.54 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 0 95 -001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued B �r� PermitteeSignature: ZI� �i°1G/ems/O e/UG/h/4 y' 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. APR-03-2014 THU 07:59 AM CHRISTENSON ELECTRIC, INC FAX NO. 95034193695 P. 03 CITY OF TIGARD ELECTRICAL PERMIT 111 • COMMUNITY DEVELOPMENT Permit : ELC2014-00114 Date Issued: 03111/2014 "(I c;A it t> 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S101 CA00200 Jurisdiction: TIgard Site address: 7904 SW HUNZIKER RD Project: AGILYX Subdivision: 1994-025 PARTITION PLAT Lot: 2 Project Description: (3)FEEDERS 200AMPS OR LESS FOR PANEL Contractor: CHRISTENSON ELECTRIC INC Owner: WALL STREET INDUSTRIAL LLC 111 SW COLUMBIA ST,STE 480 A RICHARD VIAL EXECUTIVE CENTER LLC PORTLAND,OR 97201 7000 SW YARNS ST PORTLAND,OR 97223 PHONE: 503-419-3300 PHONE: FAX: 503-419-3695 FEES Quantity Description Date Amount 3 5ewlr�q QL paeders-20U 03/1112014 5302.10 Specifies: (amps or less i ea 12%State Surcharge- 03/11/2014 $36.25 Type of Use: COM Electrical Class of Work: ALT Type of Conat: Occupancy Grp: / c S M• C3n (3' ) C - S (AA rum) \1 0` . G - Total 6 Required Items and Reports(Conditions) 65j: This permit is issued subject to the regulations contained In the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. At work will be done in accordance with approved plans. This permit will aspire if won( 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 Cooler. Those rules are set forth in OAR 552-001-0010 through OAR 952.001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 501232.1957 of 1.800.332.2344. Issued Sy: Permlttee Signature: OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale,lease of rant. OWNER'S SitMATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR.ELEC' Date: LICENSE NO. Call 503.630.4175 by 7100 a.m.tar the next available Inspection date. This permit card shall be kept In a conspicuous place on the job alts until completion of the project. Approved plans are required on the job site at the time of each Inspection. 1 City of Tigard T[GARD Accela Refund Request This form is used for refund requests of land use, development engineering and building permit application fees. Receipts,documentation and the Request for Permit Action form (if applicable) must be attached to this request form. Refund requests are due to Accela System Administrator by each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts Payable will route refund checks to Accela System Administrator for distribution to applicant. PAYABLE TO: Christenson Electric DATE: 4/3/2014 Attn: Suzi Flowers 111 SW Columbia St.,Ste. 480 REQUESTED BY: Dianna Howse Portland, OR 97201 TRANSACTION INFORMATION: Receipt#: 195195 Case#: ELC2014-00114 Date: 3/11/2014 Address/Parcel: 7904 SW Hunziker Rd Pay Method: CreditCard Project Name: Agilyx EXPLANATION: Per applicant's request due to correction of scope of work. REFUND INFORMATION: Fee Description From Receipt Revenue Account No. Refund .-Example: Building Permit Fee Example: 2300000-43104 $Amount Electrical permit 220-0000-43103 $302.10 12%State surcharge 100-0000-24001 36.25 TOTAL REFUND: S338.35 APPROVALS: SIGNATURES/DATE: If under$5,000 Professional Staff 474 r4..p If under$12,500 Division Manager If under$25,500 Department Manager If under$50,000 City Manager If over$50,000 Local Contract Review Board FOR TIDEMARK SYSTEM ADMINISTRATION USE ON Case Refund Processed: Date: 1 4e/,j frf" By: I:\Building\Refunds\RefundRequest.doc x 09/01/2010 APR-03-2014 THU 07:58 AM CHRISTENSON ELECTRIC, INC FAX NO. 95034193695 P. 01 III City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT R CEIVE a Request Permit Action TIGARD 13125 SW Hall Blvd. •Tigard, Oregon 97223 • 503.718.2439 •www.tigatt} .go x, 2.014 CITY OF TIGARD TO: CITY OF TIGARD BUILDING DIVISION Building Division Services Supervisor 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503.718.2430 Fax: 501598.1960 www.tigard-or.gov FROM: ❑ Owner Applicant Contractor ❑ City Staff (check one) REFUND OR Name: ''t‘• L. INVOICE TO: (Business or Individual) .i� w Mailing Address: SW au I T .1 I .i -46 City/State/Zip: M Vs__ �� 1 r " Phone No.: - 4. 1 PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): I. CA VOID PERMIT APPLICATION. �4 REFUN. RMIT FEES (attach copy of original receipt and provide explanation below). 'el ' a FOR FEES DUE (attach case fee schedule and provide explanation below). LI REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit). Permit#: �. • _- I Site Address or Parcel#: 1 ~rat, . Ai _ WA ►! Project Name: • Subdivision Name: Lot#: 'IN EKPLANAT' ON: .a . Ai,A! (Airs I I Al' ■ go Pk a A 41 - ' *k- �l _.1 A I .L , Date: 13/i 13/IL( Signature: - v_. Print Name: All • ILI�� ,fund Pnliry 1. The Director or Building Official may authorize the refund of a) any fee which was erroneously paid or collected. b) not more than 80%of the land use application fee when an application is withdrawn or canceled before any review effort has been expended. c) not more than 80%of the Sand use application fee for issued permits. d) not more than 8U%of the building plan review fee when an application is canceled before any plan review effort has been expended, c) not more than 80%of the building permit fee Fir issued permits prior to any inspection requests. 2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 2-4 weeks for processing refunds. FOR OFFICL USE ONLY Rte to Sys Admin: Date B Rte to Bad.Admin: Date ' / B ^' Refund Processed: Date',i B .,2M Invoice Processed: Date B Permit Canceled: Date ,'� Parcel T :Addcd: Date B Receipt# Date Metho. _ Amount$ I:\Building\Forms\ReriPermitAction,dnc Rev 05/25/2012 Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 7904 SW HUNZIKER RD, TIGARD, OR, 97223 Commercial - Electrical 199 Electrical ﬁnal PASS - No C of O May 20, 2014 at 12:52:10 PM ELC2014-00114 Jeff Grove Violation Summary: Inspector Contractor