Permit (59) C ITY OF TI GARD ELECTRICAL RESTRICTED ENERGY PERMIT
Pk DEVELOPMENT SERVICES PERMIT #: ELR2005 -00378
..��� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/31/2005
• PARCEL: 2S115AB -01900
SITE ADDRESS: 16200 SW PACIFIC HWY D ZONING: C -G
SUBDIVISION: TIGARD TOWNE SQUARE LOT: JURISDICTION: TIG
Project Description: Low voltage for audio wiring. Job No. W15107
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: X INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
BIT HOLDINGS LTD PARTNERSHIP CHRISTENSON VELAGIO, INC.
BY FORUM PROPERTIES INC 1631 NW THURMAN ST. STE 200
FIVE CENTERPOINTE DR STE 290 PORTLAND, OR 97209
LAKE OSWEGO, OR 97035
Phone: Phone: 503 - 419 - 3600
Reg #: LIC 64137
ELE 26 -1174C
FEES SUP 1994S
Description Date Amount REQUIRED ITEMS AND REPORTS
[ELPRMT] ELR Permit 10/31/200: $75.00
[TAX] 8% State Surcharl 10/31/200: $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
sta within 1 ys of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
ou to follow rules adlikpted by e Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through OAR 952 -001 s • I. •u may obtain copies of these rules or dire•: es ions to OUNC a j503 -2 4 6699.
Issued By: Permittee Sig �' _ %..
OWNER INSTALLATION ONL
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.
OCT -26 -2005 WED 02:32 PM CHRISTENSON VELAGIO FAX NO. 95034193695 P. 01
i- I ult ul l li'I' :Idyl': O,�I.1
Electrical Permit V E
Received Mer PenmtNo.: ELL, /i5 , A City of Tigard Date/13 ' f /( / s(j
13125 SW Hall Blvd., Tigard, OR 97273 P lan Re view Other Permit:
, f7 ..,s : r , i , 4 xl Dete/8: •
Phone: 503.639.4171 Fax: 503.598.1964. I �oo� J I Date ReadyBy: ES See Page 2 for wif inspection Line: 503.630.4175 CITY OF TIGAAD J supplemental Information
Notilled/Methed:
Internet: www.ci•tigatd.or.us . - - -z r � , 2 "'
4 � '? .`�� �/j : ,i � , e�R��.y� J .'.� ,L; ' ��' � �ysw.Y� `�'
'�+'.' .
•'t. � �x ' • *• Please check all that apply:
El New construction cgAddition /alteration /tep lacemen[ ['Service over 225 amps, comm'I ['Hazardous location
❑ Demolition ❑ Other: ['Service over 320 amps - rating ❑Bulldog over 10.000 sq. It.,
s ? L ' -- ` ••. Y ' ■ . Ye; , . ' - •
.. f of 1 -and 2- family dwellings 4 or more new residential
���i�•�.�����'*^ '`^ '�' �� � - - �Systcm over 600 volts nominal units in one structure
CI 1 - and 2 - family dwelling 1`'i Commercial/industrial ❑ Accessory building ['Building over three stories ['Feeders, 400 amps or more
❑ Multi - family ❑ Master builder 0 Other: ❑Occupant load over 99 persons ❑Manufac cared structures or
c�M1x —.. I i4'' � 4. 1 B esslli hung plan RV park
;y °t "4 K: y� � '�, ?y 5' I.!'a 11, N. ld k iq i IF' , w7 %! `X Q b g ❑
;' _. AR' �`� Other.
❑H�ltit� are facil
Job no.: t 01 Job site address: ` 6 BOO sl,0 te e, AN Al . . Submit x sets of plans with any of the above.
City/State/ZIP: ` I i tz • i a oz,l r The above are not applicable to temporary construction service. M
Suite/bldg. /apt. no.: 0 5 f Project name: Ri t P ` Str,R,. I Qty. Pee 1 Town I •' •
t r New residentlAl single - or multi - family dwelling unit.
Cross strec(Jdirections to job site: r i �j i a I, • i r_ _ 6-03_, Q° Includes attached garage.
1,000 sq. It or less 145.15 4
Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Subdivision: - Limited energy, residential 75.00 2
Tax map/parcel no.• Limited energy, non - residential _ 75.00 2
n. r �''ki s Each manufactured or modular
�s` ; / I ,x :! : wrlYr • > C> :'` � •, dwelling, service and /or feeder 90.90 2
r cn
I ! 1 0 ,� - ii) ► � . L._ � �LCaOE�s Q • . Services or feeders InstatlatMo, alteration, and/or relocation _
200 amps or less 80.30 2
_ ,:,.... �,,,� 7 :• > , :. ; ,' 201 amps to 400 amps 106.85 2
r �° tFF is 4 �l ` }` ..c r . - iedtij ^ ,s^
CIA wi 1� .• - .. c -: - . • !�fe, 'ch '. + �' H,^ 9 " : '":c� r ' rX'.. r 401 amps to 600 amps 160.60 2
Name:
601 amps to 1,000 amps - 240.60 2
Over L 454
000 amps or volts 454.65 2
Address: _ Reconnect only x- 2
City /State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) _ 200 amps or less 66.85 1 _
Owner Installation: This installation is being made on property that I own which is not 2 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
Date: Branch eircults- new, alteration, or extension, per panel
Owner signature: _ _ itb
���,,� e r >'yx:1 L; A. Pee for branch circuits w
;;rt „ -. v S p i t r tj.. � rSKP r � , Q :i.... • ' •i1;, service or feeder fee each
� � J1 ` ;. !,. • '.: t 4 .< r0 4, . 6.65 2
-.te
branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
- each branch circuit
Address: ,
lwach add'l branch circuit 6.65 2
Miscellaneous (service or feeder not Included)
City/State/ZIP: ---- Pump or irrigation circle 53•'t0 _ 2
Phone: ( ) I Fax: : ( ) _ ' Sign or outline lighting 53.40 2
E Signal circuits) or limited 7 5.00
K r ;: ;.,, 1 ��_•,, •9• ; panel, alteration. or ( 75.61) iM .�• ; .,,- a , �J+:�' 7v:w "' K t' r •i , 1C9.sr4'�'.,t "1};,fi'1.�ia,!'�;:?... fi14"`,c�.�"' energy __, Page 2 _ 2 .
�:;�� ' r tin" ^ Y �X.r e,...;n?4,a s 'laf:;l' R$ k�•:� ,_ �f1( �at s z .) scribe: to
Business name: CHRISTENSON VELAGIO, INC. �
1.631 NW THURMAN ST 2ND PI Each add itional Inspection over allowable in any of the above -
Address: Per inspection 62
City /State/ZIP: PORTLAND. OR 97209 - 2558 r _ investigation per hour (r hr mire 62.50 '
Industrial plant per hour 73.75
Phone(503) 419 -3300 I pax: (503) 1+19 -3333 gi._ t g , , gi ,s; • ;# ,
CCB Lic.: 64137 I Electrical Lic.: — 174C I Suprv. Lie 1994S Subtotal '5.01D
Suprv. Electrician signature, required:
Plan review (25% of permit fee)
— �.� State surcharge (8% of permit fee)
Print name: ROBERT ma l Date: I (� Q TOTAL PERMIT FEE n 1 Crip
Authorized signature: - This permit appliieauoo expires It a permit Is not obtained wlthln LAO
days after It has been accepted as complete
Print name: i Date: • fee methodology set by Th-County Building Industry Service Board
•• Number of inspections per permit allowed.
istauirding‘Peinote \P-I.C- PamitAPRdoe 12/03 440- 161Sr(10/112/COM/WER