Permit x � "' r CITY OF TIGAFZ® ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2010 -00283
I G AR1J 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/11/2010
Parcel: 2S101BCO2200
Jurisdiction: Tigard
Site address: 8330 SW HUNZIKER RD
Subdivision: Lot: 0
Project: Western Partitions
Project Description: (1) branch circuit for storage room.
Owner: FEES
HUNZIKER TWO, LLC Quantity Description Date Amount
BY MICHAEUPAMELA ROACH MGRS, 956
WEST POINT RD 1 crt Branch Circuits 06/11/2010 $56.18
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 06/11/2010 $6.74
Electrical
Contractor:
CHRISTENSON ELECTRIC INC
111 SW COLUMBIA ST, STE 480
PORTLAND, OR 97201
PHONE: 503 - 419 -3300
FAX: 503- 419 -3695
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $62.92
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 •: R 952 - 001 -0100. You ma o• _ • • • • - rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
� z
Issued By: ,S</iL�i mot Permittee Signature:
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 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.
JUN -09 -2010 WED 01:51 PM CHRISTENSON ELECTRIC, INC FAX NO, 95034193695 P. 01/02
Electrical Permit Application �r� 1'012 01,1("1' tISr. ONLY
City of Tigard �° p fjdv e�ed : Q Permit No.; �� 7
■ 13125 SW Hall Blvd., Tigard� a : 5 ), . 1 a Plan Review
• 1 Phone: 503.639.4171 Pax: 90 )60 Date/L; : Other Permit: I --CD 1
Ins ection
Line: 503,639.4175 O ,
Internet: www.tigard Date Ready / y: t Svc Page 2 for
I' I (i A I{ 1) P SUN L Notified/wood: 111M Supplemental Information
YPE 0 ' , ' t1.6, 1 !, rk t T P Lath, . P 5, v1 y ,. ti ;, .. ,
❑ New construction ddlHo
' ti < Please check all that apply (submit sets of pions whtoma checked below): lor ❑ Service or feeder 400 atmps or more El over lhrttC atones.
Cl Demolition El Other: D ��� Is e lF where the available fault current ❑ Marinas and boatyards.
. CA /WO OB' CO*ST IIC r10N.:: , exceeds 10,000 amp at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 0 Commercial -use agricultural
❑ 1 - and 2 family dwelling ommercial/industrial ❑ Accessory building amps for all other installations, buildings.
❑ Multi- family ❑ Master builder 0 Other: ❑ Fire pump. ❑ Installation 131 75 KVA or
U AN ❑ Emergency syaaom. larger separately derived system.
:.' - .. JOB.: SITE 14(11,OR 0'r,, '
lob no.. 0 , Job site address: D :LOCATION • • 0 Addition of new motor load of ❑ "A" 1'
"" "1 -2 ", "1 -3"
IOOE•IP or more. °°cupancy,
$ svo m il ❑Six or morn residential units. ❑ Recreational vehicle parks. , ❑ Health-care facilities. [] Supply voltage for more than
City/State/ZIP: `�r�N� 1 U 600 volts nominal.
1 �� 1] Hazardous locations
Su ite /bldg. /tlpt. no.: Project name: 1 , v 4., rrvme r feeder 600 amps or moro.
1 i :,'['lltwl? SCIVPVV
Cross street/directions to jab Site: m d w Descr i pt�un Qty. Pee ml
•
'rn
1 New residential single or multi - family dwelling unit. 3 .J 1y \ T luclndes attached go age.
Subdivision: Lot no.: 1 000 sq. 11. or less �� 168 54 4 -
- - Ea. add'l 500 sq. ft, or portion 33,92 1
Tax map /parcel no.: .. Limited energy, residential 67.84 2
D' CIOTION .OF''W . . ' % (with above sq. ft.)
UR1► ith a
_ Limned ener y, multi- thmily 67.84 2
x r e sidential with about sq. R.)
.116 �l f � / ~ Services or feeders installation, alteration. and/or relocation
- 6- l.' 4115 WY l�L T .. 1� elk 200 amps or less 100.70 1 2
" TENAN 11 • 201 amps to 400 amps 133, 56 2
❑ k'12 OV YN > It ; :.; � , '.:.... Q: .
401 amps to 600 amps 200.34 2
Name: _ ,,. 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552,26 2
Temporary services or feeders installation, alteration, and /or
City /State /ZiP: relocation
-^
200 amps or Less 59.3E I 1
Phone:( ) Tax.( )
201 amps to 400 amps 125,08 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 turps 168.54 z
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. — •
Branch circuits - new alteration, or extension, per and
Owner signature; _Date: A. Fee for circuits with
ONTACT' PERSON above service or feeder Ice• 7 42 2
[] ArPI;ICA]vT Q C . each branch circu
13. Fee for branch circuits without t
Business name: service or f fcc, rasa
56,18 5 if 2
branch circuit
Contact name:
- - Ezell add'I brunch circuit 7.42 2
Address: Miscellaneous (service or feeder not Included)
" Each manufactured or modular 67.84 2
City/State/ZIP: --- dwelling. service and /or feeder
Phone: ( ) Fax: : ( )
Reconnect only 67.84
2
Pump or irri Circle 67.84 2
E - mail: Sign outline lighting 67.84 2
CONTRAC'COR • • . ,_ SiE.,nal circuit(s) or limited- energy
' panel, alteration, or extension. Pan 2 2
, ` [r
13usincss name: _ is,.. p Each additional inspection over allowable in any of the abov
` tt n ��\ t ,� n ' ^ � Additional inspection (1 hr min) 66,251 hr
Address: ` ` �Y1v 'f_ rte. 1 L .' Additiun
_ 66, 225i h
^,.,�� _Livestisalion (I hr min) _
City /State /ZiP: Vi>ri
\ Y N\ t D\ 1 ` D 1 ,- Industrial plant (I hr min) 78.18/ hr -..
r Inspections for which no feu is 90.00/ hl'
Phone: '� '� Fax: ( ) _ .
� � r sp:cifscally listed ('h hr thin)
CCB Lic,: '� A 1 � Electrical Lie , Su rv, Lic.: ^ �' .ELECTRICAL. PERMIT . • .,• � �
�� f - l l p 1 Jt2� � _ Subtotal: `� Ip k l 0
Sup,v, T ecnicinn : ig rc, required: / Plan review (25 %ofpermit fee):
II/''''''))) f 1 1 �/ 4 ' State surcharge (12% of pcmlit fee):
. Print rtalllcV ],�. ", - I J r ,� ,� 1 _
/ " TOTAL. PERMIT FEE:
Authorized signature: This permit appllen expiry, If a permit is not obtainer Ono ISO
—
__ day %after it has been accepted ns complete.
Print name: -- ( Dale: • Number of inspuca inns nllow od per permit.
1 \mild inntPcn 1' 1' r.p,,,li pp.do late Vii't adn-.[f1 I'll 1tlns(rOMlwlti
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