Permit I ._ I : , CITY OF TIGARD ELECTRICAL PERMIT
I ' = COMMUNITY DEVELOPMENT Permit #: ELC2010 -00307
TIGARD: 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/23/2010
Parcel: 2S110AC01100
Jurisdiction: Tigard
Site address: 11300 SW BULL MOUNTAIN RD
Subdivision: Lot: 0
Project: Star Plex
Project Description: (3) branch circuits for dryer outlets
Owner: FEES
FINCH, KENNETH A & LYNNE M & Quantity Description Date Amount
EISERT, CLARK L & STEPHANIE, 10685 SW
CLAY ST 3 crt Branch Circuits 06/23/2010 $71.02
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 06/23/2010 $8.52
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: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $79.54
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 OAR 952- 000'1' -0011000.0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: ' `-C `;��'' 1--1- 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.
CaII 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 -22 -2010 TUE 03:14 PM CHRISTENSON ELECV I*TINC FAX NO 95034193695 P. 01/02
Electrical Permit A lication �_ 4‘ FoR Orrlt:'i LIST ()NIA
City of Tigard r \ f R i ae;Ded G 23 !
/o .� Permit N °, irL (2,/0 '/ /.330
1. / N 13125 SW Hall Blvd., Tigard, OR 972 \w,\\ e- Pl Review
Phone: 503.639.4171 Fax: 503,598,1960 ,� \v ,\ p pnte/Dy; Other Permit:
I' 1 i.i ;1 IC I? v
Inspection Line, 503,639,4175 {� . eS . \1�' e (Moto Ready /13y, 15 ® Sec Page 2 for
Internet www.hgard or.gov c . ` � � \�\ j Notified/Melhod: 1 Supplemental Intormnnnn
New construction ; ; � 01 r:- ! 1 ' , ,' , i: , 6 h
Please check all that apply (submit 2 sets of plans winning chocked below)
111 Ne tl0n Addition /altCrallOn/IeplACen1ent L1 Service or feeder .100 amps or more ❑ Bolding over three stories.
❑ Demolition Other: where the available fault current ❑ Marinas and boatyards.
C 011l lnerclal /indent less to ground, or exceeds 14,000 ❑ Commercial-use exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
: .. Ai ' G,' RYr Qli .COh($'�.�tUCTiON . � ucrcial -uee agricultural El 1 - and 2 - family dwelling rial 0 Accessory building gimps for all other installations. buildings.
❑ Multi family 0 Master builder ❑ Other: ❑Fire pump. ❑ Installation of 75 KVA or
❑Emergency system. larger separately derived system.
Q • J B ; 91TE, IiVE.O1tMAa O ;,;AND LOCATION � D Addition of new motor load of 121"A". ` • "1.3•',
+ k� � gix or mom m resi occupancy.
lob no.: � `2. Job site address: \' C [] Six or more ruaidumial unite. ❑ Recreational v°hicle parks.
Gity/State /ZIP: ❑Idealth -care foci ioiea. ❑ Supply voltage for more than
�� �� �' ! ❑fiozudous locations. 600 volts nominal.
Suite/bldg. /art. no.: Protect name ; - r La ❑ Set"i Or feeder 600 amps or more.
YiEE 51~IDULE
Cross street/directions to job site: Ducrimien r ®® •
--° r ) go L ,� New residential single- or multi-family dwelling unit.
(\ Includes attached garage.
Subdivision; 1 Lot no.: 1,000 sq. ft, or less 168.54 4
En. add'I 500 sq. R. or portion 3392 1
Tax map /parcel no.: Limited energy, residential
D T OE :'W l • (with above sq. it.) 67.84 2
_Cal ^ Limited energy, multi - finally 67.84 2
0 X. - , 1_2_, plic4 .-1-. residential (with above sq. ft.) . Services or feeders installation and/or relocation
200 amps or less 100,70 2
. n PROPERTY'OWNPR: . `' TENANT 201 amps to 400 amps 133.56 2
" �" " 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
Phone: ( ) Fax: ( ) 200 amps or Tess 59,36 1
201 imps 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 amps 1613.54 2
.54 �.
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. --
Branch circuits new, alteration, or extensionoer panel
Owner signature: Date: A. Feu for branch circuits with
-` above service or fcedor fee, 7 42 1
[}:APPLICANT , 'l�:.CONTACT PERSON • : • each branch circuit
Business name: • B, Fee l'or brunch circuits without �. / _I� t(� service or feeder fee, first
56,18 6�` 2
r 1 -'
Contact name: brunch circuit d
A E ach eddy! brunch circuit �� 7.42 I 2
Address: Miscellaneous (service or feeder unt included)
- Each manufactured or modular 67,84 2
City /Stale/ZIP: dwelling, service and /or feeder _
1.' a ' I ` 'll. .� ' 1 I /� Reconnect only 67,84 2
thane, ' Fax: :�j1�7 r �"l` r l (IQ
Pump or irrigation circle 67.84 2
E-mail: -- 2-\ '_j -Lr► l
�� tti V 4.040p Sign of outline lighting 67.84
•, CQNTRACTOR Signal circuit(s) or limited-energy
• 1, �V b ` � on,
Rosiness name; panel, alterati or extension. Page 2 2
\ �`, t `Q -� Each additional inspection over allowable in any of the A bov e
Address: `�` �.�` ��`�V t , w r 1 Additional inspection (1 hr min) — �� 56.251 hr
t ` ��� U � C1 ' . 7 � `
I In t p n (1 hr min) 66.25/ hr • T
City/State /ZIP: ' C ` ndustrial plant (1 hr min) 78.18/ hr
hone: (�� � �� 1 ax: ( l_.� lnspectiong for which no ice is 90.00 / hr
_.r
___
, S,.- t pccrtically lensed ( ' /: hr min)
'"- I � i f at. 4 , Suprv, Lic, �jo & E LECTRICAL PERMIT h L&
CCB Lic,: E lectrical Lle 1
Subtotal; I r �
Suprv. Electrician signature, required
/ ) Plan review (25% o permit fee):
Print name: J� , , I ' _ •:::= = , " 2 \ State surcharge (12 °/[ of permit fee):
TOTAL PERMIT FEE: it
Auihorized signature: This permit application expires if u permit in not obtained Rhin Igo
days rafter it has been accepted as complete.
Print name: Date: • Number of impecticm allowed per permit. r � C
T - r 7 q t 5J
PlnuiidinglPr I.c -Pc r ,,, IT App dnr 1011 ti 4- m- 46isTn llnslrwiwrn L/