Permit a CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
• ° ' COMMUNITY DEVELOPMENT PERMIT #: ELR2007 -00414
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/9/2007
PARCEL: 25101 DA -00100
SITE ADDRESS: 13010 SW 68TH PKWY 140 ZONING: C -P
SUBDIVISION: TRIANGLE CORPORATE PARK LOT: 007 JURISDICTION: TIG
PROJECT: PACIFIC SOURCE HEALTH
Project Description: Data /telecommunications.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
SCHNITZER INVESTMENT CORP • CHRISTENSON ELECTRIC, INC.
PO BOX 10047 111 SW COLUMBIA STREET # 480
PORTLAND, OR 97296 PORTLAND, OR 97201
Phone: Contact #: PRI 503- 419 -3300
FAX 503- 419 -3695
FEES Reg #: ELE 26 -34C
LIC 458
Description Date Amount SUP 1994S
[ELPRMT] ELR Permit 11/9/2007 $75.00
[TAX] 8% State Surcha 11/9/2007 $6.00 REQUIRED ITEMS AND REPORTS
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 started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344. _ f
Issued By: Permittee Signature: dAJ /9-Aj°G/ e �Ot'
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'N: ?A1/ /9-/)z./6-41- 7-70^) 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.
NOV -08 -2007 THU 07 :53 AM CHRISTENSON ELECTRIC, FAX NO. 95034193695 P. 01
• Electrical Permit ' - i n 1 olz (►I IISI: ON L1
City of Tigard * R // /� 7 �� r•• —rrRirNn.ELRo700� �j15�f`�
R>atelFiv: 9 EIV ' Plan Review Other Fermis
/100.2'r S s : s' 10 7— 'O5 /.Z,
�,;�I;�,; patrlfty:
Phone: 503.639.4171 Pax: 503,596.1960 orris; try See Pogo 2 for
tn.cpedion Line: 503.639.4175 NOV 08 20 ' • J : ru R `utyBy:
Internet; www,ti,tigard•or.wi
Notifie d/Muthod ; Supplemental Information
•w:
* U *:
....:: , , .;:... , .,.... , •<.: .., �. .: "�.....'.� ?lease sheet. all that apply, � tls,E )i .>
.
't?l
El New construction O�y�e�EDN ?lease i e ovo:r 225 amps. 1] Ilazardoue location
❑ Demolition [] Other: .. over 320 amps - rating ❑ Buildng over 10,000 sq. It.,
-a ---s w residential
dwellings 4
or more ne
-- c-- ^r...,:<:.^— r. *� .than
it d
11
of gs
y
..: �4�'�•�i, OiP". ...t~�!1!I�1'1`>lt � ; .. units in one structure
❑ Sys-tzm over600 volts nominal
❑ 1- and 2 falttily dwellutg Commercial/industrial ❑Accessory building ❑ Building over three stories ❑ Feeders. 400 amps or more
❑ Multi -family ❑ Master builds ❑Other ❑ Occupant load over 99 persona ❑Manufas turgid structures or
:. ... , .,.; �<
., ..,.:. I T.# 04 Al lll:', x,1;3(" :1.: Eg ea wire Fp a
X11 � �� , A�'141V :' k ' ❑ itt °
:''. :' : <. < ❑ Health- Willi), ❑ V par Other:
Job no.: 5$- l o, 3 Job site address: 13 r) SW to D PA rki llti � Submit 2 sets of plans with any of the above,
City/State/ZIP: 1 c - The above are not applicable to temporary construction service.
t� LJt� C� a . of +'
suitt:/bldg./apc. no.: ,,a Project name: ()etc.; C.
i ��SDLvV'G� }ler��1 - pee. ou
v rt »�
° New residential single - or multi- family dwelling unit.
Cross sueeddirwlions to job site: (.�,,, ere �1C l.s 1OtJ Includes attached garage.
1'9 "3 31(o 1,0004 B. or less 145.15 4
Ca. ;WWI 500 sq. R or portion 33A0 1
Subdivision: Lot no.: 75.00 2
Limited energy. resid�ttial
Tax map /parcel no.: Limited energy. non - residential 75,00 2
. ••n 1�f)A1 ,OAP` 11Vfl]f�K h
u
cbrred o rmodular
\ dwelling, service and/or fe 90.
061..l. Q�k-�. . Occ- \ - TT I U 1 D Y Q.1�l aTri Services or feeders inataitatiio alteration, a nd/or Macedon 200 amps or less 80,30 2
f :: . 201 slops l0 400 amps 106,85 2 ,
•:TtRAP `Iuli:s "' n � �� 401 amps to GO0 amps 160.60 2
Name: Se#A/ /TZR 1ti i/E�T /7�� 601 anlpa to 1,000 amps 240,60 2
— Over 1,000 amps or volts 454.65 '2 Addfess: �Q �0D7 !J / Reconnect only , 66.85 2
/
City /State/ZIP: 47z/9-A A.. 5'7,Z9 4, Temporary services or feeders Installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not
— 201 amps to 400 amp. 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
Owner sigttaltlre: Date: , Branch circuits - new, alteration, or extension, per panel
...::,:, ..: >:',,,::,, : :c..:• »:<.,; .,:.,,. :: ' .::;.::: Fee for branch circuits with
,.::...,. A1.0:tiO 1Vl ? .: ... ... ::. . .. - ? service nr feeder fee. each - 2
,<.,::. . , ...:.. .....: ,.. :: � 6.65
Business name:
_ branch circuit _
B. Fee for branch circuits
Contact name: without service or facdcr fee. 46,85 2
first branch circuit
Address: Each add'I branch circuit 6.65 _ 2
City /State/Z1P: Miscellaneous (service or feeder not included)
Putnp or irrigation circle 53.40 2
Phone: ( ) I Fax: : ( ) , Sign or outline lighting - 53,40 2
l mail; Signal circuit(s) or limited -
( Y
; , L "1
!kC '!<ll� . : ' ;.; s`• ;'i' qi energy panel. alteration, or
P 1f
extension. peecribc; ' Page 2 1l -15.Ce 2
Business name: Christenson Electric, Inc. bo>L \ / TQ\ o
Each additional inspection over ellnwable In any of the above
Address: 11 l SW Columbia Street, Suite 480 Per inspection 62.50 -
City/State/ZIP: Portland, OR 97201 Investigation per hour (1 hr m in) 62.50
Industrial plant per hour 73.75
50s 419-3300 ret: (503) 419 - 3695
Phone: t : (. ) ' F ,-- '' •: , : C11Ir: < p iliT `:PEES': z:;::
CCIi Lic.: 458 _ Electrical Lic.: 26 -34C S j • Lic.: 199-, Subtotal 150'.)
— r / (7 / Plan review (25% of permit fan)
Supra. E.leelncian Signature, required: ,
State surcharge (8% of permit fee) to -4p
Print name: / , A Date: >,1- -(''7
TOTAL PERMIT FEI? ' I , 00
Authorized signature: This permit application expire* ifs penult is oat obtained within I BO
days alter It has been accepted as complete
Date: • Feu nte1hodolegy set by Tr,- Bounty Building Industry S Beard
Print llalne: T' **Number of inspections per want allowed
t , ; , doc 1 2!03 440-4b1 Simvo4/r- •UM/w6B �:':" 636
ita,uldnq, Pem„Is fl•r:- I4m1.11 P� �'`\
i
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2007 -00414
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1
Phone: (503) 639 -4171 ,,�11�'i (fi
Inspection Requests (24 Hrs.): (503) 639 -4175 _ ' !,L 1 1.
INSPECTION WORKSHEET FOR DATE: 2/21/2008 TIME: 7:OOAM PAGE: 52
SITE ADDRESS: 13010 SW 60TH PKWY 140 CLASS OF WORK:
SUBDIVISION: TRIANGLE CORPORATE PARK LOT #: Q07 TYPE OF USE:
PROJECT NAME: PACIFIC SOURCE HEALTH
DESCRIPTION: Data/telecommunications.
OWNER: SCHNITZER INVESTMENT CORP, PHONE #:
CONTRACTOR: CHRISTFNSON ELECTRIC, INC. PHONE #: 503-419 -3300
Inspection Request Scheduled For: Date: 2/21/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 065331 -01 503.806 -9389 N
Corrections /Comments/ Instructions:
n (-"--\
Y V
A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: , h) 6 g Date: 2:2A • Q1 Phone #: (503) .718 -11
CITY OF TIGARD
y �
BUILDING DIVISION PERMIT #: ELR2007- 013314
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/9/2007
Phone: (503) 639 - 4171 „4 I�I
Inspection Requests (24 Hrs.): (503) 639 -4175 s' °_ ..
INSPECTION WORKSHEET FOR DATE: 12/7/2007 TIME: 7:OOAM PAGE: 53
SITE ADDRESS: 13010 SW 68TH PKWY 140 CLASS OF WORK:
SUBDIVISION: TRIANGLE CORPORATE PARK LOT #: 007 TYPE OF USE:
PROJECT NAME: PACIFIC SOURCE HEALTH
DESCRIPTION: Data/telecommunications.
OWNER: SCHNITZER INVESTMENT CORP, PHONE #:
CONTRACTOR: CHRISTF_NSON ELECTRIC, INC. PHONE #: 503419-3300
Inspection Request Scheduled For: Date: 12/7/2007 Pour Time:
Code # Inspection Description 'p onfirm_# Contact # Message
135 Low voltage 061032 -01 503-806-9398 N
Corrections /Comments/ Instructions:
.•. .►e, - LL
■ • -10 '. , W %_`T .% - Z.
-. \ZT I s e Al er t _V1� is Y/_ o VD -- Da_ ,i
LA 6cL 1`Y A 6 c 4\ &Y ,r�c. T i 0 ¢, r t--KL
citDE . c
❑ PASS PARTIAL APPROV ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N 6b Date: 12-1 '01 Phone #: (503) 718- Zyqt.