Permit p CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: ELR2008 -00011
TIGARD DATE ISSUED: 1/11/2008
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S101 DA - 00100
SITE ADDRESS: 13010 SW 68TH PKWY 140 ZONING: C -
SUBDIVISION: TRIANGLE CORPORATE PARK LOT: 007 JURISDICTION: TIG
PROJECT: PACIFIC SOURCE HEALTH
Project Description: Install low voltage security system.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: 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: SECURITY X
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 -3728
FEES Reg #: ELE 26 -34C
LIC 458
Description Date Amount SUP 1994S
[ELPRMT] ELR Permit 1/11/2008 $75.00
[TAX] 12% State Surchai 1/11/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
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.
Issue= rr
/j /��1 ' J ' Permittee Signature: \ \
- l�
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: 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.
=, �
JAN-10-2008 ?AU 10:05 AM CHRIS ELE0?QlC.lN0 FAX NO 95034193695 P. 01
--- '___ --_- �-�__� -- __--- __
-- -- -- pxkon'vE 1,|.
City of Tigard •
. le ' ' i : ' JI C I V R -'- - . :il Wh All ....
i „ . Inspection Line: 503.639.4175 Date Readyilly: Igni la See Page 2 for
0 Demolition 0 oth . DIV - 1 a h. 0 Service or feeder 400 Bums or more l:i Building over three stories
where the available fault current 0 Marinas and boatyards. .
0 1- and 2-family dwelling Igt Commercial/industrial 0 Accessory building amps for an other installations. buildings.
0 Multi-family 0 Master builder U Other. EIFire ptunp. 0 Installation of 7S KVA or
. . 0 Ementelicy system, larger smoothly derived system.
Job no.:Sq .• ii i4.. Job site address: I 501 0 5 .. ilk. 100HP ar more. occupancy.
. _. IS elf . /,-,_, 1:1Six or more residential units. 0 Recreational vdticte parks.
City/State/ZIP: 1 • • 0 1 4 g.:2. '-. 13HealtIrcare facilities. EI Supply voltage far more than
0 Hazardous locations. 600 volts nominal.
1 El Service or feeder 600 amps or nem.
Suite/bldg./apt. no.: Project name: e . A . C A.,,
Cross strect/directions to job site: a ,. ,., i, , &........... , . . 1 Total •
' • Li _ . . ii. • New residential single- or muld-famlly dwelling wilt
Subdivision: Lot no,: • 1,000 sq. ft or less II. 145.15 II
^x ~p
Limited energy, multi-family al 75.00
Se.C.I.,tf %.' - ref AQ.N.X.) ?pf ___Cdrt(p_______--- residential (with above - . It 13
Services or feeders installation. alteration, and/or relocation
:::f'' ill ..,:i(001t,lit-4:01NTECV;'0.!'[?:.,:;.: '1.'i,",;;....,:Zil.:W.CC:,%;CUIEriAlgifil,,,..;,.2:,,..:.:!..4,.„;.,...:... 201 amps to 400 amps • 106.85 B
401 amps to 600 arnps 160.60
Name: 601 am • s W 1,000 amps IIII 240.60 1E1
Address: Over 1,000 amps or volts INICE33:1 EV
.____ ---------- Temporary services or feeders Installadon, alteradon, and/or
City/State/ZIP; relocation
201 am to 400 amps II 100.30 Nu
Owner installation: This installation is being made on property that 1 own which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signatinv: -------7--— Date; . , .. , , .. A.Fee for branch circuits with
nth branch circuit
Business name; B. Fee for branch circuits
Contact Millie: first branch circuit
_ Each add'I branch circuit 6,65 2
Address: -----.____ — Miscellaneous service or feeder not InrJuded
City/StateJZIP: Each manufactured or modular III 90.90 El
Phone: ( ) Fax: : ( ) Reconnect onty, MI 6 El
E-mail; Pump or irrigation circle Ili 53.40 Ell
Signal cireutt(s) or limited-
Business name: Christenson Electric, Inc. energy panel, alteration, OT
Address: 111 SW Columbia, Suite 480 ,
City/State/ZIP: Portland, OR 97201 Each addid. . 1 In . ettion over allowable In an of the above
Per inspection 11.11 62.50 • I.
Phone: (503) 419,3300 x3328 Fax: (503)419 Investigation per hour (i he min) Ill 62.50 II.
CCB Lic.: 458 Electrical Lic.: 26 i Suprv. Lic.../ 994S Industrial plant per hour 111.115E61 III
Print name: Robert Axt Date. k 1 o E
i . Plan review (25% of pent* fee):
Authorized signature: • • TOTAL PERMIT FEE: , 1 -i. , t L
____. ---- this permit applkation Tilden it . permit le Bet abased within MO
Print name: [Irate; days after It btu been accepted as complete.
1:113gildimaninitai.C•PcnnitApoinc 03123/06 440•4615101/09C ED
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7 ?US 7 6 T .
MY OF TOGA RD '1
UOL[IIING DIVISION PERMIT # 1.R2p0$'
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: �;
Phone: (503) 639 -4171 '
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2. 12 A TIME: PAGE:
SITE ADDRESS:13On5 W 6 O CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: S cs(kil
OWNER: V PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 2. Pour Time:
Code # Inspection Description Confirm # Contact # Message
tqC:\ — I-1 A\-,
Corrections /Comments / Instructions:
TAPASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G N Date: Phone #: (503) 718- /-4
LI-10