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Permit T I G A R D C IT Y OF RESTRICTED ENERGY � 4, DEVELOPMENT SERVICES PERMIT #: ELR2004 -00026 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 DATE ISSUED: 2/6/04 SITE ADDRESS: 13535 SW 72ND AVE 105 PARCEL: 2S101DC -00200 SUBDIVISION: 72ND AVE OFFICE BUILDING ZONING: C -P BLOCK: LOT: JURISDICTION: TIG Project Description: Low voltae for data /telecommunication. 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: PACIFIC NW PROPERTIES LTD PTNSHP CHRISTENSON TECHNOLOGY SERVICES 9665 SW ALLEN BLVD STE 115 1631 NW THURMAN ST. 2ND. FL. BEAVERTON, OR 97005 PORTLAND, OR 97209 Phone: Phone: 503 419 - 3600 Reg #: LIC 64137 ELE 26 -1174C SUP 1994S FEES Required Inspections Description Date Amount Low Voltage Inspection [ELPRMT] ELR Permit 2/6/04 $75.00 Elect'I Final [TAX] 8% State 2/6/04 $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 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. Issued by a, egi Permittee Signature en-, 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: Cali 639 -4175 by 7:00 P.M. for an inspection needed the next business day F ,15 -2004 THU 04:56 PM CHRISTENSON CORPORATION FAX NO. 503 419 3636 P. 01 Electrical • cation Received n / Electrical ooh Datc/B :a4 - —D . Permit No.: a City of Tigard r 5 2QQq Planning Approval Sign Date/B : PertnitNo.: 13125 SW Hall Blvd. t U O Plan Review Other Tigard, Oregon 97223 0 TIGARD Datr/B . PermitNo.: Phone: 503-639-4171 Ott Y � C $ Post Review Land Use � � i�;• ^j;i;11,i, . l ; \ DateB : Case No • Internet: www.ci.tigila t! a iJ. •f i I Contact Juris.: _. See Page 2 for 24 -hour Inspection Request: 503 -639 -4175 '"---- Name/Method: T1 Gc Su .. Intents! Information. � _ t` � r• -fig ../ ^J "•Y'�i � "';'' y �;: ,O, <r :�. i' i i i12,,p[��� ,�;e:•• ,4 -a �`. 7 v e l .'' '. r , Pi r a y S'° t • 1 tSICi.JAtMI - . ; . �i.; l•.<• i :'V'i',11•.td�r.:.�i:f;.iV..gTA r�rt�•'=il � ,. • .i; `��'"�tv.� >� ��i�., 3:F :�l;�i'±3� Sr,..�:L'.:`��i: � ...f.tU.,i1'.:�'.�1...a.�....�. ` '' ,r ustio • Service over 225 amps- III Health-care facility ,� New construction ■ Demolition commercial ❑ Hazardous location , r. • Ad dition/alteration/re • laCement in Other: ❑ Service over 320 amps - rating of ❑ Building over 10,000 square :eel, M ^^ ' , , - '. 7 . ` -�c , ' 1 & 2 family dwellings tour or more residential um LS in ❑ System over 600 volts nominal one structure r� i 1 & 2 -Famil dwellin: In Commercial/Industrial 0 Building over ttaec stories ❑ Feeders, 400 amps or more Accessory Buildin ! I/ Multi -Famil Q occupant load over 99 persons' ❑ Manufactured structures or R V park I . • Master Builder - Other: ❑ Egress/lighting Submit t sets of plans with any of the above. rrw.. t e abo F : i : - '/ ✓ i a T ! t'' ' y 1 i ,1 i '^ , ., are not a , . ra construction service. 5 SW 72ND AVE �! �� �. a ° . +'r • c „ , 1 C �, s 1 _ ° � . 1 .:n.. � , 4 . . . z.: The above � livable W tem � . 135 4t r ,: e . ,' yrpY. tr,r4�c`°..4 �Ji` :e " ' %- •) -j- ' •'Zii,!.::`:r...' 'r Job site address.' .� v "s. Suite #: t Bld _ ./A • t. #: Number of ins • ections . er • emit allowed Description Qty pee (ea.) Total II Pro'ect Name: PERS New residendsl- single or mufti- family per Cross street/Directions to job site: dwelling unit_ Includes attached guage. QUESTIONS ?CONTACT CHRIS GORMAN ( 503) 419 3352 S 1000 sq. ervice in 145.15 El Each additional 500 s.. or • •rtion thereof 33.40 Limited energy. residential 75.00 El Subdivision: LOt #: Limited ere a non residential MN 75,00 man E manufactured home or modular dwelling Ill Tax ma./ • steel #: _ f 90.90 II ,fit ,�'f. .'f �; L - It irII:J,�y 4�j11r - 1 °: �..i '�.1:.:;j�SJ ; ft`a.:1'! 'K" :`'r e"FE�F� -s Services or feeders - installation, OW VOLTAGE DATA /TELECOMMUNICATION alteration or relocation: lio 30 '^ 200 straps or less 106.85 401 am. - to 600 •= NM 160.60 — 401 stn •• to 600. , • s _ 240.60 7"h'''...'-' t , ., tf; .� ,-V•t".;::,., 601 am' to 1000 IIIIIIIIMII in li$ iw�°a.' 'ff y7'� } � : . .A ..-'''' ' I' ' ' ' '' * f f ' i ' ? f "t^i_L� ` '' ,!� Over 1000 ,,,.sorvolts - Mil 454.65 Q' Name: PERS HARRY MORGAN — Reconnect only Mal 66.35 © Address: Temporary services or feeders - installation, alteration, or relocation: 66.85 e City/State/Zip: 200 am" or less 166113.35 75 Phone: 503 603 7592 Fax: 503 603 7615 201 am_pa to 400 amps 3. , �,', 401 CO 600 ti t t 1- ,k ? -:: ` C ,r. .. a:re rc ? ,. r. -. 4.1a 7 y, u : 1_. -[ N f • :. - _ ) 4 .' --::..1 Branch circuits - pew, alteratton, or Name: n19112'011 per panel: _ A. Fee for branch circuits with purchase of ti 65 Address: service or feeder fee, each branch circuit II Ci /State/Zi • :.' B. Fee for branch citctuts without purchase of 46.55 service or feeder fee, first branch circuit Phone: Fax: Each additional bratteh circuit 6.65 WA Misc.(Setvice or feeder not included): III 53.40 E - mail ((jj * rs Each •ta orirri on circle o; ,,,, -, 1Y . 1, ' + '. lc: H 7, l { 4, . -.` i n '. , ,. 53.40 me ca,r s u Each sign Or outline lighting_ IN Job No: 39 - 0057 7 — Signal circuit(s) ora limited energy panel, © 75 - � static or extension Business Name:CHRISTENSON TECHNOLOGY SERVICES •' . n TELECOMMUNICATION Address: 1631 NW THURMAN ST 2ND FL Each additional inspection over the allowable in an of the above: Ci /State/Z1 • : ' R - per ',• . , - • on • - hour min. 1 hour MIE 62.50 � � Phone:(503) 419 -3600 Fax:(503) 419 -3636 brvesttaamanihe_ /'gyp T #�{ 2 6 -117 4 C other: - _ . , . •'•.� ... l CCB Lic. 6413 1.10. rr : 5 r .. , 'l, ; ,fruit._.. � t, J , i : 1•n. .� J;Ci Supervising eiectricia n subtotal IIMIIIM signature required: �D'i� (fit ' Plan Review 25% of Permit Pee Print Name:ROBERT.. AXT Lic. #: 1.9 S _ State Surcharge!% of Permit Fee) $ 6 - • TOTAL PERMIT PEE $ 8.1 0(1 Authorized Notice: This permit application expires if a permit is riot obtained within Date: 180 days after It has been accepted as complete.**TRUST ACCOUNT DEI Signature: °Fee methodolo set by Trl -Cone Building Industry Service Board. ELECTRICAL TRUST ACCOU D 26 - 34C 458 (Please print name) i :\Dsts\Permit Forms \ElePer iitApp.doe 01/03 CITY C'r r .GARD 24 -Hour BUa-DING Inspection Line: (503) 639 -4175 - INSPECTION DIVISION Business►tine: (503) 639 -4171 MST BUP Received 1 e ' � // Date Requested - 3 /3 AM PM BUP Location ` " 7 S � 2 /%4 Suite S MEC Contact Person \J L Ph ( ) ' �� 7 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: a o Q Ftg Drain �ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS P T FAIL CTRI Rough -In UG/Slab ow Vo Y° ire Alarm Fina ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. CT PART FAIL SITE fl Please call for reinspection RE: ❑ Unable to inspect - no access Fire Supply Line (�. • � ( � Approach/Sidewalk Date 5 D y Inspector " ` ��' �v " L - Ext Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL