Permit ,, CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR2011 -00139
Date Issued: 06/17/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S113AC00103
Jurisdiction: Tigard
Site address: 7244 SW DURHAM RD, BLDG# 600
Project: Tolt Subdivision: PACTRUST BUSINESS CENTER Lot:
Project Description: Data Telecommunications system.
Contractor: CHRISTENSON ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES
111 SW COLUMBIA ST ATTN: N PIVEN
STE 480 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97201 PORTLAND, OR 97224
PHONE: 503 - 419 -3300 PHONE:
FAX: 503 - 419 -3695
FEES
Description Date Amount
Specifics: Restricted Energy Permit 06/17/2011 $75.00
12% State Surcharge - Electrical 06/17/2011 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: Y Fire Alarm: N
HVAC: N Instrumentation: N
Intercom /Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N Total $84.00
Other Desc: 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 - 001 -0090. You may obtain a ules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.,
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Issued By: Permittee Signature: ei .4cei t ■Ag L.:041
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 the next available inspection date.
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-17-2011 FRI 09:33 AM CHRISTENSON ELECTRIC, INC FAX NO. 95034193695
- P. 01/03
..,.....,.....„,... ,-.„,, .
Electrical Permit A licati ' cEivE :1" wiz ''IC LISE ONLY
City of Tigard Received f Agrar.211 ' .
Dam/5 : (0 Afar Permit No.: , ••• _
, ii,, y
i / 4" '-' 'L-J o
! II IN , - 61 13125 SW Halt Blvd., 'figard, OR 972 i .. i Plan lteview
: 1 Phone: 503,639.4171 Fax: 503.598.19e 1 7 2011 Date/5 : Other Permit:
1'1GAR1) Inspection Lino; 503.639,4175 Date Ileady/By: lurid! 0 See Page 2 fur
'
Internet! www,tigard . CITY OF TIGARD Notified/Methmil I -- Supplemental information
.. :.__. T y. • u: .1.. ,,. • • TistoN . ... . L,;.,, ....:..,..; ,..:. :.,..,..:-..,..;goviP0*:!:
, — ph. chcck all that apply (submit 7 sets of plans w/itams checked below);
0 New construction A . T ddition/alteration/replacement 0 sice or eeder4100 amps or more r,:lBuilding over three stories.
D D 12 emoliti w f
o n Other: where the available fault current 1:11‘darinds and boatyards.
WIN■■•••■■•■
' . . • . 2: . CAT 1 GO 0••01?-cONsTgucTioN:! . •'•••• .. .. • • - .,:.... :• . exceeds 10,000 amps at 150 volts or 0 Floating buildings.
... • . • • • . ,. , . ,. •, , . • • . . • •
.... ICU to ground, or exceeds 14,000 1=1 Commercial-use nericultural
1=1 1 and 2 dwelling ommerci • a . •
aVindustrial • n Accessory building amps for all other installations. buildings.
n multi_family 0 Master builder 0 Other: 0 Fire pump- n Inatanutioo 0175 KVA or
J no -'-'-'---- ID Einergeney system, hirser separately derived system.
.'
JOB: SITE: INVORMATION .AN 0 . LOCATION , . • 1:Addition of new motor loacl of El
- 100I Or more. occupancy.
ob .(pAll Job site address: 7 b tY\ ar
...,, • • • „,:_,..... , -4- wkAy...... -
.. n Six or more residential units. 17:1 Recreational vehicle parks.
City/State/ZIP; - 1 - 1 • , 0 11 . Q 3.. 3
t._ 0 Health-care facilitie$-
_-_----- 0 Haztu locations. Supply voltage for more than
600 volts nominal.
Suite/bldg./apt. no,: 69 ' Project narne: i •r 10-5 0 Service or 'feeder 600 arnrii: or more,
• .. . .
• • .•..
• • ' 'At SCHEDULE L•,..,' ' :...,:. .. ;.,...,.; ....:',: •
Cross strect/directions to job site: „ ra EMI Fee- Total "
— - ___-- New residential single- or multi-family dwelling unit.
Includes attached garage.
___________— -__________- — _ •
Subdivision: Lot no,: 1,000 sq. ft, or less .. - 168,54 4
—
__,--- .----------. - Eu. lid0 500 sq. It, or portion 33,92 I
Tax map/parcel no.: . Limited energy, residential
. —7-7.-", 75 00 2
- . - ,.,. '.
• * * 1 . 'Dt$C*TION 'OF .WORK : • : • . .
. „ , „ ,. n■ (With . . . .• f • • • P
,..
' ... Limited energ,y, multi-family
' 75.00 2
rn-5\6,LL 1-kel) i.s.- Z14 0 Ilk residentia1Swith libossA -
— ServiEes or feeders installation, nitration, and/or relocation _
200 amps or less 100,70 1
— ___„.,_- ., —
• D PROP EIITY.OW1O10 i TENANT 201 amps to 400 amps - 133.56 2
-.....■IM '. 40 1 arn PS to 600 amps . 200,34 2
Narnc: _ -
. - - _ - _ . — 601 amps to 1,000 amps 301,04 2
— __
Address: Over 1,000 amps or volts 55226 2
---- --------- Temporary services or feeders installation, alteration, and/or
C
.y __ — relOCation
' ...,. __—__.
200 amps or less Ila 59.16 1
Phone: ( ) Fax; ( )
.
— 201 amps to 400 amps 125.08 2
Owner installation z 'I' his installation is being made on property that I own which is not
lot Imps to 595 amps 1.111 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits — TIM, alteration, or extensiori.perpanel _
Owner signature:_, Date: A, Fee for branch circuits with
0
_
. .,
• above Service Of feeder fee,
A.1ZPLICANT :!, „ •,:..... , , .. • • • . • 1:::): PIRSON. 7,42 2
.. each branCh Circuit
---- •
\ i _ , -
., di, 4- 13, Fee for branch Circuits without
Business name 0 n' '
AiN '
A - . 'I" -■ aTa t _ service or feeder fee, rim 56.18 2
branch eircuil
Contact name: - - —
—, —. - . _ --------- Each add'I branch circuit • 7.42 _ 2
Address: Miscellaneous (service or feeder not ineluded) _ .
- '"--- Each manufactured or modular 67.84 2
City/State/Z1P: dwelling, service and/of feeder
---• -- -------
67.84 2
Phone! ( ) Fax: : ( ) Reconnect only —
• .. . -- Pump or irrigation circle 67,84 2
—..—
E-mail: Sign or outline lighting 67.a4 2
— . _ — ,_--- --
. CONTRAC.FOR . Signal circuit(s) or limited-onerffy
. .
_
— — 2
C .
Business name. V., ' A: bn \t,.C.s-Ve., ‘c,th.) pane alteration, or extension. Page 2
— _. Each additional ins i,pion over allowaltike above
Address; \\\ • kA,N( • ' 31) "11-0— Additional inspcction (1 lir min) 66.25/ hr
- ,-- -
City/State/ZIP: k\,CIJ • c ____. Investigation (1 hr min)
Industrial plant (1 lir min) 6 hr _
_ r
Phone: 4 # - 3 !_ifits Mb /1-. 0 - `.(i9qS, '
inspections for which na fec is - „
90.0W hr
CCB .; (6. Electrical Lic,.., • Jo v. Lic , :,5a.Z5
ELECTRICAL. .PERMIT FE
410 __Ipecil listed ch hr min) ... _
Suprv. Electrician signature, required: . _
• U • • ..
_ Lic — Subtotal;
____
PS: . ill- 4,-.1 Plan review (25% of permit fee):
_ _
_ _,—,
State surcharge (12% of permit
Print name: - 6 \4144...1 110, # , Date:
■■
. W.. .4T.m.•■•■•••■. TOTAL PERMIT FEE.:
.Authorized -----qt.
___ w
zed signature :
This permit nap,fylicItieerni:zp.i,rbesecifyla.p,,earptuteitdix,:utot m ob r r i :i t i e le . ti within 180
Print. name: Date; .■■ Number of ihdpaiirim allowed per pcnnit.
....
10.46 I Mil I 1}5 !C 01 , 1 1Wkn
i do, irna 1110
JUN -17 -2011 FRI 09:33 AM CHRISTENSON ELECTRIC, INC FAX NO. 95034193695 P. 02/03
Electrical Permit Application - City of Tigard .... ... . ...
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WOR ICON .Y:.; • .
Fee for all residential systems combined .... $75.00
Check Type of Work Involved:
11 Audio and Stereo Systems*
0 Burglar Alarm
0 Garage Door Opener
Heating, Ventilation and Air Conditioning System*
0 Vacuum Systems*
0 Other: .
COMMERCIAL WORK ONLY
Fee for eq.tc.la commercial $75.00
system •
(SEE OAR 918 -309 -0000)
Check Type of Work Involved:
0 Audio and Stereo Systems
O Boiler Controls
7 ,
0 Clock Systems
D sta Telecommunication Installation
7 fire Alarm Installation
❑ 'I lVAC
0 Instrumentation
Intercom and Paging Systems
El Landscape Irrigation Control*
LI ;Medical
• Nurse Calls
D Outdoor Landscape Lighting*
a Protective Signaling
• Other.
Total. number of commercial systems_
*N licenses at required. Licenses are required
for all other installations
INkildi ,,kovermirslfl.r- Perm'iiApp.doc 07 /01 /ID