Permit CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2000 -00508
DEVELOPMENT SERVICES DATE ISSUED: 8/25/00
s` I-I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1 S136AD -05800
SITE ADDRESS: 11465 SW PACIFIC HWY
SUBDIVISION: ZONING:
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of one branch circuit for a/c unit.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201.- 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
EQUILON ENTERPRISES LLC CHRISTENSON ELECTRIC INC
PO BOX 4453 111 SW COLUMBIA
HOUSTON, TX 77221 STE 480
PORTLAND, OR 97201 •
Phone: Phone: 241 -4812
Reg #: LIC 000458
SUP 3289S
PLM 2468S
ELE 26 -34C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT CTR 8/25/00 $37.50 2720000000( Elect'I Final
5PCT CTR 8/25/00 $3.00 2720000000(
Total $40.50
This Permit is issued subject to the regulations contained in the Tigard Munidpal Code, State of OR. Spedalty 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 -0080. You may obtain copies of these rules ordirect questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE ! r ISSUED Y:
• 1 . � : �.. i.� I _ iu
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: -�-� �-d— DATE:
LICENSE NO: 2 7 3 S
Call 639 -4175 by 7:00pm for an inspection the next business day
Sent by: CHRISTENSON ELECTRIC 5032056721; 08/24/00 2:57PM;JetFax #199;Page 1/1
CITY OF TIGARD Planrd%#
Electrical Permit Application
13 XSW HALL BLVD. Red r
Date Recd J -24-1-6
TIGARD OR 97223
Data to P.E. -
Phone (503) 639 -4171. x304 Date to DS
Inspection (503) 639 -4175 Print of Type Permit # e ta - 8
Fax (503) 598 -1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development , Number
evelopment Number of Inspections per permit allowed
Name (or name of business) TEXACO STATION Service included: Items Cost Sum
Address 11465 SW PACIFIC HWY Residential -per unit
C /Statei'Zip. TIGARD OR 97223 Eac i 117.75 4
RY Each additional 500 5q. It or
portion thereof 5 26.25 1
Commercial la Residential ❑ Limited Energy S 60.00
QUESTIONS? CONTACT HARRY MCCLANE Each Menufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder S 72.75 2
(Prior to permit issuance. applicants must provide contractor license db. Services or Feeders
information for COT data base). Installation. alteration. or relocation
ElectritalContractor CHRISTENSON ELECTRIC, INC. 200 amps or less $ 64.25 2
Address 111 SW COLUMBIA, SUITE 480 201 amps to 400 amps $ 85.50 _ 2
C POR TLAND Slate_ OR Za p 97201 -5886 401 amps (0600amps $ 128.50 2
601 amps to 1000 amps $ 152.50 2
Phone No. 241 - 4812 Over 1000 amps or volts 5 363.75 2
Job No. 65 -13772 Reconned only $ 53.50• 2
Elec. Cont. Lice. No. 26 - 34C Exp.Date 10/1/00 . 4c. Temporary Services or Feeders
OR State CCB Reg. No. 4 5 8 Exp.Da : 5/ . 03 Installation, alteration, or relocation
COT Business Tax or Metro No. ...i.1 6 � D. e 1 31/0 ) 2 00 amps or less $ 53.50 2
`�� / 201 amps to 400 amps S 80,25 2
401 amps to 600 amps $ 107.00 2
Signature of Supr. Eaec'n Over 800 amps to 1000 volts.
//�� see "b" above.
License No. b -4 Exp_Da e 10/1/01
241 - 4d. Branch Circuits
Phone NO. _ New, alteration or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name Each branch circuit 5 5.35 2
Address b) The fee for branch circuits
without purchase or service
City State Zip or feeder fee.
Phone No. First branch circuit I S 37.50 37. 50
Each additional branch circuit $ 5.35
The installation is being made on property I own which is not 4e. Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or irrigation circle $ 42.75
Owner's Signature Each Sign or outline lighting $ 42.75
Signal circuits) or a limited energy
* panel, alteration or extension 5 60.00
3. Plan Review section (if required). . Minor Labels (10) 5 107.00
Please check appropriate item and enter fee in section 5B. 4f. Each additional Inspection over
4 or more residential units in one structure the allowable in any of the above
Per
Service and feeder 225 amps or more inspection $ 50.00
Per hour $ 50.00
_System over 600 volts nominal In Plant $ 58.00
Classified area or structure containing special occupancy as
described in N.E.C. Chapter 5 5. Fees:
Sa. Enter total of above fees $ 37.50
* Submit 2 sets of plans with application where any of the above apply. 5% Surcharge (.05 X total fees) 82 $ - 3 . 7 -
Not required for temporary construction services. Subtotal $ 40.50
Sb. Enter 25% of line Sa for
NOTICE Plan Review If required (Sec. 3) S
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ 40.50 /
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FORA PERIOD OF 180 DAYS Y. Trust Account # 26-34C (40.50)
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ -0-
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