Permit „- CITY OF TIGARD ELECTRICAL PERMIT
__ , 5� i��i DEVE SERVICES PERMIT
ISSUED: E L C O 8 - 0 5 0 1 8
PARCEL: 1S135DD -03301
SITE ADDRESS...:11945 SW PACIFIC HWY #232
SUBDIVISION •HOFFARBER TRACTS NO.1 ZONING:C -G
BLOCK • LOT -002 JURISDICTION: TIG
Pro ect Descript : Installation of one branch circuit for rooftop HVAC unit.
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS • 0 0 - 200 amp • 0 PUMP /IRRIGATION • 0
EACH ADD'L 5O0SF...: 0 201 - 400 amp • 0 SIGN /OUT LINE LTG..: 0
LIMITED ENERGY • 0 401 - 600 amp • 0 SIGNAL /PANEL • 0
MANF. HM/ SVC /FDR..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (10)...: 0
- - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- -
0 - 200 amp • 0 W /SERVICE OR FEEDER: 0 PER INSPECTION • 0
201 - 400 amp : 0 1st W/0 SRVC OR FDR.: 1 PER HOUR • 0
401 - 600 amp • 0 EA ADD'L BRNCH CIRC: 0 IN PLANT • 0
601 - 1000 amp • 0 PLAN REVIEW SECTION
1000+ amp /volt : 0 > =4 RES UNITS > 600 VOLT NOMINAL•.:
Reconnect only : 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: FEES
CHRISTENSON ELECTRIC INC type amount by date recpt
111 SW COLUMBIA STE 480 PRMT $ 35.00 DEB 08/24/98 98- 308528
PORTLAND OR 97201 -5886 5PCT $ 1.75 DEB 08/24/98 98- 308528
Phone #:
Contractor:
CHRISTENSON ELECTRIC INC $ 36.75 TOTAL
111 SW COLUMBIA
STE 480 REQUIRED INSPECTIONS
PORTLAND OR 97201 Elect'1 Service
Phone #: 241 -4812 Elect'1 Final
Reg #.. 000458
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 , roug 1'R 952- 001 -1987. You lay obtain a copy
of these rules or direct questions to OUNC by calling (503)246 -1987.
Permittee Signature: _./.1/. * , 1 A _/ L. d Issued B : L _ -.. - _ � / /.lam.
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for
sale, lease, or rent.
OWNER' SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
�j�
ONLY p
SIGNATURE OF SUPR. ELEC'N: , 4 P . /C�-/ t - DATE: C j6
LICENSE NO: 8735
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD Electrical Permit AppligafiPRED Plan Chec
13125 SW HALL BLVD. Mee, cil -o3,1 Rec'd By ,
TIGARD OR 97223 ATTN:DEBBIE AUG 2 - 1998 Date Recd 6�
(503) x4 DEVELOPMENT SERVICES
Phone 3 Date to P.E.
( ) 639 417130 D ate to DST
Inspection (503) 639 -4175 Print or Type C Of. MUNITY DEVELDPi;Ei91 Permit # t --`/ S' /
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
RECONNECT (1) ROOF UNIT
Name of Development Number of Inspections per permit allowed
Name (or name of business) ROTH HEATING Service included: Items Cost Sum
Address 11945 SW PACIFIC HIGHWAY SUITE 232 4a. Residential - per unit I
TIGARD 1000 sq. ft. or less $110.00 4
City/State/Zip Each additional 500 sq. ft. or
Commerci l Residential ❑ portion thereof $25.00 1
Limited Energy $25.00
QUESTIONS? CONTACT STEVE MARL 701 - 8673 Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all current licenses) 4b. Services or Feeders
Electrical Contractor CHRISTENSON ELECTRIC. INC. Installation, alteration, or relocation
200 amps or less $60.00 2
Address 111 SW COT.TIMRTA, SUITE 480 201 amps to 400 amps $80.00 2
CityPORTLAND State OR Zip 97201 - 5886 401 amps to 600 amps $120.00 2
Phone No. 5133 -741 -4819 601 amps to 1000 amps $180.00 2
Job No. 220 - 6492 Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. 26 -34r Exp.Date Reconnect only $50.00 2
OR State CCB Reg. No. 00458 Exp.Date 4c. Temporary Services or Feeders
COT Business T No. 5946 Exp.Date Installation, alteration, or relocation
200 amps or less $50.00 2
/� 201 amps to 400 amps $75.00 2
Signature of - c n- �_ S / . . 0 1. �� . 401 amps to 600 amps $100.00 2
-
`) 1 Over 600 amps to 1000 volts,
License No. 873S Exp.Date see "b" above.
Phone No. 503 -241 -4819
4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
Print Owner's Name feeder fee. •
Address Each branch circuit $5.00 2
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee.
35.
First branch circuit 1 $35.00 2
The installation is being made on property I own which is not Each additional branch circuit $5.00 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required):* Signal circuit(s) or a limited energy
panel, alteration or extension $40.00 2
Minor Labels (10) $100.00
Please check appropriate item and enter fee in section 5B.
4 or more residential units in one structure 4f. Each additional inspection over
Service and feeder 225 amps or more the allowable in any of the above
System over 600 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00 _
as described in N.E.C. Chapter 5 In Plant $55.00
* Submit 2 sets of plans with application where any of the above apply. 5. Fees: 35.
Not required for temporary construction services. 5a. Enter total of above fees $ 1.75
5% Surcharge (.05 X total fees) $
NOTICE Subtotal $ 16.75
5b. Enter 25% of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY �1
TIME AFTER WORK IS COMMENCED. ❑ Trust Account # �1 /
Total balance 9yrato 411 ` 0§p25 $
3-
I:\DSTS\ELC96.APP Rev 9/96
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
3// (51 5- Date Requested 7 -- l p d p AM PM BLD
Location / [ l T5 � 7s1J Gti Suite c2 MEC
Contact Person 6 �./ Ph ?-oq -53 /l PLM
' C' /`�� -ems Ph SWR
Contractor NCI
®
BUILDING Tenant/Owner 1 re_Pl�� c „we rt /Q5OJ
Retaining Wall ELR
Footing Acce �j
Foundation Cad g ?-0 FPS 64 -q Ftg Drain `/ ( J
Crawl Drain Ins
tion Notes. DD -- SGN
Slab — SIT
Post & Beam
Ext Sheath /Shear !/ /
Int Sheath /Shear
Framing
Insulation // '' �
Drywall Nailing G O1 rr i✓p Be / eh) - /l"s'
Firewall
Fire Sprinkler
Fire Alarm /�
Susp'd Ceiling •`� q/1¢-/Ge
Roof
Misc:
Final
P ASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
gi
S ervice
Rough In
UG/Slab
Low Voltage lt66
Fire Alarm
Ina s
a PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk `
Other D a t e 9 ' 7 ' ?f Ins pec t or E x t
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.