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Permit a n CITY OF TIGARD ELECTRICAL PERMIT t `1 2 • COMMUNITY DEVELOPMENT Permit #: ELC2012 -00707 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/17/2012 Parcel: 1 S136DA00101 Jurisdiction: Tigard Site address: 11410 SW 68TH PKWY Project: Oregon PERS Subdivision: PFAFFLE PLAZA CONDO Lot: 2 Project Description: (6) branch circuits for installation of new receptacles at test lab Contractor: CHRISTENSON ELECTRIC INC Owner: OREGON, STATE OF PUBLIC 111 SW COLUMBIA ST, STE 480 EMPLOYEES' RETIREMENT FUND PORTLAND, OR 97201 11410 SW 68TH PKWY TIGARD, OR 97223 PHONE: 503 - 419 -3300 PHONE: FAX: 503 -419 -3695 FEES Quantity Description Date Amount 6 crt Branch Circuits wo /Purchase 12/17/2012 $93.28 Specifics: Service or Feeder 1 ea 12% State Surcharge - 12/17/2012 $11.19 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $104.47 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 m y obtain a co y of the rules or direct questions to OUNC by calling 503.2332. 1987 or 1.800.332.2344. Issued By: Permittee Signature: i 0A1 pfpiotic/4T7afq 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. DEC -12 -2012 WED 02:42 PM CHRISTENSON ELECTRIC INC FAX NO. 95034193695 P. 01/02 El Permit Application RcPcill FOR oil If l': I S[ 0\1-\ City of Tigard y Ili° B ° / ?-11 0- Permit Nr / I a - 6o7 07 114 -- 't 13125 SW Hall Blvd., Tigard, OR 07223 Plan Review Phune, 503.71 X.2439 Fax: 503.595,1960 DEC 1 2 201 - pat/Bs: odic, Pcmrit: Inspection Line: 503.639,4175 pate Ready/11y: .ieris: Scc rase 2 for TIGARD interne: www.tiBaM nr.guv C�� p ��uAl7LJ otified/Mhhh.rl: 7 (0 , supplemental lnrunnrtion "' . 1 n{► �^P� MM 11 pt OR WOA CJ1LING I,/tVIS1QP. •; .. -• PLAN , REY , IEW ' . •• . ❑ New construction Addition /alteration/replacement Pleaw cheek all that apply (sul„nit 2 sets orphans wlitems checked heh+w): ❑ Service or feeder 400 amps or more [.7 Building over three stories. ❑ Demolition ❑ Other: whore the available fault current ❑ Marinas and boatyords. O ea eeds l 0,000 a mps at 150 votes or ❑ Flouting buildings. CATE,G Y AF CONSTRUCTION exceeds less to ground, or exceeds 14,000 ❑ C :ummeroial -use agricultural ❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building nnrrs for all othcr installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑Firc ❑ Installation 0(75 KVA or © linMrgency system. larger separately derived system. JOB, :SITE INFORMATION AND :LOCATION ❑ Additionornewmouar load of ❑"A" "E", "1.2" - 1 - Job no.. ili Job site address: W-1 10 en (gee 1?P�f. ,001-1P or more. occupancy. ❑ Six or more residential 116.1. ❑ Recreational vehicle pads. City /StAte/ZIP: - cif OI 10 • ❑ Health -care facililic+. ❑ Supply voltage for more dun / ' rte► Q Hazardous locations. 600 volts ncnrnial. Suite/bldg. /apt. no.: Project name: cx-N - ❑ Service or render 600 amps union:. FEE: SC' • Cross street/directions to job site: naeo I Qtr. i Pee. J Telei 1 - ( 9 b — ----1401 l t �n -- ) `4111) New residential single - or multi- family dwelling unit. / � J C Includes attached garage. Subdivision: } Lot no.: 1,000 sq. ft. or less 168.54 4 Ea. add'I 500 sq. ft. or poniun 33.92 I Tax map/parcel no.: Limited energy, residential 2 W , .. (with above sq. R.1 75. DESCRIPTIQi;?Q F. . WORK , ; Limited energy, multi- family 75.00 2 kvi1. I I f Q /��+ I �� I ' - L k % -- � / I , residential (with above sq. ft.) _ 1 K �--9 Scrviee8 or feeders installation, alteration, And /or relocation 200 amps or less 100.70 2 201 amps 10 400 amps 133.56 2 ❑ PROp . OWIyEIt; : ,i.. 1 ' '.. C. TENANT ! '�i 401 amps to 600 amps 200.34 2 Name: _ 601 amps to 1.000 amps 301.04 2 Address: Over 1.000 amps or volts 552.26_, 2 Temporary services or (ceders Installation, alteration, and/or City /State/ZIP: relocation Phone: ( ) - Fax: ( ) 200 amps or less 59.36 l 201 amps to 400 amps 125.08 2 Owner installation; This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - new. alteration, or extension. per pared Owner signature: Date: A. Fee for brunch circuits with WC a bove service or feeder fee, 7.42 2 L ® C QNTKCrt.'P R$ON each brunch circuit Business name: , B. Fec for branch circuit; without l �� a service or feeder fcc, first I 56.18 tat A. 8 2 Contact name: brunch circuit Each add'i branch circuit b 7.42 ' r 1. 2 Address: Miscellaneous (service or feeder not included;; Each manufactured or modular 67.84 2 City /State/ZIP: dwellinaice and/or feeder Phone; ( ) I Fax:: ( ) Reconnect only 67.84 2 _ Pump or irrigation circle 67.84 2 E-mail: Sign or outline lighting 67.84 2 CONTRACTOR : ' ' ,: ' Signal circuits) or limited - energy ,. or e xtension. Pate 2 2 Business name' • t ���`� panel, alteration Each additional inspection over allow hie in any of the above Address: 1 .lV �t � , Additional inspection (I hr ruin) 66.25/ hr investigation (1 hr min) 66.25/ hr City/State/ZIP. fi - M A � o_ a industrial plant (1 hr min) - 78.18/ hr Phone: A / _...b -' Fax.i�, al �� r InspecllUns for which no fee is 90.00/ hr specifically listed (IA hr rani/ COB i -ic.: - Suprv. Lic. S •, : ELECTRICkiii .: PERMI PEES t 1 % , r JO( i! 3 Subtotal: 11 Suprv. Electr" signature, require` PM r Plan review (25"A of permit lee): �7 lift f lrlJr/P r T.., wig � Print name: t� ( r `' ( D+ - + j 2 x ' State surcharge (12% permit fee): TOTAL PERMIT FED • Authorized signature: This permit appiicatiun expires If a permit Ii nor ohtaineu days altar it has been accepted as complete. Print name: Date, I • Number of inspections allowed per permit. I t ouitdinp \Pcmiil,\rI.C- Permitwpp.doc 07/01/10 440- 451nt1Iw9COM/woa DEC -12 -2012 WED 02:42 PM CHRISTENSON ELECTRIC INC FAX NO. 95034193695 P. 01/02 El Permit Application RcPcill FOR oil If l': I S[ 0\1-\ City of Tigard y Ili° B ° / ?-11 0- Permit Nr / I a - 6o7 07 114 -- 't 13125 SW Hall Blvd., Tigard, OR 07223 Plan Review Phune, 503.71 X.2439 Fax: 503.595,1960 DEC 1 2 201 - pat/Bs: odic, Pcmrit: Inspection Line: 503.639,4175 pate Ready/11y: .ieris: Scc rase 2 for TIGARD interne: www.tiBaM nr.guv C�� p ��uAl7LJ otified/Mhhh.rl: 7 (0 , supplemental lnrunnrtion "' . 1 n{► �^P� MM 11 pt OR WOA CJ1LING I,/tVIS1QP. •; .. -• PLAN , REY , IEW ' . •• . ❑ New construction Addition /alteration/replacement Pleaw cheek all that apply (sul„nit 2 sets orphans wlitems checked heh+w): ❑ Service or feeder 400 amps or more [.7 Building over three stories. ❑ Demolition ❑ Other: whore the available fault current ❑ Marinas and boatyords. O ea eeds l 0,000 a mps at 150 votes or ❑ Flouting buildings. CATE,G Y AF CONSTRUCTION exceeds less to ground, or exceeds 14,000 ❑ C :ummeroial -use agricultural ❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building nnrrs for all othcr installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑Firc ❑ Installation 0(75 KVA or © linMrgency system. larger separately derived system. JOB, :SITE INFORMATION AND :LOCATION ❑ Additionornewmouar load of ❑"A" "E", "1.2" - 1 - Job no.. ili Job site address: W-1 10 en (gee 1?P�f. ,001-1P or more. occupancy. ❑ Six or more residential 116.1. ❑ Recreational vehicle pads. City /StAte/ZIP: - cif OI 10 • ❑ Health -care facililic+. ❑ Supply voltage for more dun / ' rte► Q Hazardous locations. 600 volts ncnrnial. Suite/bldg. /apt. no.: Project name: cx-N - ❑ Service or render 600 amps union:. FEE: SC' • Cross street/directions to job site: naeo I Qtr. i Pee. J Telei 1 - ( 9 b — ----1401 l t �n -- ) `4111) New residential single - or multi- family dwelling unit. / � J C Includes attached garage. Subdivision: } Lot no.: 1,000 sq. ft. or less 168.54 4 Ea. add'I 500 sq. ft. or poniun 33.92 I Tax map/parcel no.: Limited energy, residential 2 W , .. (with above sq. R.1 75. DESCRIPTIQi;?Q F. . WORK , ; Limited energy, multi- family 75.00 2 kvi1. I I f Q /��+ I �� I ' - L k % -- � / I , residential (with above sq. ft.) _ 1 K �--9 Scrviee8 or feeders installation, alteration, And /or relocation 200 amps or less 100.70 2 201 amps 10 400 amps 133.56 2 ❑ PROp . OWIyEIt; : ,i.. 1 ' '.. C. TENANT ! '�i 401 amps to 600 amps 200.34 2 Name: _ 601 amps to 1.000 amps 301.04 2 Address: Over 1.000 amps or volts 552.26_, 2 Temporary services or (ceders Installation, alteration, and/or City /State/ZIP: relocation Phone: ( ) - Fax: ( ) 200 amps or less 59.36 l 201 amps to 400 amps 125.08 2 Owner installation; This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - new. alteration, or extension. per pared Owner signature: Date: A. Fee for brunch circuits with WC a bove service or feeder fee, 7.42 2 L ® C QNTKCrt.'P R$ON each brunch circuit Business name: , B. Fec for branch circuit; without l �� a service or feeder fcc, first I 56.18 tat A. 8 2 Contact name: brunch circuit Each add'i branch circuit b 7.42 ' r 1. 2 Address: Miscellaneous (service or feeder not included;; Each manufactured or modular 67.84 2 City /State/ZIP: dwellinaice and/or feeder Phone; ( ) I Fax:: ( ) Reconnect only 67.84 2 _ Pump or irrigation circle 67.84 2 E-mail: Sign or outline lighting 67.84 2 CONTRACTOR : ' ' ,: ' Signal circuits) or limited - energy ,. or e xtension. Pate 2 2 Business name' • t ���`� panel, alteration Each additional inspection over allow hie in any of the above Address: 1 .lV �t � , Additional inspection (I hr ruin) 66.25/ hr investigation (1 hr min) 66.25/ hr City/State/ZIP. fi - M A � o_ a industrial plant (1 hr min) - 78.18/ hr Phone: A / _...b -' Fax.i�, al �� r InspecllUns for which no fee is 90.00/ hr specifically listed (IA hr rani/ COB i -ic.: - Suprv. Lic. S •, : ELECTRICkiii .: PERMI PEES t 1 % , r JO( i! 3 Subtotal: 11 Suprv. Electr" signature, require` PM r Plan review (25"A of permit lee): �7 lift f lrlJr/P r T.., wig � Print name: t� ( r `' ( D+ - + j 2 x ' State surcharge (12% permit fee): TOTAL PERMIT FED • Authorized signature: This permit appiicatiun expires If a permit Ii nor ohtaineu days altar it has been accepted as complete. Print name: Date, I • Number of inspections allowed per permit. I t ouitdinp \Pcmiil,\rI.C- Permitwpp.doc 07/01/10 440- 451nt1Iw9COM/woa