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Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT COMMUNITY DEVELOPMENT Permit #: ELR2013 -00141 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/25/2013 Parcel: 2S110DCO2200 Jurisdiction: Tigard Site address: 15570 SW PACIFIC HWY Project: Safeway Subdivision: 1997 -016 PARTITION PLAT Lot: 2 Project Description: Data telecommunications. Contractor: CHRISTENSON ELECTRIC INC Owner: TRC MM LLC 111 SW COLUMBIA ST, STE 480 5973 AVENIDA ENCINAS STE 300 PORTLAND, OR 97201 CARLSBAD, CA 92008 PHONE: 503 -419 -3300 PHONE: FAX: 503 -419 -3695 FEES Description Date Amount Specifics: Restricted Energy Permit 06/25/2013 $75.00 12% State Surcharge - Electrical 06/25/2013 $9.00 Type of Use: COM Class of Work: ALT Total Number of Systems: 0 Audio & Stereo: 0 Boiler Controls: 0 CCTV: 0 Clock Systems: 0 Data & Telecommunications: 0 Fire Alarm: 0 HVAC: 0 Instrumentation: 0 Intercom /Paging: 0 Landscape /Irrigation: 0 Landscape Lighting: 0 Medical: 0 Nurse Calls: 0 Protective Signal: 0 Security Alarm: 0 Other: 0 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 952-0 . You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permlttee Signature: o/V /fro, e ,f/ 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 603.639.4176 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 -21 -2013 FRI 10:17 AM CHRISTENSON ELECTRIC, INC FAX NO. 95034193695 P. 01 Electrical Permit Application,RECEIVE a - IUI( urnc�'Ii IISL ONLY If :Ir. ecetved City of Ti and - rar �/� h' g Omelnv: L'L/Z02o/3 —1:20/V " 13125 SW Hall Blvd., I•igard, Oft 97223 JUN t Plait Review ' 7 1 3 Phone: 503.718.2439 Fax: 503.598.1960 O 13 Date/By.. Other renttii 4 ,3 —go a9 4 T t t i A R t1 Inspection Line: 503.639 CITY Q fl � ® Die acady /Sy. June // Sea Page 2 fur t5 Internet: www,ttgard•audov �� ® f I I GP"t t� Nonnec/Mcthod; 1' / lJ Supplemental Information 7Y i 0 '�4 f � 9� �lep sv;1... ` . •, I'" PL:(4N {i<E EW i • � I l'19 I 4 r' ❑ New construction D Addition /alteration/replacement Please check oil that apply (submit 2 sets of plans writers checked below): 0 Service or feeder 400 amps or more © Building over three sturica. ❑ Demolition 0 Other. where the available fault current 0 Marinas and boatyards. • - , - ' , ' ,. cAiiP.PA ,. iVi 0,r4bO IO ',, ; -' Jill ., :l , , , 1 1 oxcads 10,000 amps at 150 volts or ❑ floating buildings Iesc to gmund, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other lastalladons buildings. 0 Multi - family ❑ Master builder ❑ Other: ❑ Fir pump. ❑ Installation of 75 KVA or "y ' „} ; , 1 ,r , 1 • � 0Emergency system. larger scpamtely derived system, �,A ;4t )1,445410 PIh ,1 4 161t7N, a ,,;jI 1 7 ?f' © Addition ot'new motor load or ❑ "A" "P ", "f -Z ", "I -3" lob no.:6 3196 I Job site address: 15570 SW PACIFIC HWY 1oalll'ormore, occupancy. ❑ Six or more residential units, ❑ Recreational vehicle parks. City /State /ZiP: TIGARD, OR 97224 0l'lealth•cure facilities. 0 Supply voltage for more than 0 Hazardous locations 600 volts nominal. Suite /bldg./apt.no.: 1 Project name: SAFEWAY it,1478 0 Service or feeder 600 amps or mum. Cross street /directions to job site: ' :t'a,, 'ni ll! 'Ile+ lil rigid+, 4 ,8C]'1ilDG_1, :' ' 1 BILL RICHARDS 503 -806 -9406 Description Ill I Fes. I Turai � New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: I Lot no.: 1,000 sq. fl. or less 168.54 4 Tax map /parcel no.: Eu. add'I 500 sq. R or portion 33.92 I :r' -1, %y + I I ?i+ j i r 1; t.I a i ,; , , ___ Limited energy, residential 7 ,u .. Zr-- s .I•„ 1,, I 5.00 2 - :i�` • 'iii: ,,,, • °C � ;��9�5CIT4�,{��F i ' �Ql � �, . Ii�� . �' l•ry ? !� �'.r';ilE �1 :, '-Cli Swish above sq. R.) - Limited energy, multi-family LOW VOLTAGE VOICE /DATA CABLING residcntialswith above sq. ft.) 75.00 2 Services Or feeders Inetallatlan and /or relocation 200 amps or less 10!1.70 2 1 '7i11 :?11'I• ' C 1,d• I 4d' ;1•� . , 1 , t t1, , I 1 , .ia,r, iii 2 aim to amps i ' 'd ., ra r4o it'F ' '' , O;V {( IliF. , ai ,, 1, - , 01 , ,r , ILL , , ri, 1!ha';d R Yl!I l ii l ll' 1 1 1 ' Lll' �.. 1' •1.t , Ps 133,56 2 Name: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 1 552.26 2 City /State/ZIP: Temporary services or feeders Installation. alteration, and /or relocation Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1 I 201 amps to 400 amps _ 125.08 1 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, . er • um Owner signature: Date: A, ice for branch circuits with 1 ,� ,µ� p ± ; ^�� ii . p i +,�;.' r ," J � ,u lWn •`.• above service or reeder foe, + , i , 10, AP!�'i, �l ^��, , i :i4ie ,; .i141. V M rid., 1 ! . 00 " " frgiirERS e. ,� � -l� I .�1, �•T each b ranch c 7 2 Business name: CIRISTENSON ELECTRIC B. Fee for branch circuits wuhour service or feeder feo, first 56.111 2 Contact name: branch circuit Each add'! branch circuit 7.42 ! Z Address: _Miscellaneous (service or feeder not included) City /State /ZIP: Each manufactured or modula 67.84 2 er dwelling, service and/or feeder - Phone: ( ) Pax: : ( ) Reconnect only 67.84 2 • on circle or irrigation 67.84 2 E -mail: Sign or outline lighting 67.84 2 _ ,, ; I` 11eco+' qr,o .v,11 U 1!'i't.P'II_ :Ill # 1q,,''I,,,r ?i.p . .:;!1 . 1,'11.0A Si circuit(s) or limited- energy Business name: CHRISTENSON ELECTRIC _panel, alteration, or extension. 1 mtge., 75.0o 2 Each additional Inspection over allowable In any of the above Address: 113. SW COLUMBIA, SUITE 480 Additional inspection (1 hr min) 66.25/ hr City/State /ZIP: PORTLAND, OR 97201 investigation (1 hr min) 66.25/ hr Industrial plant (1 hr mm) _ 78,18/ hr V Phone: 1 503 ) 419 -3354 12 03 )419 -3695 inspections for which lto fee Is siweilicall listed ('h hr min) 0.00! hr CCB Lie.: r 158 Electrical Lie.; 6 4 up • ic.: 52155 r '1:• : ; "'ll? , ` r i!'I xGxC 'RRIICAL4, 7 ' I —' Suprv. Electrician signature, required: Subtotal: 75.00 .. Plan review (25% of permit fee): Print na m e ' ROBERT BRUENE Date: 6/21/13 State surcharge (12 %of permit fee)- 9.0 Authorized signature: TOTAL PERMIT FEE _8.4 n0 This permit application expires Ira permit is not obtained within Ise days after It has been accepted as complete. Print name: Date: • Number of inspections allowed per permit. 1lBuitdmgPertmt :lL'LC- rmnitetpp 07lullla 440 46157(II tiwEB JUN -21 -2013 FRI 10 :18 AM CHRISTENSON ELECTRIC, INC FAX NO. 95034193695 P. 02 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WOAX , : • , Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* El Burglar Alarm ❑ Garage Door Opener" ❑ Heating, Ventilation and Air Conditioning System" • ❑ Vacuum Systems" ❑ Other. COMMERCIAL; WORK ONLY , Pee for each commercial $75.00 system. (SEE OAR 91$ -309 -0000) Check Type of Work Involved: • • ❑ Audio and Stereo Systems . ❑ Boiler Controls • ❑ Clock Systems Data Telecommunication Installation Fire Alarm Installation ❑ HVAC [] Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Gulls ❑ Outdoor Landscape Lighting'` ❑ Protective Signaling ❑ Other - _t_ Total number of commercial systems: . *No licenses are required. Licenses are required for all other installations I \ fliiilainmpgmilftLe- pg.i:App.do. 07 /01 /10 Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 15570 SW PACIFIC HWY, TIGARD, OR, 97224 Commercial - Electricial Limited Energy 199 Electrical ﬁnal 2013-11-08 (null) ELR2013-00141 FAIL No info on site regarding the work done Violation Summary: Inspector Contractor