Permit CITY OF TIGARD rpo 401111 ELECTRICAL PERMIT
• = COMMUNITY DEVELOPMENT Permit#: ELC2013-00562
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/24/2013
TIGARD Parcel: 2S 112AA00900
Jurisdiction: Tigard
Site address: 14140 SW 72ND AVE 100
Project: Polycast Subdivision: 1992-007 PARTITION PLAT Lot: 1
Project Description: (1)200 amp or less service. 10/10/2013: REPRINT permit to add(1)200 amp service.
Contractor: CHRISTENSON ELECTRIC INC Owner: WALTON CWOR NELSON 13 LLC
111 SW COLUMBIA ST, STE 480 BY CTMT-WALTON RE TAX
PORTLAND, OR 97201 4678 WORLD PARKWAY CIR
ST LOUIS, MO 63134
PHONE: 503-419-3300 PHONE:
FAX: 503-419-3695
FEES
Quantity Description Date Amount
2 ea Services or Feeders-200 10/10/2013 $201.40
Specifics: amps or less
1 ea 12%State Surcharge- 10/10/2013 $24.17
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $225.57
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,* 2--01190. V. may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ,'_ P' / - Permittee Signature: �� /9--,,,04,,009-770/1
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.
CITY OF TIGARD ELECTRICAL PERMIT
ti
:� ! It COMMUNITY DEVELOPMENT Permit#: ELC2013 00562
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/24/2013
Parcel: 2S112AA00900
Jurisdiction: Tigard
Site address: 14140 SW 72ND AVE 100
Project: Polycast Subdivision: 1992-007 PARTITION PLAT Lot: 1
Project Description: (1)200 amp or less service
Contractor: CHRISTENSON ELECTRIC INC Owner: WALTON CWOR NELSON 13 LLC
111 SW COLUMBIA ST, STE 480 BY CTMT-WALTON RE TAX
PORTLAND, OR 97201 4678 WORLD PARKWAY CIR
ST LOUIS, MO 63134
PHONE: 503-419-3300 PHONE:
FAX: 503-419-3695
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 09/24/2013 $100.70
Specifics: amps or less
1 ea 12%State Surcharge- 09/24/2013 $12.08
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $112.78
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. ATTENTI : egon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-001 rou h OA 952-00 090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.27 or 1.800.332.7x344.
Issued B
k.__ evV Permittee Signature: r e i�1
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' 1111.0 ���iii" 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.
SEP-23-2013 MON 09:28 AM CHRISTENSON ELECTRIC, INC FAX NO. 95034193695 P. 01/02
1: , CEVED
Electrical Permit Applica;i r.i Vcllt OFFICE usE ONLY
City of Tigard � Received (,
+ oatony: %ier /3 Pem,lt No.:E�,6/ —�56�
s q 13125 SW Hall Blvd.,Tigard,OR 9737 P 2 3 2013 pints Review OlhcrPermit t■)//tr Phone: 503,718,2439 Fax; 503.598.1960 Date/By:
TIC:ARD Inspection Line: 503.63q,4175 CITY OF TIGARD DaicReady/By: Junt: ®•
Sec Page 2for
Interact: www.tigard-or.gov t�+"If`]t,l�•I Noll fiedlMellwt:
Supplemental Infermution
• TYP_ ;0[i G ,. v+;�;1 ,;_ PAN REViEW p D
❑New construction ❑Addition/alteration/replacement Please check all that apply(submit a sets of plans w/itonu checked below):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: where the available fault current
T .�uE ❑Marinas and boatyards.
;, ,,,', CHAT*!r'OrYT,R i t914STRU�.f 1+i(QN,.-. 11� I„r, . .;.9,. ' exceeds 10,000 amps at 150 volts or LI Floating buildings.•
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 75 K VA or
r c F r r w1,. -.1.1 ❑Emergency system. larger separately derived sy+teal.
AB'SE iRIK If$ . ,41-i.,ko k 'iOIV ''F,:.]tl N.,''
, 1 , •- .I, ti l', i'.C'- :. ❑Addition of new motor load of ❑"A” -E" "1.2•'"1.3"
Job no.:26923. Job site address:14140w SW 72ND AVENUE IOOFIParntare. occupancy.
❑Six or more residential units. El Recreational vehicle parks.
City/State/ZIP:TIGARD, OR 97224 ❑tinsldi•cnre facilities. LI Supply voltage for more than
^� ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.; /!�(9 Project name: P@E.Y.-C-AST po j CA 5 ❑Service or feeder 600 amps or more.
!ia,er ; ;;u i ` I' E ISGI` J r p4 ., •:!. „ih� ; �. t : I .Cross stree/directiens to job site U Uen �1M Pse •
!. 'w.t i BOB BRUENE 503-419-3646
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 _ 4
Tax map/parcel no.: Ea.addi 500 sq.ft.or portion 33.92 1
.r.l"t'_ '.1.{1 )'" :;i- ,,t��f I ��Dye �' L. "I'::'a,:k[r ,,�. i o,• ..�. limited energy.residential
1,- ,.;1, ,,L. ie }W0I oiii , !i1 :j,,,-7 1� Ii _with above sq.R.) 75.00 2
"Ir. ra:' IpF s�Ft� X111•�: aid
� ,dN zi' v'.: 'Iii:
Limited energy,multi-family 75.00 2
OA 2 0OAMP OR LESS SERVICE residential(with above sq.II.)
Services or feeders lnetallatton.alteration,and/or relocation
200 amps or less 1 100.70 100.7 C`2
l •.�, „;f�i ,
r '❑.'0O rR - ol� ,.1.17. �, PFI. rIp� ,0'},Tq�11 }1-i.,F iH'', � I,'.. 201 em s to 400 ani s 1 33.56 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 552.26 2
City/State/ZIP: Temporary services or feeders Installation,alteration,and/or -
relocation
Phone:( ) I Fax:( ) 200 amps or leas 59.36 1
201 amps to 400 amps 125.08 2
Owner installation:This installation is being made on property that I own which is not _
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps -168.54 , 2
Branch circuits-new,alteration,or extension,eerpanel
Owner signature: Date:
A.Fee for irranch circuits with
,... ,. ,,,I. i .. .r-i 4 e.,l'j,'.,',;d"p+y a J;�t ".04,tlr''iI;,�.,,iris-ty--p,i rFr:' t'i I above service or feeder fee,
, y, .,,till i41741PPP'.; 11-d:.f rI'4Iµ1lri1,.,- �i f.,_.1,1 x4ii.1,N8•t`lA... ,.,P^.,7,0. • :i,l1 .,i,,'I.:1: 7.42
each branch circuit 2
Business name: CHRISTENSON ELECTRIC B.Fee for branch circuits without
service or feeder fee,first
56.18 2
Contact name: branch circuit
• Each add')branch circuit 7.42 I 2
Address: _Miscellaneous(service or feeder not Included)
City/State/ZIP: Each manufactured or modular 67.84 2
dwelling,Service and/or feeder
Phone:( ) Fax::( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E-mail: -
„ Sign or outline lighting 67.84 2
.• ..r, I . i]'';. I ■ ':;'::..1::•,!:1..).A ll,,C"1)8'1.T:six0' 'iihA:1 1°ilaiC`i 1f 11r ,,1 • i.∎4.`': 11. i.
Signal circuits)or limited-energy
Business name: CHRISTENSON ELECTRIC panel,alteration,Or extension. Pa c 2 2
Each additional inspection over allowable In any of the above
Address: 111 Sw COLUMBIA, SUITE 480 Additional inspection(1 hr min) 66.25/hr
City/State/ZIP. PORTLAND, OR 97201 Investigation(lhrmin) 66.25/hr
— Industrial plant(1 hr mmn) 78.18/hr
Phone:(503 )619-3354 Pa (50 ) 419-3695 Inspections for which no fee is
— s i eeificsll listed f,hr min) 90.00/hr
CCD Lie,: 458 Electrical Lie.;26-34i •up - c•:5215$ 'il!';',iri,'„°lpE;"•rti; s' ''PE Ml'b-.F.�'E9'" I`
Suprv.Electrician signature,required: IF � • r Subtotal: 100.70
_ Plan review(25%of permit fee):
Print name: ROBERT 13PUENE Date: 9/23/13 - State surcharge(12%,of permit fee): 12.08
TOTAL PERMIT FEE: 112.78
Authorized signature: This permit application expires if a permit la mot obtained within 180 -
Print name: Auto:
days It bar been accepted us complete. U(•t/
• Number of inspections allowed per permit.
P,auildingiFrrmluttrlC•Permitnpp ax 07/111110 440-4615711 I/a51COM/WGa
----Tr-6;2r— Aec-r- .
OCT-09-2013 WED 10: 11 AM CHRISTENSON ELECTRIC, INC FAX NO. 95034193695 P. 01/02
Electrical Permit Ap lication A� 4 c h'(IK 014'1(T:t tit.ONLY
City of Tigard OCT 2013 "PeLi' �
rr Dme,t3,: , ,,anvil Nn�EL 0/3 Dp,S ,72
13129 SW Hall Blvd..Tiva tl,OR 97321 iO /�3 :• ��
If
Phone: $113.7) .2439 Pax: 501,576.19 liltY�6�nF _ �) plan Ituvlcw --
Inspection Line; 543.639.4175
U Y Or' b'Q�j�t i t t)iiio Ry: Other Permit;
T I t;A 1t D ilnto Rruly sy: 4,;e. k1 Ste rage 2
Internee www.li and-or. Pv 1:' I'Or
6 2 .� AB� 9I�A �� 4 NutificA'Mcitwd: T��3n1,plemenral Infnrnhnuan
' TYpE 6.0. WORK,• — PLAN REVIEW•❑ New cunstructiorl ACldition/alteration/replacement - Please Check all that apply.(suhmit 2 9e1S of plow:w/items sleeked Wow):
❑Demu)111011 ❑Other; El Service or reader 40U amps nr more ❑Building n■cr ditty Andes.
„ where the nvnilahle full[currant ❑Marinas and boatyards.
�^ r
CA'i1E:�ORY•''OF'CONS'rRUCTI'ON ' ' ': ,' CXCeca$1 0.000 amps at 150',ohs or ❑rloalinp hullJinyi,
❑ I-and 2-family dwelling ®Commcrciallinduetrial ❑Accessory building "` less to ground,orexceeda 1,01)0 D Coumlercial-use 4griculaual
❑Multi-fumil (' amps for ahother iasiallarions. bmlding::. .
Multi-family ❑Master builder ❑Other; ❑Flre pomp, ❑Installation or 75 KVA or
J9I3'SITE'INFOR 1Q. ❑Eddhlo; y new war lanyer ac 1)r: y
[}4}I) N AcNf]:''G'QC?xT1l3N p net derived
CI Additionofnewnwarloadot' Q •q^ '•g^ ,••••i,j
Job no.: 26921 Job site address:14140 SW 72ND AVE 100gP unnorc. occupul cy,
• �� - gsix or more residential units. ❑Recreational vehicle parka,
City/State/ZIP: TIGARD, OR 97223 ❑Health-carp rucilities, ❑Supply voltage for more than
❑Hurirdaus locations. 600 voile lumina!,
Suite/bldg,/api.no.: Project name: POLYCAST U Service Orfecdor600 amps ormore.
' ;; ', .I ':, ` "?LE:SC�EDi),i
•.Cross street/directions to lob site: Mauritian IRM� .I'nlnl BOB BRUENE 503-419-3046
New residential single-or multi-family dwelling utdl.
Includes attached garage.
Subdivision: 1.000
Lot Ito. sq.R.or less 168.54 4
Tax map/parcel no.: Ea.ndd'1 500 sq.It.or portion • 33.92
---�,
, e
_Llmitcd energy,residential DESCITI N;gF,WORK � 17„ with abov , f) 75.0() 2
PLEASE ADD TO EXISTING PERMIT Limited energy,multi-family
ELC2013-00562 • residential(with above sq.ft.) 75.04 2
(1) FEEDER 200AMPS OR LESS Srrvlccs ar feeders Instsllatl0n,alteratiun,and/or rclecallun
100 70
D,r'Rt7 CRT1r 2
amps or less 1 100,70 2
ii;i :r'..t: (^I;:rEN1itR?VT.:....sr ,y 201 amps to 400 arnPa 133.96 2
?Marne — 401 amps to 600 amps - 200.34 2
— 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 5522d
2
City/State/ZIP:
•Temporary services or feeders installation,alteration,and/or
relocation
Phone:( ) Fax;( ) 200 amps or lass 59.36 I
Owner installation:This installation is being made on property that 1 own which is not ?ot`imps to 400 amps 125.08
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
Owner signature: Branch circuits new,alteration,or extension,per panel
Date: A.Fee for branch circuits with
::`.',; '.!a'AP4i,c,iot..I.:gi., ',.:,.;'iii' l.." %'' E.I!(h'f.r,...!.. r above service or feeder fee,
each branch circuit 2
Business name:CHRISTENSO:NQ ELECTRIC S.Fee for branch circuits without
- service or fader fee.first
Contact name: brooch circuit 56.18 2
Address: ^Each add.]branch circuit 7.42 2
Mlicellaneores(service ur feeder not Included)
City/State/ZIP: Each manufactured or modular
dwelling,servir�and/or feeder 67.14 2
Phone:( ) + Fax::( ) Reconnect only 47.84
2
E-mail: Pumper irrigation circle 67-14 2
C1�N714i11�TOR.. '.:, Sign or outline lighting ^,67.84 2
„ . .-. .1 .:. Signal Clreun(e)or l(mlted-energ'Y
Business name: CHRISTENSON ELECTRIC nell ullerntiot orexlantlon, Page 3
each additional inspection over allowable in any of the above 2
-
Address; 111 SW COLUMBIA, SUITE 480 _ P
—
Additional inspection(1 hr min) 66.25I hr
City/State/ZIP: PORTLAND, OR 972 01 Investigation(1 hr min) 6(1.25/hr
Phone:
Industrial plant(1 hr min) 78.18/hr
(503 )419.3354 F 03 )419-3695 Inspections for which nn lee is
speciric0IW haw((4 hr min 00.00/hr CC3 Lie.:q 5 R Electrical Lic.2.
-3• Suprv.Lie.: 52155
"'.ELECTRI(CAL'PERMIT•'FE;IEs';-
Suprv.Electrician signature,required: / Subtnutl: 100.7070
Print name: J nIr•1r"11. flan review(25a/„OI'pelmil fee):
ROBERT BRUENE I s,:r-• . State surcharge(12%en-permit fee):
12.08
Authorized signature: TOTAL PERMIT FEE:
This permit application n expire.If a permit IS not obtained within 150
Prime 111 name: Dgtc.
oar,after It has linen acceprco an nemplet,.
• Number orinapectitnls allowed perpurniit.
t.,quitdinp,na,rnOnft31.C-rkunitAppdoa 07/0111U 4415-461511 I I Mi/C nM/W LB
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
14140 SW 72ND AVE 100, TIGARD, OR, 97224
Commercial - Electrical
199 Electrical final
2013-10-29 (null)
ELC2013-00562
PASS - No C of O
Violation Summary:
Inspector Contractor