Permit (117) CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT #: ELR2003 -00253
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/14/03
SITE ADDRESS: 16200 SW PACIFIC HY Y2 PARCEL: 2S1156A -00101
W
SUBDIVISION: TIGARD TOWNE SQUARE ZONING: C -G
BLOCK: LOT: 001 JURISDICTION: TIG
Project Description: JOB NO. 85 -00200 Paging System
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING: X
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
BIT HOLDINGS LTD PARTNERSHIP CHRISTENSON ELECTRIC INC
BY FORUM PROPERTIES INC 1631 NW THURMAN
FIVE CENTERPOINTE DR STE 290 2ND FLOOR
LAKE OSWEGO, OR 97035 PORTLAND, OR 97209
Phone: Phone: 503 -419 -3608 permit la
Reg #: LS03 -3414I 36
SUP 3289S
ELE 26 -34C
FEES Required Inspections
Description Date Amount Ceiling Cover
[ELPRMT] ELR Permit 8/14/03 $75.00 Wall Cover
Elect'I Final
[TAX] 8% State Tax 8/14/03 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. 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 rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 throuc
•
Issued by Permittee Signature
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 DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
AUG714 -2003 THU 09:23 AM CHRISTENSON CORPORATION FAX NO. 503 419 3636 P. 01/01
Electrical Permit Application
A ...........................................,..................■
`I D ` Datetr;celved pernritno.:/j ,Zp�.oa 7.4
• EC I v E Hxpiredate:
,;ii:‘ 41 . City of T�
`./ Project/appi.no.:
Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: • Dy: Receipt no.: •
CiryofTigard Phone: (503) 639 -4171 AUG 1 2003
Fax: (503) 598 -1960 Ca se file no.: • Payment type:
Land use approval: crry nF TIGARDD . .
01 & 2 family dwelling or accessory X10 CommercialTndustrial CI Multi - family 0 Tenant improvement •. •
❑ New construction ID Addition/alteration/replacement U Other: U Partial .
;1)v *NH; l\litl ;\4 ■ilt1'.
Job address: 16200 SW PACIFIC HWY • 97224 Bldg. no.: Y2 Suite no.: Tax map/tax lot/account no.:
Lot: Block: Subdivision:
Project name:TU DAV 1r1O1INGS gTO ' ..on and location of work on , remises: LOW VOLTAGE PAGING SYSTEM
J 503 419 -3367. . ..
Estimated date of corn .letion/ins .: on:
a1 • • 0 •CT KEN FOX
('ON in : \( 1412 AI'I'l A h(1` I -11.; •
S( 111'.1)
. pee Max
Job no: 85 -00200 p Qom. (ea.) Total Ito. rasp
• Business name; CIRISTENSON ELECTRIC, INC. -single � y. yPer •
Address: 1631 NW THURMAN ST 2ND FL dwellbrglatif. Includes ad d prage..
cit PORTLAND State: OR ZIP :97209 -2518 vlodfadudel: •
f. or less Ph ine503 t000 sq. ft. s 4 419 360 Fax: 419 3636 E -mail: 100qt erponionthoreof - •
• CCB no.: 00458. ec. bus. tic. no: 26 -34C 1- imitedenergy,residentia! 2
City /me n . no.: 5 , • • Limited - : ,rwa•rrsiaantiat • 2
•
y�`� /r�+0 Each manufactured home or modular dwelling O 2
Service and/or feeder •
Si. ' '• of of sir• � •"•� ( 4 -� � Senlcaor /eeders�luiWlation,
Sup. erect ranee (p tIAN CHRISTOPHER License no: 87 3S alteration or relocation:
lI({)Pl It 11 OII Ni It 200 amps orient 80.2 . 2
TUESDAY MORNINGS STORE LAUREL 201pato403°Ma — 2
Name (print): r =Pa
amps to 600 amps _ 2
60 1 amps to 1000 2
Mailing address: � ar il' s
City: State: ZIP: Over 1000 Wks ar votta 2
Phon§)._::..._62.Q.2.9.52., Fax: B- trail: Reco --... y • 1
g property 1 own '�ry' seniors or feeders - .
Owner installation: The installation is heir made on roperty b iatioo, loa.orMacadam
which is not intended for sale, lease, tent, or exchange according to 200 amps orlas 2
ORS 447.455. 670.701. 2 01 amps to 400 lumps • 2
• Owner's signature:
Date: _ 40110 600 2
Branch circuits -new, alteratloa,
oratteadoo per panel:
Name: —_ A. Fee for branch circuits with pnrrd:ase of y . 65 2
Address: • service or feeder fee, each broach circuit
• City: I State: • IMP: P: B. Fee for branch circuits without purchase 46.85 2
of service or feeder fee, fiat branch circuit: ; . b5
Ph • a , I Fax: E -mail: Bach additional branch circuit:
I'I..\N It l \'I1 clay. I.:ill III:.t apply► Misc. (Service or feeder not included):
Each . mp or inigerree circle 2
CI Service ova 225 empgrn
ouma�cial ' 0 Health -tarn facility 2
of 1 &2 0 Hazardous location Each signor outline lighting
O Service over 920 *tops -rating Si clrcuit(e) or a limited energy panel, 1 75. 7 5.0 2
• (amity dwellings O Building over 10.000 square feet four or — Sigma
O System over 600 volts nomin mom residential units in one structure alteration, orextension' -
YAl�1NC; SYSTi'+M
O Building over thre atoriar D Feeders. 400 amps or more *Description:
TS, Occupant load ov er 99 per Cl Manufactured structures or 1W ti each additional i nspection over the allowable in any of the above:
0 Eg��ightingpl O Other- Per inspection I 1 I 3
Subm _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other ,�.
Permit fee • $ 7 5 - -
N« art jtafaedam ntnxsp c redo cans plume J ter m01° '"r°'�m1°d Notice: This permit applica Plan review (at %) $
0 vim U MesrerCar expires if a permit is not obtained State surcharge ( .... $
aedb cad numb= j / within 180 days after it has been
era ' accepted as complete. TOTAL $ —.81...00- -
N> tmeattar4hdderasU�ro ** *TRUST ACCOUNT DEDUCT * * * **
$ 440461S (6i1101COM)
Catd6old s< Amoaar
OCTOBER 2000 +FEE ON BACK OF FORM
i ,
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (50 ;) 639175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 2 - cz o AM PM BUP
�
Location / o� D U (� - _ Suite r- a MEC
Contact Person 1 < u24"- Ph ( ) Y / « " 336 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 7 - t t .Pi • ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR 3 - v as
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall I . r
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
'Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
d am . Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
4I:3 PART FAIL
Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date &)) P.69 Qj Inspector .• Ext
AV Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL