Permit CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2008 -00233
IN COMMUNITY DEVELOPMENT
DATE ISSUED: 5/1/2008
'TIOARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S 136DC -04500
SITE ADDRESS: 07501 SW DARTMOUTH ST 100 WINCO ZONING: C - G
SUBDIVISION: PP1995 - 013 LOT : JURISDICTION: TIG
PROJECT: WINCO
Project Description: Installing (3) branch circuits for customer service cabinets.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAUPANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 2 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
WINCO FOODS LLC NORTHSIDE ELECTRIC
PO BOX 5756 PO BOX 12323
BOISE, ID 83705 SALEM, OR 97309
Phone: Contact #: PRI 503 - 585 -4879
FAX 503 - 364 -0248
FEES
Description Date Amount Reg #: ELE 24 -14C
[ELPRMT] ELC Permit 5/1/2008 $60.15 LIC 80593
[TAX] 12% State Surchar 5/1/2008 $7.22 SUP 1877S
Total $67.37 REQUIRED ITEMS AND REPORTS
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 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: ' !� • ermittee Signature: /.
OWNER INSTALLATION ONLY f � '
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 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
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•
- - -Eiv.u:,rica1 Permit Application _ FOR OFFICE USE. ONLY
City of Tigal - fl DetelB 1� �L iC�J /� Pctmit No.: // : 'CO 0 2
111 • 13125 SW Hall Blvd., Tigard, OR 97223 Plan licvicw Other Permit • l MIMEO Phone: 503.639.4171 Fax: 503.598.196(1 , ' datc/B : I1. r I Il . 1
D ata Read /B km' El See Page 2 far
f I C AR D Inspection Internet Line: 503 -or. 0 175 y y' Su
IntemeC www.tigard�r.gov `, NcNotified/Method; DD lemcntul Information
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Please check all that imply (submit I sets of plans w/itcros checked below):
['New construction Addition/alteration/replacement 0 Service or feeder 400 amp; or more p Buildwg over three stone,.
❑ Demolition ❑ Other: where the available fault Currant ❑ Marinas and boatyards.
d g. " a .., exceeds 10,000 amps at 150 volts or ❑ Flontiny, buildings.
� . .. . f T t)C�YIQ1`1
ii :r:':,:;::'
��+ t i� 1 ja `; . ,, ,, ,. . . ' Tess to Bound, or exceeds 14,000 ❑ Commercial-use agricultural
❑ 1- and 2- family dwelling Commercial/industrial ❑ Accessory building turps for all other installations, buildings,
❑ Multi - family Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
larger separately
y* . Emergency system cly y m.
�4s +1 t{ I Ft ''uU7''1'', Y fr .�r.t� " at derived
la ,.:i Gi .Y, I YE ` °H'!. 4 J� ✓f 1nice � '.I ' ) ltr� j ,04:' i .. r
II''y� k Y c
u , Ut a Od � � '�',,, , � •, �L r � ❑Addit o new motor f on d o ❑ `•A .. L• .. :`l.r•• "1_� ^,
100HP or more occupancy.
Job no.: 9S 9 Job site address: 1n gjd ❑ six or more residential unit,, ❑ Recreational vehicle parks.
I ' • l � Project name: ❑ Savi c c e o r feetdcr t 600 amps or ,,,ore. ID 60pm y voltage than
for more
Suitc/bldg./apt. t. no„ 1
�l
City /Scare /ZIP: ❑ Hazardous locations. 600 volts nominal.
Cross street /directions to job site: Deecr . tI°n J Qt., 1 Per 1 Total' 1 "
New residential single- or multi- family dwelling unit.
includes attached garage.
Subdivision: Lot no.: 1,000 sq. fl. or less 145.15 4 -
Ea. add'l 500 sq, ft, or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
,fi ,,: , i 1 1 ,!, `', t, ',I�t'� O ti 7s.00 2
t .�,w��'�,�, ,'i�bR'F III �, ? . (wiUtabovcsq.R.)
Limited energy, multi- family 75.00 2
C V .V.Yl r- ' . 1 residential (with about sic .
l • ^' Services or feeders installation, alteration, and /ur relocatio
200 amps or less 80.30 2
'.ii P 'S ,tit rr ry I '' v 106.85 2
. r i`tt�l" u'' o •� � '' TENANT I, ; 201 am to 400 amps
Name: \
` , I n41 401 amps to 600 amps 160.60 2
Ni \k 601 amps [0 1,000 amps 240.60 2
ydress: Over 1,000 amps or volts 454.65 r 2
City/State/ZIP: /State /ZIP: Temporary services or feeders Installation, alteration, and /or
y relocation
— —
Phone: ( ) Fax: ( )
200 amps or less 66.85 1
201 amps to 400 amps 100.30 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps _ 133.75 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fcc for brunch circuits with
' 4 use l' a) , ; ' 1r 0 CONTACT PEI 6.010,1•;::: ; : r. above service or feeder fee, 6.65 2
L� i t � ' 1 I y ,
_
each branch circuit
Business name: 9. Fee for branch circuits '6 woo, service or feeder fee. 46,85 yb 2
Contact name: first branch circuit
Address: Each add' branch circuit "Z 6,65 \,'S) 2 -
Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular 90,90 2
dwelling, service and/or feeder
Phone: ( ) Fax: ; ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle: — 53.40 2
' r r, r e `N' i7;.. i' , r. • s" , C) . ,Ii::' . ' . :: . ::.. •, ':.,0: : Sign or outline lighting
53.40 2
1.,,.
Signal circuit(s) or limited-
Business name: 1 % Atom, L 1 1 . , tom energy panel, alteration, or
extension. Describe: Page 2 2
Address: ' , y , w � 2 _
City /State /ZIP: ` ‘ _ a , • + 40 Each additional inspection over allowable in any of the above
Per inspection 62.50 -
Phone; EjZ ." r Fax: Et) ) , "'�1CT,� • Investigation per hour (1 hr min) 62.50
CCB Lic.: loi nCI6 EMZEIMINI Suprv. Lie.: Industrial plant 75
hour per ho 73
p e r ho TRTICAIX RIVIIT 7 3 . .
Subtotal: �Y `
l ^
S prv. Electrician signature, required: , 1 � � � , _ ^ Q r (S
/ L Plan review (25% of permit too), gat name: h a te:
State surcharge (12% of permit fee) . �tp
Authorized signature: . _ TOTAL PERMIT FEE: zp Q �7 .f)7
Thin permit application expires If a permit is not obtain within 180
Print name: Date: days after it hug been accepted as complete,
" Number of in allowed per permit.
1, \ Building \Parmlet \1:,LC 05/21/06 44046I5 r(I)/u5ICOM/WEB
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CITY ���~��� ���� � U�������� `
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BUILDING DIVISION PERMIT #: BC2008-00233
13125SVV Hall Blvd, Tigard, OR07228 DATE ISSUED: 5/1/2008
Phone: (503) 639-4171
Inspection Reque�a(24Hmj:(6U3)G3Q'4175 ,,,_414t1
INSPECTION WORKSHEET FOR DATE: 5/12/2008 TIME: 7:O1Ahn PAGE: 36
SITE ADDRESS: 07501 SW DARTMOUTH ST 100 YNMCg CLASS OF WORK:
SUBDIVISION: pp1995-013 LOT #: TYPE OF USE:
PROJECT NAME: WINC0
DESCRIPTION: !n��»d|ing (3) branch circuits for customer oenice cabinets.
OWNER: VNNCQ FOODS LLC. PHONE #:
CONTRACTOR: N0RTH;31DE ELECTRIC PHONE #: 503-685'4879
Inspection Request Scheduled For: Date: 5/12/2008 Pour Time:
--
Code # Inspection Description mo=t Contact # Message
199 Electrical final 5O�585-4879 N
Corrections/Comments/Instructions: /
N. /
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'
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A PAS RARTk�LAPPRO\�\L El �ANCEL | 1 NO ACCEGS
D
ri CALL FOR INSPECTION [| ADDITIONAL FEES ASSESSED
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Inspector: ~.� ' �w,��� Date: ���u���$ Phone #: (503) 718111% ' X" K ` '
Ii. ) r /.� / .
'
CITY OF TIGARD
BUILDING DIVISION - x PERMIT #: EL.C2008 00233
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5! 1/20013
Phone: (503) 639 -4171 �'i rili
Inspection Requests (24 Hrs.): (503) 639 -4175 .._...
INSPECTION WORKSHEET FOR DATE: . 5/6/2008 TIME: 7:00AMV1 PAGE: art)
SITE ADDRESS: 07501 SW DARTMOUTH ST 100 WINGO CLASS OF WORK:
SUBDIVISION: PP1995 - 013 LOT #: TYPE OF USE:
PROJECT NAME: WI NCO
DESCRIPTION: Insialling (3) branch circuits for customer service cabinets.
OWNER: WINCO FOODS LLC, PHONE #:
CONTRACTOR: NORTHSIDE ELECTRIC PHONE #: 503 - 585.4879
Inspection Request Scheduled For: Date: 6/6/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 069384 -01 503-932 -0792 Y
Corrections /Comments/ Instructions:
F PASS n PARTIAL APPROVAL CANCEL NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6 ---- i N te) LE Date: 61 gat Phone #: (503) 718- vv.()
CITY OF TIGARD
t-
BUILDING DIVISION PERMIT #: Lt_C 00 00233
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/1/20013
Phone: (503) 639 -4171 ������� '�r „ 11 4' l
Inspection Requests (24 Hrs.): (503) 639 -4175 '+i A.L,
INSPECTION WORKSHEET FOR DATE: 512/2008 TIME: 7:00AM PAGE: 36
I
SITE ADDRESS: 07501 SW DAM ST 100 WINCO CLASS OF WORK:
SUBDIVISION: PP1995.013 LOT #: TYPE OF USE:
PROJECT NAME: WINCO
DESCRIPTION: Installing (3) branch circuits for customer service cabinets.
OWNER: WINCO FOODS LLC, PHONE #:
CONTRACTOR: NORTHSIDE. ELECTRIC PHONE #: F,0:: btu x4879
I
Inspection Request Scheduled For: Date: 5/212006 Pour Time: I
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 069224 -01 503- W5.4879 N
5x3.431 -• olet I
Corrections /Comments /Instructions:
t4 0 ON< 6N .5 'a : 4 41 Q : it%CC'
•'b ZI cz1 1 , 4 ,0 ■,# < $= 11•,3
• GJSlcM Ct- gi.&vv Li A
P 1, v\no,,.® p 1 G Gut-
E.k.. Cl. PNO-c. •
❑,_PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Al ��nn' ✓
Inspector: Cr 1"`� Date: GI 0 Phone #: (503) 718- 1.41414 :