Permit CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2008 -00575
COMMUNITY DEVELOPMENT DATE ISSUED: 10/14/2008
jr I c A}t D 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S136DC -00500
SITE ADDRESS: 11626 SW PACIFIC HWY ZONING: C - G
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: TIGARD CINEMA
•
Project Description: (1) temporary service and (1) branch circuit for concession televisions.
•
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 1 • PUMP /IRRIGATION:
EACH ADD'L 500SF: • 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVCI FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: 1 PER INSPECTION: .
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 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:
TOM MOYER THEATRES • IDEAL SERVICES INC •
BY ACT III 3525 S ALDER
7132 COMMERCIAL PARK DR TACOMA, OR 98409
KNOXVILLE, TN 37918
Phone: Contact #: PRI - 253 - 671 - 2160
• FAX 253 - 875 -8886
• FEES
Description Date Amount Reg #: ELE 37 - 988C
[ELPRMT] ELC Permit 10/14/2001 $73.50 LIC 154353
[TAX] 12% State Surchar 10/14/2001 $8.82 SUP 5129S
. Total $82.32 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.
401 •
Issued By: � ``� / - er teeSignature: �� �
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 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.
•
INSPECTOR'S SIGNATURES ARE NOT...,
• Inspections Required for: , p__ 75 REQUIRED ON GREEN INSPECTION CARD.
Code I Inspection Description I PASS Date 1 By 1 Code I Inspection Description I PASS Date I By
•
BUP - Building Permit _ELC - Electrical Permit .
405 Excavation 105 Underground /slab cover •
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing k 120 Electrical rough -in
•
805 MFG - Structure grading /footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl dram 145 A/C or heating unit circuit
225 Post /beam structural 150 Hot tub /spa /pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors ,X' 199 Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
. 260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG - Structure set -up MEC - Mechanical Permit
•
280 Insulation 605 Post /beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in •
295 Misc. inspection: 620 Hydronic piping
899 MFG - Structure final 625 - Duct work •
498 Grading final 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
• 640 Exhaust hood
• 695 Misc. inspection:
699 Mechanical final
•
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab
910 Sprinkler rough -in PLM - Plumbing Permit
915 Fire alarm rough in 305 Plumbing underslab
310 Crawl drain
920 Suppression trip test 315 Post /beam plumbing
995 Misc. inspection:
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan
fi
330 Water service
• 335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert /catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing _ 399 Plumbing final
210 Foundation walls
215 Footing drain •
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: • 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 - Final inspection
•
I: \Building \ Forms \InspCard- AOP- Blank.doc 02/02/07
CITY OF TIGARD ELECTRICAL PERMIT
II
� g� g
COMMUNITY DEVELOPMENT PERMIT #: ELC2008 -00575
DATE ISSUED: 10/14/2008
IT1GARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S136DC-00500
SITE ADDRESS: 11626 SW PACIFIC HWY ZONING: C - G
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: TIGARD CINEMA
Project Description: (1) temporary service and (1) branch circuit for concession televisions.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 1 PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
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: 1 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 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:
TOM MOYER THEATRES IDEAL SERVICES INC
BY ACT III 3525 S ALDER
7132 COMMERCIAL PARK DR TACOMA, OR 98409
KNOXVILLE, TN 37918
Phone: Contact #: PRI 253- 671 -2160
FAX 253- 875 -8886
FEES
Description Date Amount Reg #: ELE 37 -988C
[ELPRMT] ELC Permit 10/14/2001 $73.50 LIC 154353
[TAX] 12% State Surchar 10/14/2001 $8.82 SUP 5129S
Total $82.32 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: /rte ` ` e4 e ,:,--_, , •er - - Signature: .0":".' N �
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 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.
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard Received D fft1-,f II Permit No.: ::::L. Fl - A)5
a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C • Phone: 503.639.4171 Fax: 503.598.1960 Date/B : Other Permit:
T l GA R D Inspection Line: 503.639.4175 Date Ready/By: IMI 0 See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
- TYPE OF WORK PLAN REVIEW
❑ New construction g Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling Commercial /industrial El Accessory building amps for all other installations. buildings.
❑ Multi- family Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ",' l -2 ", "l -3 ",
Job no.: Job site address: 1 (, . ^ , 100HP or more. occupancy.
tJ `� VL` s , j J i-( r l C� `1w y, ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: ' --r\ e��- , l a- 3 / ❑ Health -care facilities. ❑ Supply voltage for more than
1 4 ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: I i 0 or feeder 600 amps or more.
L ` FEE SCHEDULE
Cross street/directions to job site: S1/4 ' - 1 ,Q„ � Description Qty. 1 Fee. Total 1 { ` New residential single- or multi - family dwelling unit.
T 9N-c Includes attached garage.
Subdivision: J Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. 11. or portion 33.40 1
Tax map /parcel no.:
Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
( Limited energy, multi - family 75.00 2
a k& C , .You- t f I �S \ Cc ow(-Le, - •� �C� residential (with above sq. ft.)
bQ ,� ,( Services or feeders installation, alteration, and /or relocation
( vi \A, a, ♦ a ♦ id yL / 200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TEN N 201 amps to 400 amps 106.85 2
Name: 'DUX Co �` 401 amps to 600 amps 160.60 2
1 ' PIA r Over 1, to m p s amps 240.60 2
Address: 01 �� � Over 1,000 amps or volts t 454. 2
City /State /ZIP: r_. `J 1� / , .�• ' f Temporary services or feeders insta alteration, and /or
�i/ p relocation
Phone: ( ) Fax: ( ) t o / T , 200 amps or less l 66.85 (k, 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amp 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449. 670. and 701. 401 amps to 599 amps 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee,
' each branch circuit 6.65 2
Business name: - 1 c /'t x - l ( B. Fee for branch circuits
�A without service or feeder fee,
Contact name: _ first branch circuit 46.85 2
Address: Each add'I branch circuit 1 I 6.65 6 , 6• 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: j) /� TjY\ /� Signal circuits) or limited -
�C�! LAL . ` .0 ' � ` / energy panel, alteration, or
Address: d _ -) r /� �) CI W' , i --.)t) extension. Describe: Page 2 2
City /State /ZIP: ` ` � ,`� — 24 Each additional inspection over allowable in any of the above
'����'� ) f te Per inspection 62.50
Phone Jj ..r j 'ax: � ) '5 , — '5M `r /� Investigation per hour (1 hr min) 62.50
CCB Lic.: i 514.-3t 3 Electrical lc . 3 D r, S . prv. Lic.:S i S Industrial plant per hour 73.75
/ l ELECTRICAL PERMIT FEES I ?
Suprv. Electrician signature, required. Subtotal: 2 l � 1 , C 9
7
Print name: Q k ; Date: \0 I r „ 0 Plan review (25% of permit fee): lY State surcharge (12% of permit fee): ,f'�,- g O'
Authorized signature: , TOTAL PERMIT FEE: 7 t R ti p fx
This permit application expires if a permit is not obtained within 180
Print name: tY L Date: / , „ (� -{ B days after it has been accepted as complete.
* Number of inspections allowed per permit.
1:\ Building \ Permits \ELC- PermitApp.doc 05/23/06 440- 4615T(11/05/COM /WEB