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Permit CITY OF TIGARD ELECTRICAL PERMIT l: s: COMMUNITY DEVELOPMENT Permit #: ELC2009 -00465 P!' Date Issued: 09/08/2009 :11.1 G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S136AD06503 Jurisdiction: TIGARD Site address: 10900 SW 68TH PKWY Subdivision: WAY LEE Lot: 2 Project: Changs Mongolian Grill Project Description: (12) branch circuits. Job No. A2173. 12/4/09 ADDED (1) 200 amp or less service and (1) restricted energy panel. Owner: FEES WAY W LEE GENERAL CONTRACTOR Quantity Description Date Amount 5210 SE 26TH AVE PORTLAND, OR 97202 12 crt Branch Circuits 09/08/2009 $120.00 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 09/08/2009 $14.40 Electrical Contractor: 1 ea Services or Feeders - 200 12/04/2009 $100.70 THREE PHASE ELECTRIC amps or less 493 NE 3RD AVE SUITE B200 1 ea Signal circuit or Limited 12/04/2009 $67.84 CANBY, OR 97013 Energy Panel PHONE: 503-263-2558 0 ea 12% State Surcharge - 12/04/2009 $20.22 Electrical FAX: 503- 651 -3540 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $323.16 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 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. 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' Q �. C Date: LICENSE NO. ry ` 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. 2&09 -12 -03 16:48 503- 651 -3540 three phase electric P 2/3 Electrical Perm A � pV4. _C y . '. " I tl11(t� Fi f , f e • ' ' C of Tigard b Receive � u 4v. * t ps /B r Permit No.: 't.'5";14 1 3125 SW Hall Blvd„ Tigard, OR 97223 .'!j - 4 41 • 44. I a Phone: 503.639.4171 Fax: 503.598.1 M , r - ``gii inspection Line: 503.639.4175 1 i 1 h ■J' Plan Review . � Fermis 1, p : i as Date Ready/By: Internet: www.tigard- or,gov ��, ri Notified/Method: Pape T for 1. ; tED , rs, it, i.,m tly y �, a Supplemental Informadoe r/ PP � r �y��� • , f i SCI la'rY� �d i� � w t � �{ '� }lf+ �rl� 9"�+?yr�,1" ry�l'r'n ��.i ur�g ,use I � a. 'td wflziamatai , ^ . u '"-r}f f.x.•..YutS .77, �:.. gtfuft!i1t . .y.f i 17fG' core 'Smr +Ai,i"ull7cfu ercdhlYttxl.+ll.l6rlrtfr "'e `, { tvl;. New construction ❑ Addition/alteration/replacement Plee check all that apply (submit 2 sets of plans w/items chocked below: Demolition ❑ Other CITYOF as TIGARD ❑ Service or feeder 400 amps or more ❑ Building over three atones. N I l I i it w +vu w u u .rw o W, where the available fault current { EH• t � $12 rL °� M"MK of a" e" 3R tt r'1 r u+nv r t , . ❑ Marinas and boatyards m, t ?ria£ ii t".k" du ` � dtea`w u ` rrxltlamsazc2�c anaa ts} y; j tAA I R t - 4 . 0 l ( d exceeds 10,000 amps at 150 volts or ❑ Floating buildings. ❑ I- and 2-family dwelling [l Commercial/industrial ❑Accessory building less to ground. or exceeds 14,000 ❑ Commercial -use agricultural allies For all other installations. buildings. © Multi - family ❑ Master builder [I Other: ❑ Fire pump. ❑ installation of 75 KVA or l at(k t "� lit $ t(t "" ° r x" t Mari f tutu t: y +ak aaP4 , ,, ct , amcvuzs,t . 5 ya& r c r Y Y larger separately derived a atnm. " � o nr i r .; � *i f" r�l M ,, '� ❑ P.tttergehc a stem, Fu "r rmfl�u5�i i'craun i uxa . a'. reebs .a�P,„tiatnheiir::xc L -{�i, 4Ya24.d �� ir^ , Y r ❑Additi of new motor load of ❑ •' '•E•' ° 1.2" ° I •�.. Job no.: Job site address: 1 6 • • - tOOHP or more, occupancy, '!'•�' W * ❑ Six or more residential units. ❑ Recreational vehicle parka. City/State/ZIP: 11 ❑ Health-care facilities. r', \ ❑ Supply voltage for more than NV Haserdous locations, 600 volts nominal. Suitefbld ,rTh g. /apt. no.: Project name: ■ t l] Service or feeder 600 sips or more. Cross street/directions to job site: 4su: {,, u Dosed . don r�arM=M713111.111 New residential single- or multi- family dwelling unit Includes attached garage. Subdivision: Lot no : 1,000 sq, ft. or leas IIMEMEI t � Es. add Tax t m { ap /parcel no.: add'! 500 sy. ft. or portion 33.40 �},''# W •S.(a r ia 1" try r� ' +' , TiM"MKr' +a4W[lararfn• rivas.,r xwrwretiK+v'C , Limited energy, tmidential � 7J'c,n,,.tti.!' ' 1 a,5 + ,.' y .. a: 1 P+:;aiia� r n�,ta' , d�'� " i 1?E.ai?;�'. ,t�'.lir t i�' with above :.. it, 75 Limited energy, multi family ■ © �~ ' Oak 21 .. SAL , . ■ 01_ f i resi I deruial with above 75.00 Services or feeders installation alteration and/ r Mora r ,p, w „ 7t " m vv y w rrrrn axc� mugs - Y 200 amps or less r PtM' �Y r� +tY- a < i� r J�. f :r ��' d ' �t� r�� "i! 1.' 1 t �'P' 4 �c F tC �. . Y ti tan pun k as n � -7 , viv .i l:fr i 'n' t ., 2 ., ' . uWrw«n�7 ii. g . ? ." 74 , 7 .` Mut�wau, } M w ut?i�t 201 amps to 400 amps 30 ' d¢` � • " l � 1:n1111111111111111 . Ja+ s.1". P rap : 106.85 �© 401 am • s to 600 a .5: © 601 antes to 1,000 amps In IM 240,60 in Address: • Over 1,000 arnps or volts - 454.65 1111.11E1 City/State/ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) EIMIIIIIIIIIMIIIIIIII 200 amps or less all 66,85 mi Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100. Ell intended for sale, lease, rent, or exchan ee, according to ORS 447, 449, 670, and 701. 401 a - mps to 599 amps ME 133.75 �4 Owner signature: - Date: Branch circuits - new alteration or extension , er aacl �La?, '�4"f.fRw^a y 9 ' 't�pt •a'"r',"�'r "," E r aly'�'.. wa,� y yty����p,' f ro•a "1r• ra r, rrnn a�rv� r A. above e r ice r circuits with • Mil A."�+ -a�W: �:,)i��''1G �" tl �: t o,S.:�''..A.(a?Ilhlk5::'��. � h f ,. � :r^ (3 '„�, l iii about service or Easier fee, t. u�a,a..r. sarrers+A.a „- z ,1�.. , , �, ooiasmaxr+S.lrWntvrr«^x:tfi.�atl m.ra 6.65 Business name. each branch circuit B. Fec for branch circuits Contact name: first without service or feeder fee, 46.85 first t b brannch h circuit Address: Each add'l branch circuit IM 6.65 MIMEO Miscellaneous service or feeder not included City/5tatc/ZIP: Each manufactured or modular - Phone: ( ) Fax: : ( ) dwell .1 service and/or fender 90.90 11 Reconnect only - 66.85 0 • E-mail: • or irrigation circle - 53. oe 1`t • r ,+, K R " r a7 c� , ilk i .•, h ,.. prv3F+ r 4 nx^�+nRr, r+t �+ p � 1 LaV (n .., ac�r �;{." �. ��> �rs' �l {�.."�;rL��w�iru�a,r�cs�. - �,4 �'r� G1i �l' k:' S�idir�r ,Q.>fJlc: i�t Sign Or OLLUInC Ii c ; si ci..it(s) or limited- • ♦. ♦ t ►!. tt► enetgy , or Address: 3 , �� s _ \� '�' ' ` extension Describe: Page 2r - 7 ( f IMEMMI C)ititi f( --) Each additional ins , action over allowable In an of the above Phone: ( � � Fax: ( ! . Per inspection 62.50 - :a• +t: _ A Investigation hour° hr min) - 62,50 rIII CCB Lie.: • Electrical Lis: ' IN a - Suprv. Lic.: �e Industrial plant per hour - 73.75 Suprv. Electrician signature, required: ,� Gs .,y[ ° rati�'� w:1 =- °gi " 1+' .1 it ' s "f. • . Print name: N� ,+ Date: Plan review (25 %ofpermit fee): r� State surcharge (12% of permit ffc): • �� el 0 • a d- Authorized signature: TOTAL PERMIT FEE: nririal Print name: Date: This permit application expires If a permit b not obtained within IRO days after it hat been accepted as complete. t: muilaina \permiiatII.C•PemtltApp.doc 07 • Number of inspections allowed per permit n _ 440.4615T(1IMI5/CO.bt/WEi 1 ? 7 / „ 'd' Q oxtrt La. © VI 2009 - 12 - 03 16:49 503 - 651 -3540 three phase electric P 3/3 Electrical Permit l ication - City of Tigard APP tY � Page 2 • Supplemental Ids on LIMITED ENERGY ERMIT FEES: �. +•fir _�i v1 a��._ i '�a d^ ;° �s � �. Rc.jl��f�•.,;, V° aa. � p , 4 "� c. , Fee for all residential system combined $75.00 Check Type of Work Involve • ❑ Audio and Stereo Syste s" ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation an Air Conditioning System" ❑ Vacuum Systems* Other. %!' 111, "'7 Q 4G :t1"Tra g : 1r.., � .u�1`'i.n..lv�wlatip aatn f�Ai�il at ti .� F'" Fee or each commercial $75.00 system. (SEE OAR 918 -309 -0000) Check Type of 'Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems RI Data Teleconununicati Installation ❑ Fire Alarm Installation ❑HVAC ❑ Instrumentation ❑ Intercom and Paging S ems ❑ Landscape Irrigation Control" ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Li ting* ❑ Protective Signaling ❑ Other Total number of commerci systems: *No licenses are required. icenses are required for all other installations I: gluildingiPmuiti\ELC•PemitApp.doc 0323/06 • CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2009 -00465 T j G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/08/2009 Parcel: 1S136AD06503 Jurisdiction: TIGARD Site address: 10900 SW 68TH PKWY Subdivision: WAY LEE Lot: 2 Project: Chang's Mongolian Grill Project Description: (12) branch circuits. Job No. A2173 Owner: FEES WAY W LEE GENERAL CONTRACTOR Quantity Description Date Amount 5210 SE 26TH AVE PORTLAND, OR 97202 12 crt Branch Circuits 09/08/2009 $120.00 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 09/08/2009 $14.40 Electrical Contractor: THREE PHASE ELECTRIC 493 NE 3RD AVE SUITE B200 CANBY, OR 97013 PHONE: 503 - 263 -2558 FAX: 503 - 651 -3540 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $134.40 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 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. A NTION: Orego law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 010 through OAR 952=00 You may obtain a copy of the rules or direct questions to OUNC by calling • •. • •.6699 or 1.800.332.2344. Issue y: A 4 0 16 - - 4 41 T Permittee Signature: TL i 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 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. — r 1\ Electrical Permit Appl ; ; +- p , !-,!•-, ,--4 Fo>i oFFi i• :1 si•: ONLA tr City of Tigard `� 7 q o9 4- PermitNo.: !Le_O` O O i 13125 SW Hall Blvd., Tigard, OR 97 3E P 0 4 2009 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Date/ay: Other Permit: i : \ {; , , Inspection Line: 501639.4175 T /� C f � /1 P1i iii r7 t°� Gate ReaayReady/By: y. ! . 53 See Page 2 for Internet: www.tigard -or.gov C� I i �/ L) t �V Notified/Method: "' `G ' Supplemental Information i1I r• II' n "a h%1t 1 '� V C �+ r { t 7 C a [ } 1t ( ' .x. ...c .,-,...:.,11.T.::, .. 4 R ( 1G r n . II. r �0 1 {` f{ { , h r ! ` C S i �. y. ' y J , � . p , t " 1 :1',;,‘ r r } i f' � t r } k � .r { } a , t ... :.... ; .. „..s ,t,ti #, : \.,..>.......... .. . .. . ,...*..-..c.,• � l r, \ s , i `. :•,!,.:,-,E_ t. a .a + .,. :1 ..- . i itc^ t 1 •' t ai ' . .._: , ... m ' i r- li .. {I L_ . :..cG- ❑ New construction CI Addition/alteration/replacement ebeok a ll that sooty (submit 2 sets of plans wTi eras checked below): ❑ Service or feeder 400 amps or more ❑ Building ow three stories. ,.Demolition FrOther where the available fault current ❑ Marinas and boatyards. j f f { # ' s# ' rt } ^� , exceeds 10.000 amps at 130 volts or ❑ lloating buildings. 1'li. +i, + r �. . : ;.iii, i 7. '..‘/1,:.:7[': ._,..•d.?`a. ✓._.1 {,(,,. a y.r i _. _....s. . _... ... , , ._._........_...... •� .... � >:... • loss to Bound, or exceeds 14.000 ❑ Commercial -use agricalooai ❑ 1 - and 2- family dwelling s mmercial/industriai ❑ Accessory building t» for all other installations. b 11.1Mgs ❑ Multi family ❑ Master builder ❑ Other: ❑ Tiro pump. ❑ Imaallanon of 7S KVA or larger separately derived system. t a ❑ Fmngeaoy systems, m i f t f J i.1. t._.; .+:'.::.!`''i r i „ rt (1..:u}. L l ., •+. i / ' w + i x : i ❑Addition Of sow motor coed of ❑ A 1 0 ) . "1 - , 13 3 Job site address: (0 (t�O �LO 6 ' ' s oop or more. R Job no.: aeon �/- Y ❑Six or more residential twits. ❑ ttccrrcational vehicle parks. City /State/ZIP: 7 r, l / � 1 (� r ' . � �? ❑ Healdt� are facilities. ❑Supply voltage for more than `� V ❑ Hazardous bettors 600 volts nominal Suite/bldgJapt. no.: Project name: C. i ,r c; ❑ Service or feeder 600 amps or more vA `” G J { i a t " t" } ,t • I t ; .: a: Cross street/directions ctions to job site: . ''_� u •. -- 1 2� . _. .w_ .. ,( Y ,.... W . iv,<. � p i I 1 (�� New residential single- or multi- family dwelling unit. Hi tt) 9 r Includes attached garage. Subdivision: Lot no.: 1.000 s'l ft or leas 145.15 4 Ea. add'I 500 sq. ft or portion 33.40 1 Tax map/parcel no Limited energy, residential ' .�i,. : 1 ' ' .Ha + (' Jr.,: t.. k': ',.;(,''''...'',1',' ' f a 6Q ft) 2 . !,. ..i : .. 1.. }1:.: .. a.. :. . .. . ...n... . .. • , ,i ..4._;w_ ..,...� .. ,.....%...... . i Cwith bove l r Limited energy, multi- family i 75,00 2 cX Q , O 5ek 12 P_>Ci t7 v C (' cuk.t1T Y� v PJ C residential (with above sa. R.) s. i Services or feeders installation, alteration, and/or relocation r L _, �e 0 , 200 amps Ps or less 80,30 2 • } I / i� , ., E S ," e j " i 201 amps to 400 amps 10655 2 401 amps to 600 amPs 160.60 2 Name: likwA ' S I MT 1 ian � P t ` -r il r--. 601 amps to .000 amps 240.60 2 Address: i t o A,) 7 �7 4—' Over 1,000 amps or volts 454,65 2 City /StateIZIP: (5V-0 (_ ! , y O '7 '7 2n Temporary servic or feeders installation, alteration, and/or 8 �(. U ! �,/ relocation Phone 5'17. L iC (Q Fax: ( ) 200 amps or less 66.S5 1 Owaef' installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 100.30 2 intended for salt, 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, r panel Owner signature Date: A. Fee for branch circuits with K 1 ,o h r ,, ", , > 1 ,. , above service or feeder fee, . 6, 65 2 1 .iL.{.u.t__ . _. 11,. .i . , _ .... +..v{ . ....._. l \� _ . ,. .:i .. . .......... „n , . : 1 ..... t: _1 ....;... 7.1 — .t.. .,., Th rte. P! ! , E .0 l \ t ... C Fee branch circuits ran circuit --- Business dame: V � G . k, B. Fee for b Contact name: , ' without service or feedcr fcc, t 46,85 4 6$C 2 To VIA V) 0 0 (, V. f 0 {■ 'H/N. first branch circuit Address: Each addl branch circuit 6.65 2 � L - �• a • Miscellaneous (service or feeder not included City /S _ • t' • .„ Each manufactured or modular 90.90 2 - dwelling, service and/or feeder ' hone: (5 3) • • , S Fax: : ( 9 ) - . - • Reconnect only 66.85 2 t � Pump or irrigation circle 53.40 2 �� a rah ���r11 4. �171ik1 � ra r,e i6f /iii n p � I1 ,� h r ' r 1_ i ' t° ', ' - l , i S I o r o nt h neh 53.40 2 ( #u + J ,.J:. `�_ �: }, ,L _'�F , �: "�.. .. 1 s .. 1 .. -: (.. .:. .. ,... : . _ /.�.,......� Cd' { Li,t:. f,W['`4 r.. : : ;i ( .; � ghtrig i' /� 1 n � w Signal p al or alteration, or Business Hama �,! y� d -� - energy panel, alteration, or Address: (s • r ie l extension. Describe: Page 2 2 ._ ,i ..I City /State/ZIP: Each additional inspection over allowable in an of the above ���'� i © r Per inspection 62.50 Phone: (50 1 _5 •-iikr Fax: ( ) Investigation per hour (1 hr min) 62.50 CCB Lic.: / Electrical Lic_: 7 q 9 c Suprv. Lic.: ?13 5 Industrial plant per hour 73 75 / f { . v It i s ", ��� �.. "ir { .A, -''�ii 1 1 t i 1 l :. + ,�, { { } . , �.. i i Ht :` . ;i._ tK l,...._a ( ...tat. a4 .. ,.... v Suprv. Electrician signature, required: Z � 4_ /„L Subtotal �( .fi r i/'�� �� Plan review (25% of permit foe): 110 Print name: , . 1 . _ . e A c k. Date: 09 _ O4_ V� State surcharge (12% of permit fix): W� ;1 "r Authorized signature: TOTAL PERMIT FEE: I — Print name: Date: days permit application expires if a permit is not obtained within 180 4D days after it has been accepted as complete. i( f 414 • Numbs( of inspections allowed per permit. f 1 L' 1&ojding1PeimizeeLC- Pemtt*App.doc 05mro5 +0 145151 \ Z0 /Z0 39tid HINOM000M NHOf 909tL59E05 00 :170 800Z/0E/90