Permit ® ELECTRICAL PERMIT
q CITY OF TIGARD
PERMIT #: E /17/20 - 00591
COMMUNITY DEVELOPMENT
i DATE ISSUED: 10/17/2008
TiG■RD, 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135BC -00201
SITE ADDRESS: 10765 SW GREENBURG RD ZONING: C - G
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: 7
Project Description: (5) branch circuits for hot food equipment. Job No. S20834 - 2820
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: SIGNAL/PANEL:
MANF HMI SVCI 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: 4 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:
BELANICH, ROGER M CHERRY CITY ELECTRIC
BY SOUTHLAND CORP 1596 22ND ST SE
PO BOX 711 SALEM, OR 97302
DALLAS, TX 75221
Phone: Contact #: PRI 503 - 566 -5600
FAX 503 - 540 -8147
FEES
Description Date Amount Reg #: ELE 37 -620C
(ELPRMTI ELC Permit 10/17/2001 $73.45 LIC 91668
[TAX] 12% State Surchar 10/17/2001 $8.81 SUP 2781S
Total $82.26 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 1 =:.ays. ENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 95 .01 -0010 throug OAR 952 - 001 -0100. You may obtain copies of these rules or direct ques •• o 0 NC at 503.246.6699 or 1.80-.332.2344.
By: (Permi Si _ ,- Issue, B Sig ature: I.� � ,,iii
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: r ��%�r <!/ 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.
May 06 08 01:52a Cherry City Electric Rese p.2
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Electrical Permit Applica t' o41 3 1... C
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` ywti j{ i CI of Tigard t . i pe ravt I'1 �����/ CAL /3/
g _OCT 1 20'33 / 1 7 Ti � /
II `` 13125 SW Ball Blvd., Tigard, OR 9722) Plan Rrt ten
i 2 Phone: 503.639.4171 Fax: 503.5 I ARC P alr 2r d.9her Penal
f Inspection Line: 503.639 - 4F/2 ®I° Date heade B, tr u El See P e 2 for
IGARD, gIIILDING DIVISION
ter AFf: +, Internet: www.iiprd ar -gov Notified/Method: F Supplemental Information
I
t
' TYPE • OF WORK • PLAN REVlEA \'
❑ New construction Addition /alteration/replacetnent ! Please check an that apply (submit 2 sets of plans wlitemc checked below):
D i
emolition ❑ Sevtce or feeder 400 amps or more ❑ Building aver three starie
❑ 011tef where the available fault current
❑ 1vSnr nas and boatyards.
CATEGORY OF CONSTRUCTION I exceeds 10.000 amps at 150 volts or ❑ Floal buildings.
171 y t� ❑ Acce tso bttildin I le=tog-ound, or eae ds 14,000 ❑ Commercial-use amieutnval
1- and 2 -famil dwellit Commercial/indu stria! r g amps for all other ieslailatons. buildings.
❑ Multi - family Master builder ❑ Other: ❑Fire pump ❑ Installation of 75 KVA or
❑ Emergency system ! r_er separately derived system
JOB SITE INEORALiTION AND LOCATIOty
['Addition ar new motor load cC ❑ "A" °E" ; -�" - 1 -3 ",
70b 11°- . / ` SItC addrESS: IL 1001 -IP or more_ occupancy ,
: . �t`1 1 e 1'7� Q'r, ❑Sin or more resiticntial units. ❑ Recreational vehicle parks. 1
cily/slalP/Z1P 1 1- v 4 ❑ Health -care facilities. ❑ Supply volta,<,�c 0 more than i
y rte. �' ] �—
� ❑ Hazardous locations. 600 volts seminal. l
Suite/bldg. /apt no.: :J Project name: r — 4 \ J ❑ Service a: feeder 600 amps or MOM
FEE SCHEDULE Lr
Cross street/directions to job site: nes trra : I oi+. l Fes. 1 r.,rat I
New residential single- or multi- family dwelling writ
Inetudnaattached garage.
Subdivision: 1 Lot no.: 1,000 sq. ft or less 145.15 4
Tax run ] no. E add'S 500 sq. 4. or ptatiou 33.40
p r ^ Limited energy, residential
75.00 2
DESCRIPTION OF WORK (web ab. s e sq 6 >
I 1 (. Limit energ multi -famil 75.00 2
t \ za tQ—`� - 1 .i 1P f Li.)+ 1�' � �( T \t ,[t�� residential ;with abo a sq ti 1
�rr Services or feeders insta IJation.alleratiou and/or relocation
.-4' 0 L ; tom. { _ �-- --- --
200 ara}n or less 80.30 2
PROPERTY OWNER I :❑ TENANT 201 amps to 400 amps 106.85 2
Name. 401 amps to 600 amps 160.64 2
601 amps to 1.000 amps 240.60 2
Address: Over 1,000 amps or volts I 454.651 12
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax_ ( ) 200 amps or less 66.85 1
Owner installation: This irslallntion is being made on pro ty per that I own uhich is not 201 ads to 400 amps I 00.30 2
intended for sale. lease. real. or exchange. according to ORS 447. 449. 670. and 701. 401 amps to 599 amps (33.75 2
Branch circuits — new. alteration. or extension. per panel
(.honer si _na ture: Date:
A. Fee t:x branch eueuns u•Ira
❑ APPLC :vVT 1 ❑ CONTACT PERSON above service or feeder fee,
ch branch circuit 6.65 2
Business i ame: • ri
B. Fee for branch circuits
I without service or feeder fee.
Contact name: fir., - branch circuit 46.85 .L.-1 2
l-
Address:
Each add't branch circuit .C} 6.65 ;',„S,4, . (j 2
A llan listee•r is (sersicr or feeder not
City /State/ZIP: Each manufactured or modular
dwelling. service and/or feeder 90.90 2
er
Phone: ( ) Fax: : ( ) Reconnect only 66.55 2
-- — -
E Pump or irrigation cinJe 53-40 2
• CONTRACTOR Sign or outline lighting; _ _ 53.40 2
-- ‘1 --- C energy Signal circuit(s) or limited
F3ilSlI3C5S name: C. , 1 ^., '1 ' f Q t k Panel, alteration. or
Address: exttcnsion. Describe: Page 2 2
City /State'ZW: 7- P q C �C 1 y) ) 2 rc0 Each additional inspection over Alton-able in any of the above
� _ 'J `' _ Per inspection 62.50
Phone: (5 JLC( �� , l)'" FaX (5 , ) 1, J Lf J investiption per hour (1 hr rain) 62 -50
CCR T.,ic_ L I LU Electrical Lic.: l j� �' t mg ,Suprv. Lic. : lc i nutria[ plant 73.75
C` JLL'CCICIC.hL PE RMIT FEES
Suprv. Electrician signature, required , } '� � . ' 0 e /1 J 1( - Subtotal: 9 :43
uG J Plan review (25% of permit inc):
Print name: a Dale: l / r s
i ` +�v I � l l-.' ';I State surcharge (12% of permit. fee): ( A , k
Authorized signature: TOTAL PERMIT FEE
This perm application expires applicatio expires Ir a permit Is not In d w 180
Print name: Date: days alter it has been accepted as complete.
------ -- - 4 Number or irsppcumis allowed per permit. A4 ,
I' t8niliiaStFermia \Fl- C- P�rrtitApF.doe 11723!06 44;1 - 461 ntI L'05/CO.wttEe Gl a •
CITY OF TIGARD ,4 -..ti
BUILDING DIVISION PERMIT #: FL 02008.00591
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 10//712008
Phone: (503) 639 -4171 - �9jMl�t>IIA
Inspection Requests (24 Hrs.): (503) 639 -4175 ±i
INSPECTION WORKSHEET FOR DATE: 1/7/2009 TIME: 7 :0.1Am PAGE: 34
SITE ADDRESS: 10755 SW GRFENBURG RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: 71 1
DESCRIPTION: (+,;,') branch circuits for hot food equipment. Job No. 520834 - 2620
OWNER: f3ELANIICH ROGER M, PHONE #:
CONTRACTOR: CHERRY CITY ELECTRIC PHONE #: 503..566 - 5500
Inspection Request Scheduled For: Date: 1/7/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
1 99 EIect.ricii final 078441 -02 503 551 - 0337 \ Y
-
Corrections /Comments /Instructions:
r �
N\
:1
(VA/ \ •
w // \l
V \
IA PASS n PARTIAL APPROVAL n CANCEL n NO ACCESS
FAIL _ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: ` e v'v LE Date: t f ' q Phone #: (503) 718- 1141-&
'\ - .
CITY OF TIGARD ," . ,. ; .k. : "
BUILDING DIVISION PERMIT #: ELC200St10591
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 10f1//20013
Phone: (503) 639 -4171 /ONO I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 12/18/2008 TIME: 7 : 01AM PAGE: 8
SITE ADDRESS: 10705 SW GREENBURG RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: * ' -11
DESCRIPTION: ( branch circuits for hot food equipment. Job No. 520834 -2820
OWNER: BFLANICH, ROGER M, PHONE #:
CONTRACTOR: CHERRY CITY ELECTRIC PHONE #: 503- 556 -5600
Inspection Request Scheduled For: Date: 12/18/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 079110 -01 503 -551 -0337 N
Co rections Comments /Instructions:
0 O 4-r e Liq) 141 e-14 )1- - o oPe sz_r
c
n 4-i- sacv /GL
0 PGc -e y s Cmc 4 /e f e.ek—es)
1101- ,C A e v "2cL_ ce,P r^e? tl it •cL
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
IL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Il Date: /2 / a -cP Phone #: (503) 718-