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Permit ELECTRICAL PERMIT CITY OF TIGARD COMMUNITY DEVELOPMENT Permit #: ELC20.10 -00345 TICrARh 13125 SW Hall Blvd., Tigard.OR 97223 503.639.4171 Date Issued: 07/08/2010 Parcel: 1S136DC04500 Jurisdiction: Tigard Site address: 7501 SW DARTMOUTH ST 100 Subdivision: Lot: 0 Project: Winco Project Description: Cheese island remodel. • Owner: FEES WINCO FOOD, LLC Quantity Description Date Amount ATTN: SUSAN BUSCHE, PO BOX 5756 BOISE, ID 83705 10 crt Branch Circuits 07/08/2010 $122.96 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 07/08/2010 $14.76 Electrical Contractor: NORTHSIDE ELECTRIC PO BOX 12323 SALEM, OR 97309 PHONE: 503 - 585 -4879 FAX: 503 - 364 -0248 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $137.72 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. ma obtain a cop of tie rules or direct questions to OUNC by calling' 503.246.6699 or 1.800.332.2344. Issued By: 0 _ Permittee Signature: I1111■_ ... 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. • JUL /07 /200;9 /TUE 03:21 PM NORTHSIDE ELECTRIC FAX No, 503-364-0248 P. 001 • • . liiiiirP :E+ leetrlcai Permit Application u e da is - " � i : l t •o r U1+FICE USE O V '' , ' Ll�r 0{ leitl C I ��1� Pe sr F 1 g C ' ' 1 ! R VIW ' r nntNo:: ?C 13125 SW Hall lvdTi ard, OR 97223 -. � ° Phone; 503.639.4171 Fnx; 503:598:1960 `r Oth er P enn it : I TI.GAKE� . Inspection Line; 503.639,4175 JUL pare Read Q See F' age t for r �`. Iniernet www.tigard -orgov JUL o Notr f ed/lvietbod', matlon p 7 7 2010 Y wr Su�ppie menYnl lnfor . ' ,2fr 1101' fi's4 JZ �1 ' T , ,fi t r � r YWl a�M 1f# !1 � ,- '` t � f�N # w ^� ,� G�. � �t'mix w�� +a ^b t�r�4rrRyaa17 � . u� x 7 , a 4� ❑ New` construction dditiOn /alteration /ropiacement Please check Ali that apply (submit j sets of plans w /items cbecked below): .t , i s b Building .over s. three'stori e r hion _.. - © :Qt(ter _, - ... - . uoi�vt allt�..l3IVISIQ�� .' ,.. ❑ Ceereth avalable p lbuit tr • uMnt 1 or more Maritias boatyards. _ ❑ lac rnO 'F '; '. .... : ' e ' at 47 179$ , % . ' ,,'C,+ c ,•.,m rv r.Eh`11i 6StX1E-n a xSli_'! ? ' �;;�aage VP; . _ :7 -0 R4f )e pat ,,,b p yolts :a -, s ..1K 3 0 e40.%it ' 4.'"' C1 '' r .y - - - esd'tia U ri ;'or eite 000. :' omineic,al-lise abiticllltlnal 1 ❑ 1- and 2- family,dwel.ling 11.1 Commercial/industrial ❑ Accessory building amps for all other installations. buildings, 0 Multi- family ❑ Master.builder ❑ Other: 0 Fire pump. ❑ Installation of 75 KVA or ki N r ` • / w g t t CI Emergency system. larger separately derived system. m : t d! S T g. ii g a 11IWO " ALlD It 6Stiub ✓f t h A;1 5 +s t l n:Itc xik,M;:t ;; _ ,e i ,,i -, .s7Y.a,. aNsw�.,w__ ,n -_- Atf +h ' :l �e a : ^ lii ❑ Addit ionoP new motor load of ❑ A'; "B" f -2" "1 -3 " J no :` (_ Job site address: \ k)) r i ree ttl0i or more. occupancy. Siz or more residential units, ❑ Recreabonatvehicle parks. • City /Stall /ZIP: ` / ID Health-care i Sup voltage for znorethan , l -, r C , 1 1 r. 0 Service or feeder 600 600 volts nominal ----- V ,•'(, amps more, Suite /bldg. /apt. no : Pro�cct name: a m �y�,p ocecrin(oe f? ....s. FIE; SCEIEDei Er f, „ � rCGi f r , lnw� FP,. . . Cross street/directions to job site: . . • - Qty. ' f Q y I tee j 'Nall 1 — - - -- New residential single, - - or multi- (amilydwclliYig unit. • Includes attached garage. Subdivision: Lot na:: 1;000 stl. 61;.or less - 168,54 4 • Tax ntap /parcel no:: Ea, add'I 500 sq. ft, or portion 33.92 1 • r+.: ve{ .� 5 .?' +�. s + ^. L � r+ r, z: „ �,Fbw v+ Litnited energy, residential 67.84 2 fa,, , < S uaW-1- Gt ,6;; .' ,siNi ;;& i y '� `- � Y (with ;above sq. ft,) . . 6" . • . ', \_.(2s41,,Q.:_, Limited energy, multi family 67 84 2 l ' �� � f� t r_c residential (with above sq. ft.) •� Servlces feeders installation alteration, Anil /Or relocation " ` M r gifig Tiifi . iNfi 2ti ?1,�.a Sd""!ilN'?: q & -n:k. ' 1 ' ` ; ` ' ' ' '' W ` ; ` ' ' ' '' W 20 am t s - 133:56 o ,. o 400 am 2 ,.•P ,• ; ,sue p P 401 amps to 600 amps • 200.34 2 Name: aD\ — - 601 amps.to 1,000 amps 301.04 2 Address: Over 1,000 amps or v_o 552.26 4 • Temporary services or feeders installation, alteration,. and /or - „ity / State / ZIP: . • - 'relocation Phone: ( • ) . ' . Fax ( - ) 200 amps ,or less Y 59.36 I Owner installation; This installatioo is being made on,property that I own which is not 201 amps 1 400 amps 125.08 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449; 670, and 701. 401 amps =t 599 amps 168.54 2 Branch circuits — new, alteration, or extension, per panel' Owner signature: • - - Date: , • A. Fee for branch circuits with SW"�, ,1!1 t 1 : ai 1st l ,lr t yOI ,[c t "' • ` i x , y G ` ' above.servicc or feeder fee, , , ' , 6 n FFnx . ., .. , . ?r.. �'E i7.S' i 4.. *" ,,, 9 .^..i?. �U� i4 , , ` ' - - — ' '' �" - -"'1 7,42 2 each branch circuit • Business name: _ — B . Fee for branch Circuits Contact name: - wtthout'service or feeder fee, . 56.18 2 • firs branch circuit Address: Each add'I branch circuit . CI 7,42 l(12(0, 2 . Miscellaneous service or feeder not included City /State/ZIP: Each rrtanufacturcd or modular _ T_ -- �'^" dwelling, service and /or feeder 67`84 2 Phone: ( ) Fax :: ( ) Reconnect only 67:84 ' 2. -mail: : - Pump or irrigation circle 67F84 2 :. OR t , 1 : i r t , }y v(s4r �r,�m , Sin or outline.li lighting 67.84 2 ,f k GCyN�'F1��.II' t ,,,... ,. t ,>�,. ,r.. „�, :w.» •,,,1 �. t g g g Signal circuits) or limited Business nude'. rl1 energy panel, alteration, or . Address extension. Describe: • Page 2 2 • City/State/ZIP: 1~ach additional ins p cction over allowable in any • of the above y "° '' , ) � Per inspection 66.25 -- Phones ,). x .. — Fax'. �c/ J �} -{ + - J — — - 1nve5tigati0n per hour (1 Itr -- - -. '�. .25 —.— � r �� ` min) 6 • COB Lic.: Electrical Lic.: ,1 Suprv. Lic.: 2 l S Industrial plant per hour 78.18 ..h.,. ":, 4GTCAPFTt(1C.11E$;;c?h Suprv_ Elaotriciaasignature, required: Subtotal: _11-g3 Q ( ` l Plan review (25% of permit fee): ,'rint name: .Q a, , ` ("lp; eri Date: State swchar c 12 %of permit gc p ) 1 Authorized signatur - 1 At? . i � ,�I� � "mss __.___ . TOTAL PERMIT FEE: (S-1 t • 1B Print name: 0 Date: This permit application expires if a permit is not obtained within 180 • days after it has been accepted as complete. ' Number of inspections allowed per permit. L\3uildinglpermitsTIS -Pero I A.pp•doe 1 O/01 /09 - 440.4615T(1 1 /05 /COM/wg$ , —Ivv\�5 L. VAu tS