Permit 1 C CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2009 -00019
° COMMUNITY DEVELOPMENT DATE ISSUED: 1/14/2009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S102BD -02600
SITE ADDRESS: 12977 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: NORTH TIGARDVILLE ADDITION LOT : 037 JURISDICTION: TIG
PROJECT: CRICKET WIRELESS
Project Description: (1) sign lighting.
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: 1
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: 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:
KIM PENNEY HIGHLIGHT SIGN CORP
395 NW SILVERADO DR PO BOX 230428
BEAVERTON, OR 97006 PORTLAND, OR 97281
Phone: Contact #: PRI 503 - 729 -7978
FAX 971 - 228 -2455
FEES
Description Date Amount Reg #: ELE 517S1G
[ELPRMT] ELC Permit 1/14/2009 $53.40 LIC 104599
[TAX] 12% State Surchar 1/14/2009 $6.41
Total $59.81 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for
more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 -• ; -6 • • •ugh OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.2 or 1.800.3 .2344.
Issued y: tO I Permittee Si nature: (
y /
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent. •
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Electrical Permit ApplicationRECEIVED FC)I2 OI FIC:t: USE ONLY
City of Tigard Received
13125 SW 17811 Blvd., Ti gard, OR 97223 JAN 13 2009 »at J Permit No.: L • , � G ���
' �
Phone: 501639.4171 F
+ ax: 503.598. Plan Review ` � • 44111 1
Inspection Line: 503.639.4175 D EFT OF TIGARD Dam Ready/By: Other Permit: yy
J
T 1 r /, It " p B UILDING DIVISION S see Page 2 Internet: : www,tigard�r.gov Notified/Merhod Suppkmet nformation
Internet:
- a �'... a; r� Y . I ,. , V'•:t7 :,s, "I�,h�r.� �;°�� 7i; . „ • c �h7V'r"`,' , \ ti i ,' ; � n { "�'�' .a ;e,. nq,., / r�, ; . �:,, ,y, ., �„ _
sl .'�., ]<'E,Ca saa.fA✓t.a�5. o a P ri '! G '•, f f f }fU� .aE •t"r 4'r`T °' ',^£i "' h �:; "� 7: +'' :`•r%'�\• u•`=':at»i 7jr^ n\ E ^, ^'^ E ar x.
����� " '�$rA•,:4n���3/��.,� „ �, Z 7��Y` ?; r; 4tti.: . �k• ��± ro' 4 nEw�1• iz�. i�r; YAw��•,,;' uad" u, �. 1. 4-, �r,. ��'' d�1���Z �IA 's�,'ciSS�S�11�.�.�.^f.;itF�r�A
❑ New construction ❑ 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: SI
;;',:d:FC4 ,F % , fir 1 ✓A °2` s ,� r = Y a�' ' �r where the available fault current ❑ Marinas and boatyards.
;
". .7;• i.'/,�sia �.r� ;} , N .>.rtrg /)a•,•, 1 -. .s.ra , ; . G a n l " , , a „ v; i exceeds 10 ,000 amps at 150 volts or 1] Floating buildin apicultu,at
❑ 1- and 2-family dwelling I'u Commercial/industrial less to ground or exceeds 4,000 ❑ Co l use
❑ Accessory building amps for all other installations. • buildings.
❑ Multi family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 kVA or
` rt ; r " %1 ;� i "^ ri ;, V: a' l s ,. P y �' ,° r ;i f 5 d } a rh4i, � + , s'/ ^r.�. ['Emergency system. larger separately derived system.
r.:.. ' Af 1 •.6. r ele ly a1 '7ETSilS a .M7a�b r Ll$� � ..� n 1 .f. : r f, + "+k' ` ' _ /t el ju J° � ca'�•l�t ❑ Addition of new motor load of ❑ .•A• "E "I-2 "...1 -3"
Job no.: 12. 41 ° if $ w " 1 00HP or mom, ode
Job site address:
,//�� t om., upaney,
wad. • ► "`� ❑ Six or more residendal units. ❑ Recreational vehicle pants.
City /State /Z1P; , 1 A J b ,, ❑ Heahh-care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
. Suite/bldg. /apt. no.- Project name: ' - 14 � '°�' p Service or feeder 600 amps or more.
•
Cross strcet/directions to job i 4 it ° a ^ y'' Ra j r�t ;' , t
b s te: v` , .,.
o6on + Ozy. Fee. Total •
New residential single- or multi- family dwelling unit.
Includes attached garage. •
Subdivision: Lot no.: 1.000 sq. R or less 145.15 4
Tax map /parcel no.: Ea. sal 500 sq. ft or portion 33.40 1
.. /A %yy:, �, 5 ," P r, � ,ms �, y;r;'Tyryvu1.... u r Limited energy, residential
u 7 a t ,., at p'?yc k�ql rr� gya�r1 �ay�wsz 75.00 2
m:'hIr . ii '� ii- FAtiriidu cn1r ,, rstr'V�„rkyy.. )r�,1�Z �r. rl-Se'�1', , .�ri,k°.d4'Ma, .' •rh:. (withabov
oat �J , Limited energy. multi- family
i QJ..Y , , ' . , , a , r ` residential (with above an. R.) relocation
75.00 2
�y 9 ', Services or feeders installation, alteration, and/or
_ . _ . t S te • 200 2
�, amps or less 80.30
-�1 �j p� � � �sr:. •. -ae�, °';fir
S:l� .k."" t r. , Cni L ' 1 • :1 rM1 y; !:y'a - S , i ';r� U, /, . U n • A' / G7 •'
a.,: A ¢ a ny
..... :.:.i� r , r , '. ,lh,'Y �1:(.. F: %b% _ +Ir � t 1n1 atf!•!'��.9�?i•;,ii� ��rJ v, i' � .':+`�6rH5Y�'F;l����yaruspl,�`b 201 amps s to 400 amps 106.85 2
Name: if-t 1._( / e t,)0 2 401 amps to 600 amps 160.60 2
� ' .. 1 601 amps to 1,000 amps 240.60 2
Address: N ,_ n
L-�' �Ae -�T� �2 • Over 1.000 amps or volts 454.65 2
City /State /ZIP t4 J • Q. rot∎ Ole- 9 7G) , Temporary services or feeders installation, alteration, and/ar
relocation
• Phone: ( ) Fax: ( ) 200 amps or less 1 I 606.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps I 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, , r panel
r .p �� A- Fee for branch circuits with
'iJ'id.,c ...a:.r, r S y ks, ° ) • r, 'r�...P•��''r``2 �I�t( f•l'i K am„ ,{ above service or f
a '' 1• n t h lrcJ 3 ,1d 'm '' , . 5 t c' ' ,W . " ?' ' 8rl feeder fee, 6.65 2
EMMill each branch circuit
-....*' (OK + CZ; P. B. Fee for branch circuits
Contact name: without service or feeder fee, 46.$5 2
�� first branch circuit
Address: PC Sty 2,76.61. Each add'l branch circuit 6.65 2
City/State/ZIP; 1-'1 l� �1 6 2%' Each Miscellaneous
or modulal not Included)
Phont: ( dwelling. service and/or fbeder 90.90 2
dr D ) � . $ Jr Fax:: ( ) Reconnect 1
j ` ` Pump Or i only 66.85 2
E -mail: ik
1. � � �" • e y .iii Pump or irrigation circle 53. 2
u:yx,:.i.�•r �'g 'iU .xt: q j v ¢,;^� f a• �q..
, , s'xv:S f'.0 e, ;` Zi',. /.7t14. ��„ itia r , Si or outline lighting 53.40 40 •40 2
Business name: "� Signal circuit(s) or limited-
energy panel, alteration, or \,,,,
Address: . extension. Describe ;. s ; • Page 2 2
City/State/ZIP: - Each additional inspection over allowable in any of the above
•
Phone: ( ) Per inspection 62.50
Fax: ( ) Investigation per hour (I hr mm
r q -• El p � ) 62.50
CCB Lie.: l b (. Electrical Lic.: ( Suprv. Lic.: t • f. t. 1 Industrial plant erh
,� P P cur 73.75
Suprv. Electrician h; 1 �= 5 +�'3u?ta�i a T :��ix> :.; s r � c � „' . r1 • ( 7
P s required: ot a `66'61 6 � '7 . '' .
Subtotal: / 3. �/Q
Print name; �+l i Atz` D am: j ,V t � y D ^i - _
w Plan review (25% of permit fee): , .$-
: /% IV.Arj y
i State surcharge (12% of permit fee): b. r f
Authorized signature
Lam TOTAL PERMIT FEE: 59 , 8
Print name: r T his permit application expires If it permit is not obtained within I80
days after it has been accepted as complete.
e: lauilCin glPermit6lEl.C- PermrtApp.eoc (15/2.3/06 ' Number or inspections allowed per permit.
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/
3 ��/ t (t.,64_ NSIS 1HDI1HDIH SZL EtZ9E05 EE :ET 600Z/ET/TO
. . . . .. ,
CITY '
p TIGARD
BUIL - G DIVISION PERMIT #: FL.C2009.000.19
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/3/2009
Phone: (503) 639-4171
,
Inspection Requests (24 Hrs.): (503) 639-4175 At
INSPECTION WORKSHEET FOR DATE: 2/5/2009 TIME: 7:OOAM PAGE: 13
SITE ADDRESS: 11746 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: DUTCH BROTHERS COFFEE LOT #: TYPE OF USE:
PROJECT NAME: DUTCH BROS. COFFEE
DESCRIPTION: Installation of temporary service for construction of new drive-thru coffee stand.
OWNER: GRUNBALIM FAMILY TRUST, PHONE #:
CONTRACTOR: AC & E ELECTRIC CO PHONE #: 503-363-2301 •
Inspection Request Scheduled For: Date: 2/5/2009 Pour Time:
Code # Inspection Description Confirm4 Contact # Message
--_,
110 "Tel 5. t ^ ! .51 .. 1 080316-01 503-480-4799 N
(ill 9 - '1 nho■L e irt k■ clek ;
Corrections/Comments/Instruc ions:
, ■
( 4>\/ v
15I(PASS 0 PARTIAL APPROVAL n CANCEL H NO ACCESS
0 FAIL 0 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: G" -- I 1\1 o 6 t_.. Date: 2 - '5 Phone #: (503) 718- 2-4144
CITY F TIGARD
BUIL G PERMIT #: EL C2009-00048
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/3/2009
Phone: (503) 639 -4171 itii"
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2M/2009 TIME: 7 :OOAM PAGE: 12
SITE ADDRESS: 11745 SW PACIFIC HVVY CLASS OF WORK:
SUBDIVISION: DUTCH BROTHERS COFFEE LOT #: TYPE OF USE:
PROJECT NAME: DUTCH BROS. COFFEE
DESCRIPTION: Installation of temporary service for construction of new curve -thrtr coffee stand.
OWNER: GIRUNBAUM FAMILY TRUST, PHONE #:
CONTRACTOR: AC & E ELECTRIC CO PHONE #: 503 :153 -2301
Inspection Request Scheduled For: Date: 2/4/2009 Pour Time:
/
Code # Inspection Description infirm # Contact # Message
110 Temporary electrical service 000271.01 5034480 -4709 N
Corrections /Comments /Instructions:
c PcoN ► wo (., 2) c- - s . NC . 2SO .
P i
I
I
I
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL \CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
I
Inspector: V ()2 Date: V I A ' I Phone #: (503) 718- 2O