Permit i t.
. CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2009 -00064
° ` COMMUNITY DEVELOPMENT
D ATE ISSUED: 2/18/2009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135DD
SITE ADDRESS: 11945 SW PACIFIC HWY 208 ZONING: C -
SUBDIVISION: TIGARD PLAZA LOT : 002 JURISDICTION: TIG
PROJECT: DOLLAR TREE ,
Project Description: Install (7) branch circuits for new refrigerator cases. Job 20 -667.
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 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: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 6 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:
TIGARD PROPERTIES INC ACCURATE ELECTRIC
2106 SE OCHOCO ST P.O. BOX 873425
MILWAUKIE, OR 97222 VANCOUVER, WA 98687
Phone: Contact #: PRI 360 -944 -7001
FAX 360 -944 -7013
FEES
Description Date Amount Reg #: ELE 37 -1029C
[ELPRMT] ELC Permit 2/18/2009 $86.75 LIC 158875
[TAX] 12% State Surchar 2/18/2009 $10.41 SUP. 5094S
Total $97.16 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 l ESL Permittee Signature: ) A3elp 1 tQak- ton
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.
•
•- .DEB -18 -2009 09:38 Accurate Electric, 3609947013 P.001
a. aca:u la:aa r CI UUlilL Li I)11.II1%:21LIUlt1
City of Tigard R E C �� Y DatelB g. c''''''' 6.6' ie .c x 1
v 13125 SW Hall Blvd., Tigard, OR 97223 • ' Plen Revie� - l
C Phone: 503.639.4171 Fax: 503.598.1960 FEB 18 2009 Date/By: Other Permit: e zzo c R •Q eyclai
T I G n RID Inspection Line: 503.639.4175 Date Ready /By: kris; RI See Page 2 for
Internet: www.tigard or.gov RE Notified/Method: 12 Supplemental Information
'.:T'Yl'E�OF WO -
-
: -F
❑ New construction Addition/alteratio cement Please check all that apply (submit 1 sets of plans w /items checked below):
['Service or feeder 400 amps or more ❑ Building over three stories.
ID Demolition El Other.
where the available fault current ❑ Marinas and boatyards.
': 'ar ': 3.=; ; : CATi " Ry, ;: < exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
.r
� g'r�j �
.;.,,..::. ..n.,, : �QR . O CON UCfiIOPt;
; '` ; d exceeds 14,000 less to ground, or exec s 13 Commercial agricultural
❑ 1 - and 2- family dwelling XI Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other ['Fire pump. ❑ Installation of 75 KVA or
' ;'.. , .. ~ .. ' „::.. Q ) APfD•`.I: . : �."__� ... � 1:1 Eme system. larger separately derived system
.... . , ... T • ❑Addition of new motor
.:,.,•., . : .
r t
Job no.: 2 "`"'t �I Job site address:, t ��l.�V ` W � . 1.Fi�i I,, 100HPormore. occupancy.
❑ Six or more residential units. El Recreational vehicle parks.
City /State/ZIPTt Cl rd q---1 L2.- ❑ Health-carc facilities. CI Supply voltage for more than
I ❑ Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: 8 Project name: �jt to .r ' ❑ Service or feeder 600 amps or more.
'
::r.t; :a: ' ; ;FLEE SCH L.Fi EDU .` ; ; -.i'.: ” "
r:.: :... ..<:_:. :
Cross street/directions to job site: Description �
1 Q9'• 1 Fa. I Total
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33
Limited energy, residential
Y, ,,,; .:,',,:;:'.',...-ii;;.!.'-,'; 75.00 2
. 5 . , �. ':: .,.. ', ;, ,;'� ,� QhF: F:W ? ; : <'. . (with above sq. I)
— Limited energy, multi - family a 75.00 2
f (l I residential (with above sq. ft)
. Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
- : :.i '` c ❑: FRO_ PERT 0WNF..R': , ;:• : '. r ., ". :,,, rFENANT : s' : ; ' - : ' ";,'.•:. 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders Installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 1 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 f 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 . :
,;:' .:. � � . -- - � ''; ,
r •'. ; , ., ;, . -
. above servi or feeder fee,
;...: ,,. , . 0' CONITAC"I ;; 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
without service or feeder fee,
Contact name: first branch circuit 46.85 y 2
Address: Each add'I branch circuit 1 W 6.65 al 2
City/State/ZIP: Miscellaneous (service or feeder not Included)
tY Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone:
( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
- ., ".C.QNTJEtACTOR > ' _ ., Sign or outline lighting 53.40 2 _
Business name: Accurate Electric, Inc. Signal circuit(s) or limited -
energy panel, alteration, or
Address: P.O. Box 873425 extension. Describe: Page 2 2
City/ State/ZIP: Vancouver, Wa. 98687 Each additional inspection over allowable in any of the above _
Phone: (360) 944 -7001 I Fax: (360) 944 -7013 Per inspection
Investigation per hour (I hr min) 62.50 62.50
CCB Lie.: 158875 I Electrical Lic.: 37 -1029C Suprv. Lie.: 5094S Industrial plant per hour 73.75
111 1 '..::ELECTRICAL. PERMIT_FEE •; ' : - ,
Suprv. Electrician signature, required: J Subtotal:
Print name: Ken Sweo Date: 2 - i c l - Plan review (25% of permit fee):
I�JJ State surcharge (12% of permit fee): /C)- f4 I
Authorized signature: �� (/ I l ` TOTAL PERMIT FEE: `•'1 , I
Print name: Debi Watts Date: This permit appllcaton expires If a permit is not obtal CV--1
within 180
Z- I g - days after it has been accepted as complete.
• Number of inspections allowed per permit.
1:• Building •Permits,ELC- PetmitApp.doc 05.2306 440-4615T( I I .05 WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2009 0IIQ64
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/10/2009
Phone: (503)639 -4171 Ill;
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2/24/2009 TIME: 7 :00AM PAGE: 7
SITE ADDRESS: 11!34€; SW PACIFIC HWY 200 CLASS OF WORK:
SUBDIVISION: TIGARD PLAZA LOT #: 002 TYPE OF USE:
PROJECT NAME: DOLLAR TREE
DESCRIPTION: Install (7) branch circuits for new refrigerator cases. Job 20 -667.
OWNER: TIGARD PROPERTIES INC, PHONE #:
CONTRACTOR: ACCURATE ELECTRIC PHONE #: 360- 944 -7001
Inspection Request Scheduled For: Date: 2/24/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 080795.01 503-702-0304 N
Corrections /Comments/ Instructions:
. ∎� PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ • ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G . (14 6a Date: 2:2_4 -- C 7 Phone #: (503) 718- 2�