Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00490
� DEVELOPMENT SERVICES DATE ISSUED: 8/31/2006
°- -° 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 101 AC -01900
SITE ADDRESS: 12615 SW 72ND AVE ZONING: C -G
SUBDIVISION: LOWE'S HIW, INC LOT : JURISDICTION: TIG
Project Description: 2 branch circuits for self checkout stands.
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: 1 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:
LOWE'S HOME IMPROVEMENT MILESTONE ELECTRIC
1000 LOWE'S BLVD. 1800 NW 169TH PL. SUITE B700
MOORESVILLE, NC 28117 BEAVERTON, OR 97006
Phone: Contact #: PRI 503 - 645 - 5323
FAX 503 - 690 -4843
FEES
Description Date Amount Reg #: ELE 34 -618C
[ELPRMT] ELC Permit 8/31/2006 $53.50 LIC 153480
[TAX] 8% State Surcharge 8/31/2006 $4.28 SUP 2113S
Total $57.78 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699 or
1- 800 - 332 -2344.
Issued By: (s .dL p Permittee Signature: y . 042 p -
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503 -639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Aug. 30. 2006 12:24PM Milestone Electric No. 3159 P. 1
Electncat remit Application or
City of Tigard n - =s` t, ,1 0 3 60 Permit rte.: = 1h�-a0 " 00 1>
13125 SW Hall Blvd., Tigard, O' , r• ( A m 0 plan Review '
Phone: 503.639.4171 Fax: 503:598.1960
A r ' • i i i D /By. Other Permit: i i;
Inspection Line: 503.639.4175 ,l - J Dan Ready/By: • role: ® See Page 2 for
Internet www.ci.tigard.or.us G c6 c,) 2006 J Notioada thod a Supplemental bztormande
".�.;" ,�u"'�i� ,logs ! s �• :� •�: �:i'r3 c:,i.. `t,yw,^r• �.vY �
: - ti;:'r-c r,r,
Syr !:Y'r . � F :: a ' t »`� a . F ti`Lq --7c . r d, , . 61 C �?, ! �, f .C�° c e rr r Z y ��o :,.r-.. err TS ti ` Y � -j
, - 3�3��.t1,3::5.3���tv:..$ ,� ''R7w5:.,v.. 1._L.; f,Na �... s.,e. u.. i:.: c����. �s� n.. �x. 1! L ..a...i.:i.e� ';
CI
4'..t`i"•.'.�Ce:e
New construction % : :,&64.614,_, n : , .. RT a n t Please check all that apply
1 fi "i 1 T
['Service over 223
El Demolition � shell ?:1A amps, � 'I ['Hazardous location
1� , p i , a� iF d` s c?�!� eu n a h� * ❑Service over 320 amps - rating ❑Butz over 10,000 sq. ft.,
�'� � rf ; z .�i3fi. =7.rsan► 5 vd �,' m �'r: E` 4*G ofl -and 2-family
rci riro,�'��,,,�c.����;�,�t.��:�•:, dwellings a or more new residential
❑ 1- and 2- family dwelling i. 'I r r errcia1Cndustrial ❑ Acoessory building ❑System over 600 volts nominal units is one structure
❑ Multi - family ❑ er ❑ Other: ❑Building over r builder three stories [Weeders, 400 amps or more
�` , >� i' �'ri � tar to Master y ' l d •� a M ,� , z c. as a 1 r r e r ❑ llpant load over 99 persons ❑Matmfaetnred structures or
•.: k. .F M 7 3. ,V7i � t t �. : "r {t t `., t7 1 . 7 ' ; .+ f , .
� ;e5:ae- `�+!':'uls't:: �nrf• ri1? i c bra? c y i�! 1. � :`'7'i'SiynL��:� ❑ g �eSS�ll$htlp $P lan park
no.: 625'7 Job site address: I 2,C, IS- $ .L/ -2 , � Cis ofpiay
ubmit 2 sets ❑once:
City/State/ZIP: �< < S of with any of above,
/ t [5 a / e 9,..., 9 7 2 _2.'1 The above are not applicable to temporary construction service.
Suitdbld / t no.: J A- 1; SCa;� :; 4Z • ' T � '"+"-: ' -'- ; ;' y t: 7 7. ..._ �-., ;t
& Project name: se_ a 6 ;� L 's „�� r D;; N 's'on.� ,::._,, .
Drsn noon Qty. Foe. Ts I "
Cross street/directions to job site New residential sink- or mult - famiy dwelling milt.
_
Includes attached garage.
• M .. •[' � _�/. j4' ' r [..' ` 1,000 5'q. ft or less 145.15 4
Subdivision: Lot no Pa. add'I 500 sq. ft. or portion 33.40 1
/parcel _ Limited energy, residential 75.00 2
Li
f , Limited energy, non. esid
a w " �trcca. r�-a c r� , •� 5 gy, �a►tial 75.00 2
;: - ' Z;i r or modular
'. n�Y� ` c � ✓�' � .eG.iCn :vikiv.�.c\ai�,�j 1 �� �i'�• ��� e:�,1n� Each mamU�CtUred tnOdlll
dwr.Uinit, service and/or finder 90.90 2
1111 .NeiggP - -- -_ - ' ' - la Services or feeders installation, alteration, and/or relocation
t � A 200 amps or less 80.30 2
. �k2_ a �' `at:. �s �a `s �wv . + :' : e s< t '' � Y " r a r�'? yr t y ; F .,, 201 amps to 400 amps 106.85 2
`� ` ```�' `� 401 t
amps to 600 amps 160.60 2
Name: it
601 amps to 1,000 amps 240.60 2
Address: / / �41 - Over 1,000 amps or volts 454.6s 2
Reconnect only 66.85 2
City /State/ZIP: ., /v� 98''i j Temporary services or feeders installation, alteration, and/or
Phone: ( ) Fax: ( ) I relocation
200 amps or less 66.85 1
Owner installation: This installation is being made on property that 1 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 600 ants 133.75 2
Owner signature: Date: `
y _ Branch cfreaita - me w , alteration, or extension, per panel
m��t r °r� \ "�"�f�.•r��f"\�;�i �',.�'�'q�- � •,:- �, -- �'T° ti ,�;� ;;��-n
,,yy�� f , 2 F ',{� j � " �r p� , ; .': ",,� a ,� i A Fee far branch circuits with
G4 JJ uu ..ad�C:, . L2M`P.,) " ., "� l)'.- .." '" T^ ��. .-v, 4 ,.. .78i
t:z.�. ���.�.,�!i3:,vc.a , servile or fader fee, each
Business name: branch circuit 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee,
Address: each branch circuit / 46.85 2
Each add'l branch circuit / 6.65 f 2
City/State/ZIP: ' Miscellaneous (service or feeder not included)
Phone: ( ) Faze: ( ) Pump or irrigation circle 1 I 53.40 2
E Sign or outline lighting 53.40 2
D
_ Signal circuit(s) or limited -
•` den e iiw �t�' tr IMi �,, � 1.1 energy panel, alteration, or
Business name: A C '�� h� 7 �.
extension. Describe Paget 2
Address: /800 ,; / 4 • /0 (90 ,p � � G 8 2 Each additional ins . ctiioia over allowable in any of the above
City/State/VP: fl _ _ ` Per inspection ( 62.50
���0?' � �� lnvesttgati � hour 1 hr min) 62.50
Phone: ( so ) C, 3--__s- .2.73, Fax: (Sep 6 __ a industrial plant per hour 73.75
CCB Lic.: /53'�e� Electrical Lic.: L . Suprv. ,4� Eosi a e r ; r ,.y
,,,b . Li a.: fL�' Subtotal sh-,3 r
Suprv. Electrician signature, required: , T S Plan review (25% of permit fee)
,,�- f State surcharge (8% of permit fee) 7
Print name: /'C ° �, r • i - U 6 TOTAL PERMIT PEE s ^, t
Authorized signature :f
This permit application expires it a permit is not obtained within 180
p � drys after it has been accepted as complete
Print name: /4",,,.. e ( Date: p ' - -06 • Fee methodology get by Mt- County Building industry Service Board
i1Bui1ding.Pe mia\ELC- PemitApp.doc 12/03 4444615T110/O2 0M/WEE i'• Number of inspections per permit allowed.
C,ITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC200C-00490
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/31/2006
Phone: (503) 639 -4171 ' n
Inspection Requests (24 Hrs.): (503) 639 -4175 "'II
INSPECTION WORKSHEET FOR DATE: 9/15/2006 TIME: 7:06AM PAGE: 10
SITE ADDRESS: 12615 SW 72ND AVE CLASS OF WORK:
SUBDIVISION: LOWE'S HIW, INC LOT #: TYPE OF USE:
PROJECT NAME: cLOWE'S -- --7- 2
DESCRIPTION: branch circuits for self checkout stands. Lowe's
OWNER: LOWE'S HOME IMPROVEMENT, PHONE #:
CONTRACTOR: MILESTONE ELECTRIC PHONE #: 503.645 -5323
Inspection Request Scheduled For: Date: W15/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 036621 -01 503-645.5323 Y
Corrections /Comments /Instructions: , A j ��-
MI a 6a_IM)
CP
N t 1,A (a @.4:W AL. C iyZtil1/4)ei 69,
c
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: • 0 O L Date: "1 f it ().1) Phone #: (503) 718 - Z44b