Loading...
Permit a CITY OF TIGARD ELECTRICAL PERMIT "`1 COMMUNITY DEVELOPMENT Permit #: ELC2011 -00151 tGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/23/2011 - F Parcel: 1S135DD03301 Jurisdiction: Tigard Site address: 11945 SW PACIFIC HWY 202 Project: Sesame Donuts Subdivision: Lot: 0 Project Description: Electrical for TI. Contractor: SERVICE FIRST PROPERTY MAINTENANCE & REPA Owner: TIGARD PLAZA LLC 17413 WAKE ROBIN CIR 8320 NW HWY 99 OREGON CITY, OR 97045 VANCOUVER, WA 98665 PHONE: 503 - 258 -7203 PHONE: FAX: 503 - 655 -6317 FEES Quantity Description Date Amount 5 crt Branch Circuits wo /Purchase 03/23/2011 $85.86 Specifics: Service or Feeder 1 ea 12% State Surcharge - 03/23/2011 $10.30 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $96.16 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 0 952- 001 -0090. You - • • . in a co•. - rules or direct questions to OUNC by calling 503.2321987 or 1.800.332.2344. Issued By: L___� y: r —:-- Permittee Signature: �� � G ,/�.a��rir 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 the next available inspection date. 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 Application FOR OFFICE USE ONLY 71 City of Tigard �� Received `J g v� Plan Review Phone: 503.71 8.2439 Fax: 503.598.1960 e/By: Other Permit: T 1 G A R l7 Inspection Line: 503.639.4175 Date Ready/13y: Juris. VI See Page 2 for Internet: www.tigard- or.gov Notified/Method: 7" Supplemental Information TYPE OF WORK 1-si 0F'T SU PLAN REVIEW " � �' Please check all that apply (submit 2 sets of plans w /items checked below): ▪ construction A ddition/alteration/re rut 1 400 y I : p > ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling fit Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system. ['Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", q l� //'� _ ' IOOHP or more. occupancy. Job no.: Job site address: h� _JL) 4)CLCS i I L am- ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP: T/ 6 P a tX 170.3 Q ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: go Project name: ❑ Service or feeder 600 amps or more. f' FEE SCHEDULE 1�7 Cross street/directions to job site: U,11 a v p ac leas j „ Description I Qty. I Fee. I Total I New residential single- or multi - family dwelling unit. .r Oa ZS Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Ea. add'l 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) ��jj n / D Limited energy, multi- family 75.00 2 U` r.,,i s e__ gLe,c,i- - . I C0`- a s r L „a f i& tl?Cvi Se-,1 residential (with above sq. ft.) `] Services or feeders installation, alteration, and/or relocation 200 amps or less 100.70 2 ❑ PROPERTY OWNER I p TENANT 201 amps to 400 amps 133.56 2 J ,, '1 401 amps to 600 amps 200.34 2 G. Name: S e S r>'l� 40 t 3 y Anw 5 tS r i 0 ill -^ N 601 amps to 1,000 amps 301.04 2 Address: "2 /fish WIGcJO oil cal— Over 1,000 amps or volts 552.26 2 A ��� Temporary services or feeders installation, alteration, and/or %� City/State /ZIP: _ J l relocation F ax: Phone: ($3 3) 7S 7 - 7-6 � ( ) 200 amps or less 59.36 1 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT I XI CONTACT PERSON above service or feeder fee, 7 42 2 each branch circuit Business name: / (/ ] a .0- y,0.) („S sa r yu (:) AA -S) B. Fee for branch circuits without service or feeder fee, lust 1 Contact name: M t 'K e, 1l/ 4 MN, branch circuit 56.18 , 11 2 OW Each add'1 branch circuit 1 -1 7.42 , 6 2 Address: IA 5.1) ) 22 N - �/ S • Miscellaneous (service or feeder not included) Each manufactured or modular 67.84 2 City/State/ZIP: 7i(iZi2 j7lz 91 ,.) dwelling, service and/or feeder Phone: (5,3) 957 i Z -S Fax: : ( ) Reconnect only 67.84 2 E- mail: in-005 i,� el , 4. Lyvd C- O Pump or irrigation circle 67.84 2 Sign or outline lighting 67.84 2 CdgTRACTOR Signal circuit(s) or limited -energy . r/ ) panel, alteration, or extension. Page 2 2 Business name: // h F �� /�� /i Each additional inspection over allowable in any of the above Address: L 7Y/3 fA,„or,- R a -,,,,,,..„ '-1 /Z c f c Additional inspection (1 hr min) 66.25/ hr Investigation (1 hr min) 66.25/ hr City /State/ZIP:Qk� � C / f- / ,p 9 7 e Industrial plant (1 hr min) 78.18/ hr Phone: 5 ii.3,__ 72 / � Fax: •c) �,6" ( 3 I ) Inspections for which no fee is 90.00 / hr 7 h / p specifically listed CA hr min) CCB Lic. �Ln(2 6 / Electrical C L � , Suprv. Lic.: 15-83 S ELECTRICAL PERMIT FEES Suprv. Electrician si Ifalafe required:9� let i3 Subtotal: .: r /C � f Plan review (25% of permit fee): ��—� Print name: � ' ' / 1/. • Date: •� / r State surcharge (12% of permit fee): / 0 , 3 c • TOTAL PERMIT FEE: q (, t (p Authorized signature/5' j a i This permit application expires if a permit is not obtained within 180 Print name' � � / �s� Date: ' days after it has been accepted as complete. � � � ,, Number of inspections allowed per permit. - I:\ Building \Penults\ELC-PermitApp.doc 07/01/10 4404615T(11/05/COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* n Heating, Ventilation and Air Conditioning System* n Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I: \ Building \Permits\ELC- PermitApp.doc 07/01/10 t CITY OF TIGARD ELECTRICAL PERMIT "II 2 COMMUNITY DEVELOPMENT Permit #: ELC2011 -00151 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/23/2011 Parcel: 1 S 135DD03301 Jurisdiction: Tigard Site address: 11945 SW PACIFIC HWY 202 Project: Sesame Donuts Subdivision: Lot: 0 Project Description: Electrical for TI. Contractor: SERVICE FIRST PROPERTY MAINTENANCE & REPA Owner: TIGARD PLAZA LLC 17413 WAKE ROBIN CIR 8320 NW HWY 99 OREGON CITY, OR 97045 VANCOUVER, WA 98665 PHONE: 503 - 258 -7203 PHONE: FAX: 503 - 655 -6317 FEES Quantity Description Date Amount 5 crt Branch Circuits wo /Purchase 03/23/2011 $85.86 Specifics: Service or Feeder 1 ea 12% State Surcharge - 03/23/2011 $10.30 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $96.16 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 0 952 - 001 -0090. You - • • - in a co., • rules or direct questions to OUNC by calling 503.2321987 or 1.800.332.2344. Issued By: L_� �:� Permittee Signature: G �/4 AY/1 /' 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 the next available inspection date. 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 Application FOR OFF I( F 1 S Oy1.1 City of Tigard �T��1� Received _ '_ . _ _ 1 Y DateB ���if/7� ermit No.: U PI 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ■ Phone: 503.718.2439 Fax: 503.598.1960 " Other Permit: L � t a , Date/B T I G A R D Inspection Line: 503.639.4175 Date Ready/By: See Page 2 for Internet: www.tigard - or.gov Notified/Method: Supplemental Information TYPE OF WORK t ^tri °' . (%1\115)1° PLAN REVIEW Please check all that apply (submit 2 sets of plans w /items checked below): ❑ New construction Addition /alteration/replacemettt ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1 - and 2- family dwelling Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "1 -3 ", { p rr r �// 10OHP or more. occupancy. Job no.: Job site address: 1 1 1i S 50 eC LCt #9. c (It..! i ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP: l / 6Pt>t 7 (3 X 17'.13 ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: go Project name: ❑ Service or feeder 600 amps or more. �'_ FEE SCHEDULE Cross street/directions to job site: J j7 .jj e l U p ICgdS$ ',y h Description I Qty. i Fee. I Total I * New residential single- or multi- family dwelling unit. 4A A& Z-S Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Ea. add'I 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: , Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) Limited energy, multi- family 75.00 2 P CA:i S e fLe_c -h i e-'- as rt.., i s e Se. J residential (with above sq. ft.) "1 Services or feeders installation, alteration, and/or relocation 200 amps or less 100.70 2 ❑ PROPERTY OWNER I jg TENANT 201 amps to 400 amps 133.56 2 Name: c� 1 401 amps to 600 amps 200.34 2 S Q sa ert,c ,n.t�l / ill' i7 601 amps to 1,000 amps 301.04 2 Address: Wary Ct.)0 0 d (54- Over 1,000 amps or volts 552.26 2 City/State /ZIP: -776 ,T o 91),P relocation services or feeders installation, alteration, and /or 1 relocation F ax: Phone: (S,) 3 ) �jS'"7 7 755 ( ) 200 amps or less 59.36 1 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT I XI CONTACT PERSON above service or feeder fee, 7 42 2 each branch circuit Business name: /1j J a ji y ,� (, ..v" . [ 190 yvyt l B. Fee for branch circuits without 1 V ^ MIX, service or feeder fee, first Contact name: ) 4l 4 K c p �y v �J' MY»pt branch circuit 56.18 % , t i 2 Each add'I branch circuit t— j 7.42 3.-q, (pg 2 Address: 1)472r si.,) -22 - 'I S Miscellaneous (service or feeder not included) City/State /ZIP: `T o eg 91 a ,) 3 Each manufactured or modular 67.84 2 dwelling, service and/or feeder Phone: ( 5,3) 967 i 1S Fax: : ( ) Reconnect only 67.84 2 E -mail: 614) r3 a /9..-1 uI,Q,.' , C o r An Pump or irrigation circle 67.84 2 Otli / TRA Sign or outline lighting 67.84 2 C CTOR Signal circuit(s) or limited- energy � , -t A panel, alteration, or extension. Page 2 2 Business name: Sri/ OM //`E. ✓Il / �> Each additional inspection over allowable in any of the above Address: i 7t.j�3 ,K' fzc � c=( !4 '—t , / ` Additional inspection(1 hr min) 66.25/hr l � Investigation (1 hr min) 66.25/ hr City/State /ZIP:©k6�"0 C. I f -, / / o f.... / S --- Industrial plant (1 hr min) 78.18/ hr Phone: 1562, S — 7203 f Fax: G ( `` ) � ?5 7 '563 ( ) Inspections for which no fee is 90.00 / hr 7 specifically listed (%: hr min) CCB Lic. /6, '7( Electrical Lic.: C ' c C I Suprv. Lic.: lg83 S ELECTRICAL PERMIT FEES Suprv. Electrician si datu(e required:?0"" ', /. (1 / t l Su f fee): , i , Plan review (25% of permit fee): oar Print name: A • / Date: ' / State surcharge (12% of permit fee): f U 3c i TOTAL PERMIT FEE: q (P t( Authorized signature/ /// f - 7 application expires permit Thi permit a hcation ex Tres if a ermit is not obtained within 180 Print name . . 4T.� �./ ��i�/�71� ' Date: ' days after it has allowed per a p c ermit. as complete. i Number of inspections allowed r rmit. I:\ Building \Permits\ELC- PermitApp.doc 07/01/10 440- 46t5T(11/05/COM/WEB Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 11945 SW PACIFIC HWY 202, TIGARD, OR, 97223 Commercial - Electrical 199 Electrical final PASS - No C of O ELC2011-00151 Jeff Grove Violation Summary: Inspector Contractor