Permit If CITY OF TIGARD ELECTRICAL PERMIT
. COMMUNITY DEVELOPMENT Permit #: E LC2011 -00265
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/24/2011
Parcel: 1 S136DC04500
Jurisdiction: Tigard
Site address: 7501 SW DARTMOUTH ST 100
Project: Winco Subdivision: 1995 -013 PARTITION PLAT Lot: 2
Project Description: (3) branch circuits for checkstands.
Contractor: PRAIRIE ELECTRIC INC Owner: WINCO FOOD LLC
6000 NE 88TH ST ATTN: SUSAN BUSCHE
VANCOUVER, WA 98665 PO BOX 5756
BOISE, ID 83705
PHONE: 800 - 573 -2750 PHONE.
FAX: 360 - 573 -9866
FEES
Quantity Description Date Amount
3 crt Branch Circuits wo /Purchase 05/24/2011 $71.02
Specifics: Service or Feeder
1 ea 12% State Surcharge - 05/24/2011 $8.52
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $79.54
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 •ted by the Oregon Utility Notification Center. Those rules are se` forth in OAR
952- 001 -0010 through*52- 001 -0090. You -. • • -in a con a co` direct questions to OUNC by calling 503.2987 or 1.800.332.2344.
Issued By: L / � Permittee Signature: _� �! if
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.
05/23/2011 15:31 FAX 360 573 9866 Prairie Electric Inc. a 001 /002
Electrical Permit ApplicaRFCF FOR OFFICE USE ONLY -
Received •
City of Tigard Dale/B = L_� Permit No.: ij// _
E
" 13125 SW Hall Blvd., Tigard, OR 9' t 1 3 2011 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 DatcI : Other Permit.
Inspection Line: 503.639.4175 �/ Date Ready/By: BI See Page 2 for
TIGARD CI CITY 1 Qt TIG, �D Su lemental lnformation
Internet: www.ugard- or.gov Notified/Method: � PP
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❑ New construction E 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: where the available fault current ['Marinas and boatyards.
ad .. n setup "• .cis ;,4'x "'lc -_ - , - `° — y° " 8 ''�: - - - ; :1 lily ii) `: -4 exceeds 10,000 amps at 150 volts or ID Floating buildings.
er . „ :_ ..a.,„ =..,_ -a tr. u ,F •.` l ,,, , ...: _ acs;a Commercial -use .�••• �;. "`= , -r ' • `��� - -• �•tc;1 rxr °• — �`�� °_ -- �'�� +" less to ground, or exceeds 14,000 ❑ Commer � agric ultural
❑ 1- and 2- family dwelling ® Commercial /industrial CI Accessory building y amps for all other installations. buildings.
❑ Multi- family 0 Master builder ❑Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derved system
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: °' r- x - - a.>w 7„ mr f.°^,9s ❑ Addition of new motor load of ❑ "A" "E" ••) 2" "I - i' •
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.. t001 or more. occupancy.
Job no.: Job site address: 7501 Dartmouth Street , j f1/ ❑ Recreational vehicle parks.
CI Six or more residential units
City /State /ZIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
Cl Hazardous locations. 600 volts nominal.
Project name: WINCO FOODS 8 2 3 ❑ Service or feeder 600 amps or more.
Suite /bldg. /apt. no.: J 1 11 : - .. t.0111 ;;Al t y.;
Cross street/directions to job site: oeacn lion I Que. I Fee I Total 1
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: I 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
x $ 4e 'j �, ii, t � �_ x I rr m 0 �t elev - t.
> ^r ..t unEr` i ` .> _ 1F � r. , ^ ..-. " n°1, ' . 'a F; T ' k'' (with above s f
Limited energy, multi fami 2
Li g , multi-family 75.00
ADD RECEPTACLES AT CHECKSTANDS 2/11/16 residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 100.70 2
e t-T i s, "i Vara ro �Hr lG n 1 r e g;,.a "" -,�75r-� �'g 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: - 2 amps to 1,000 amps 301.04
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and /or
City/State /ZIP: relocation
Phone: ( ) 1 F ax: ( ) 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
- e --... ' , a x ° r t -yo - rx ' »td above service or feeder fee, 7.42 2
x. ..7, n , , - , ::— .. 1 L. t3 t �. ..'L. :4 r Cbg, ,^th i.*r a, .M; . . ,. aar r O
7i - ii ::� , � . �.. --a • each branch circuit
Business name: PRAIRIE ELECTRIC, INC. B. Fee for branch circuits without ( L
service or feeder fee, first l 56.18 66t1 2
Contact name: ANITA PASO branch circuit
Each add'I branch circuit 7.42 1.N4''4 2
Address: 6000 NE 88 STREET Miscellaneous (service or feeder not included) 1
City/State/ZIP: VANCOUVER, WA 98665 Each manufactured or modular 67.84 2
tY dwelling, service and /or feeder
Phone: (360) 573.2750 1 Fax: : (360) 573.9866 Reconnect only 67.84 2
Pump or irrigation circle _ 67.34 2
E - mail: anitap @prairielectric.com lighting 67.84 2
n •v �
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:: e .. : °r.u`��arrt;u,...r�.8�... ,. _.',., �.,•.�- ��i`yw = �t��� =a:��.r• ....:._- , - :.- �:...I Signal circuit(s) or limited energy
Business name: PRAIRIE ELECTRIC, INC. panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the abov
Address: 6000 NE 88 STREET Additional inspection (I hr min) 66.25/ hr
City/State /ZIP: VANCOUVER, WA 98665 Investigation (t hr min) 66.25/ hr
Industrial plant (I hr min) 78.18/ hr
Phone: 360 573.2750 Fax: (360) 573.9866 Ins for which no fee is
( ) ( ) 90.00 / hr
s ecificall listed %: hr min)
CCB Lic.: 60178 Electrical Lic.: 37 -491C Su rv. Lic.: 3562S ' 0 =E "�
� _, - �
, . :;i •em
u .5
Subtotal:
I Suprv. Electrician signature, required: Plan review (25% of permit fee): \\
Print name: Bill Halberg Date: 5 -23 -11 State surcharge (12% of permit fee): �d -
TOTAL PERMIT FEE: 1,011 -/ 57j
Authorized Signature: This permit application expires if a permit is not obtained within ISO v ' L
Print name: ,('- — Date: ' L 3 — days after it has been accepted as complete.
�,( N um b er o inspections allowed per permit.
I•\ Building \Permits\ELC- PermitApp doc 07/01/10 440- 4615T(1 I/05 /COM/WEB