Permit te „,VT CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2008 -00013
COMMUNITY DEVELOPMENT DATE ISSUED: 1/8/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 104BB - 07900
SITE ADDRESS: 14300 SW BARROWS RD ZONING: C -C
SUBDIVISION: RUSSELL'S SCROLLS FERRY SUB LOT : 002 JURISDICTION: TIG
PROJECT: ALBERTSON'S /STARBUCKS
Project Description: (1) service, (20) circuits Starbucks kiosk
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: 1 W /SERVICE OR FEEDER: 20 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:
ALBERTSON'S INC #576 STONER ELECTRIC
PO BOX 20 1904 SE OCHOCO STREET
BOISE, ID 83726 MILWAUKIE, OR 97222
Phone: Contact #: FAX 503 - 659 -4968
PRI 503 - 462 -6500
FEES
Description Date Amount Reg #: ELE 26 -122C
[ELPRMT] ELC Permit 1/8/2008 $213.30 LIC 44823
[TAX” 12% State Surchar 1/8/2008 $25.60 SUP 3496S
Total $238.90 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: 1/41-52,4-14i4-4C.-- Permittee Signature: 0,1 lc-e- pv
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.
' ' 011*07/2008 14:39 FAX aooi.
_
Electrical Permit Annlic : - ro-: .
. CE1VED .
, ()FM( E I SE Mil
City of Tigard i ,,, 0 ,.
/008 Received , ..., a
0 Lb Permit No if _..._ ,, ;...... , 0
1 „, i . 13125 SW Hall Blvd., Tigard, OR 971i '.
i r '" pi Revi
1 ,
. a • Other Permit:
. Phone: 503.639.4171 Fax: 503.540-r IGARD new :
T 1 A R I)
Inspection Line: 501639.4175 ta1 1 1 Date Ready/By: kris: .---- El See Page 2 for
li
Internet www.tigard-or.gov BUI WING DWIS1ON NoliadrMeihOd. 7 Supplemental Information
Iiiglf.! . :',:gYq.'i:::::?-.''23i: ,- ,4;=:::',11:*S ::0:0771M:i
0 New construction Eg Please check all that apply (submit 2 sets of plans w/items checked below);
cA
0 Service or feeder 400 amps or more 0 Building over three stories
0 Demolition 0 Cr. ' , where the available fault current [3 Marinas and boatyards.
0**'*0:44*:44**i*#0'1I0i t e::: th eds g ,`"°: 0 ra amps e a e t c h i 5 1 0 4 7 co lts °r g buil
EFientin
g azicHilturai
El
1- and 2-family dwelling Commercial/industrial 0 Accessory building antFa for all other install building
1,3 Multi-family Master builder 0 Other ['Fire pump. °Installation of 75 ‚(VA or
-. . 0 ErnergencY sYstem- huger separately derived system.
.: ,.-., • .T.I.41. Fp_RIy1A ,..1 . N,. ;. ,.., . ,,,... ., . , -.,., ,... :-.,...,= ::!, 0 Addition of new motor load of 0 "A.", "F',
100HP or more. occupancy.
Job no.: 570o Job site address: /i/3 p o Spj 13j5 1::
0 Six or more residential unit. 0 Rewealicms1 vehicle parks.
0 Flealthrcers facilities. 0 Supply voltage far more than
City/State/ZIP: ---77/2„,i,, 0( ['Hazardous locations. 600 volts nominal.
Suitefbldg./apt. no.: Project name: .5-7..,,,,,e,esoces-- 0 Service or feeder 600 amps or more,
.t(t.t?;
Cross street/directions to job site: O 1 Qty. I Fee. I Total I •
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no,: 1,000 sq. ft. or less 145.15 4
Ea. add'! 500 eq. ft or portion 33.40 1
Tax map/parcel no.:
. Limited energy, residential
75.00 2
0*0' l''*&ei! ' ( with above s q' a)
Limited energy, multi-family
I.) /0( ,Ci, 5-7-4efieucis k ,,
ios,usii)c residential (with above sq. ft) 75.00 2
Service; or feeders installation, alteration, and/or relocation
141--455 .. . 200 amps or less / 80.30 ?Or 3 2
C1,.:*0000*.E
, :0 1 00iv ,,, ;,: . :,,P!V: - P: . ; -:, .: : •;:', ', . :- 0 1'0 201 amps to 400 amps 106.85 2
2
401 amps to 600 amps 160.60
Name:
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: ( ) Fax: ( ) 200 amps or less 66.85
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 133.75 2
Branch circuits — new, alteration, or - extension, per panel
Owner signature: Date: A. Fee for branch circuits with
..-- s -- '"''' above service or feeder fee
i l*k.tieXS k t4: : '' - .:; - :ZN4r.;" - ';' , 6,':.F : .12 001fl i :X0fli ! * 64 *c147;:.'ii'::': , ': a ach brand, tircuit ' 26 6.65 i 33 — 2
e
Business name: B. Fee for branch circuits
without service or feeder fee,
Contact name: 46.85 2
fast branch circuit
Address: Each addl. branch circuit 6.65 , 2
Miscellaneous (service or feeder not included)
City/State/ZIP: 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
0( Sign or outline lighting , 53 AO 2
Signal ciscuit(s) or limited-
Business name: STONER ELECTRIC
'energy panel, alteration, or
Address: 1904 SE OCHOCO extension_ Describe: Page 2 2
City/State/ZIP: MILWAUKIE, OR 97222 Each additional inspection over allowable in any of the above
r Per inspection 62.50
Phone: (503) 462-6500 Fax: (503) 659-4968 Investigation per hour (1 hr min) 62.50
CCB Lie.: 44823 Electrical Lie.: 26 I Suprv. Lie.: 3496S Industrial plant per hour 73.75
Suprv. Electrician signature, required: otich46....t Subtotal: 2 i 3 • 30
Print name: MICHAEL FALCONER Date:
Plan review (25% of permit fee): Ita
ii 7/06
State surcharge (12% of permit fee): Zs"; e, 0
Authorized signature: TOTAL PERMIT FEE: 2. 90
This permit application expires if a permit is not obtained within 180 -
Print name: Date: days alter it has been accepted as complete.
• Number of inspections allowed per permit
lAPetildiaskPetinitakELC-PerraitApp.doe 05/2036 440-4615T( l I/OS/COM/WEB
CITY OF TIGARD
BUILDING DIVISION
PERMIT #: ELC2008•00013
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1iBi2008
Phone: (503) 639-4171 ,... 4pli i lt\
•
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 1/18/2008 TIME: 7:02AM PAGE: 47
SITE ADDRESS: 14300 SW BARROWS RD CLASS OF WORK:
SUBDIVISION: RUSSELL'S SCHOLLS FERRY SUB LOT #: 002 TYPE OF USE:
1 PROJECT NAME: AWERTSON'S/STARBUCKS
DESCRIPTION: (1) service, (20) circuits Starbuclo: kiosk*
OWNER: ALf3ERTSON'S INC #576, PHONE #:
CONTRACTOR: STONER ELECTRIC PHONE #: 503.462-6500
Inspection Request Scheduled For: Date: 1/18/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message 0 \f\j/
199 Electrical fn( 502-01 208-949-1995 . N
Corrections/Comments/Instructions:
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—
A PASS 0 PARTIAL APPROVAL 0 CANCEL Li NO ACCESS
1 I FAIL n CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: cr" L- Date: i -1 13 ' 01 Phone #: (503) 718- /-100
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BUILDING DUNG DUVUSUON ' pER/N|T ELj�30U0UO013
| 13126SVVHaUB|vd, Tigard, OR07223 DATE ISSUED: 1/13,20013 Phono:(503)639'4171
Inspection Requests (24Hmj:0503\830-4175 a
` |NSPECT0NVVORKSHEET R}R DATE: 1MC�2DO�' TIME: 7:00AM PAGE: 73
SITE ADDRESS: 143DVSWBARROWS R[) CLASS OF WORK:
SUBDIVISION: RUSSELL'S SCHOLLS FERRY SUB LOT #: 802 TYPE OF USE:
PROJECT NAME: AL[ERTSDN'S/STARBUCKS
DESCRIPTION: (i) nen/icn. (20) circuits EUarbucknkjosk
OWNER: ALBERTS0N'S INC #676, PHONE #:
CONTRACTOR: STONER ELECTRIC PHONE #: 5Ori. 4 62-650O
Inspection Request Scheduled For: Date: 1/10/2008 Pour Time:
Code # Inspection Oeacription [t Contact # Message �
~
~
105 U0d�grmWn(��ah 503-789-0199 Y
'
- /
(Corrections/Comments/Instructions: ^`. _'^ �� ~ •
.
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c1 . 1 .._ g1= El PARTIAL APPROVAL n CANCEL | | NO ACCESS
FAIL CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
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Inspector: 6— • U^J ���� L-�� Date: � ~ ^ �J �� k) ., Phone #: (503) 718- ��~� k0