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Permit Al CITY OF TIGARD ELECTRICAL PERMIT III Per mit #: ELC2009 -00133 : COMMUNITY DEVELOPMEN Date Issued: 03/25/2009 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S136DC04500 Jurisdiction: Tigard Site address: 7501 SW DARTMOUTH ST 100 Subdivision: Lot: 0 Project: Winco Project Description: Install (15) branch circuits. Owner: FEES WINCO FOOD, LLC Quantity Description Date Amount ATTN: SUSAN BUSCHE, PO BOX 5756 15 crt Branch Circuits 03/20/2009 $139.95 BOISE, ID 83705 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 03/20/2009 $16.79 Contractor: Electrical JGCM PO BOX 12323 SALEM, OR 97309 PHONE: 503 - 585 -4879 FAX: 503- 364 -0248 Type of Use: COM . Class of Work: ALT Type of Const: Occupancy Grp: Total $156.74 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. NTION: Or on a r s ires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001- 10 through OAR 95 01 -01 . Y'oumay obtain a copy of the rules or direct questions to OUNC by callin. :.. 4:.6699 or 1.800.332.2344. (32_44,0, Issue By: v PermitteeSignat�� ' ..e * `: ���� // L--- 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 (.- ` 0 , ' J it71? -- -.----, Date: ,A17 LICENSE NO. 7/ S 5 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. :_ . - 1 v, , R/25/2000 /WED 10:27 AM NORTHSIDE ELECTRIC FAX No, 503 - 304 - 0248 P. 002 MAR /18/2009/WED 0::52 P114 NORTH, EJ tt i D FAX No, 503 - 364 - 0248 P. 002 Electrical Permit Application ' rolzclln'rc(ir USIt()NLY . City of >r MAR 1 8 2009 �aa�, Ts)zs swl at113h•d . _ Tigstrtd, tilt 4 Datc/6 : Is - , r , ktlmlSNo.: '(' C � '�Q c h , . Phone: 503.639.4171 Fie 503,59 OkiTIGARD Plaaaeyiety �, a. Ds! ✓g . Othet Emit: �,tr CARD lrtapeatiOnMtm sto3,BA35•41rs, BUOLDINGDW SION Am ReaWdyEly: Acis; .. See rap aril, . lnternmt: wurkligmtl- or.gav • Netted/Mrthote nt nI sucprnmanarrnrormn &on • New COnstrlXcti0(1 Fra Addition /alteration /replacetncnt Pleaea 'rrtifieR Ali thakapply {subm ktl .taoXplanew/itarn„checked ❑19erfdQlitSPlt 0v t; ❑ Service at fNehlr 400 amps OC Mote ❑laundinf aver dare mice. . rc.a x 11 1. 7 .. i" „'n; rdr eet1.0101) tCr0w and t. . t C' ' :' ' , '; ..; . .1± . .''_ : , . Q[>;X; 0�� ��, � S`fi! � . , „r eyceul; 10,400 at 150 trolr. a ui • 0 I - and 2- family elvraillin6 Ei CommercialiindtawinI arse to mid, ar a�eru ld,o00 (7 wroimd-uin agrlc4Ut”} ❑ Accessory building amp, far a1Gor In!teaaldaeon:, b C dIdinla. al © MU1ti - family 0 Master builder 0 Other: ritlrepatnp. . 17 Telenet* of75 ICVA or ❑Etna ann x : .JF111.91 dXt3S7GA?f1��1,�1VD,`Lt?' PTA 7`tl Nano Y? tarn. inranree15vySey I5Vt SWC�'1 1 l ' tnnor load vf C� "A . "l� ". "13', Job no.: b site address: de nrlip or more, oeaipancy. • C75iaorsnareaedldnntiaTunrA. rlRanre.donelvaliiokprgrs CitylStatelZW; `T3 0 Horn-care ileilit;aa, ❑ Supply vo'toga lbr mole titan 1��1�1 10?•a2grdavh tooatioeri, 600 voilsnod-dog, SulteIbldgJgpt, no.: 0 1"ro'eot name: ©ilanice or feeder GOO pupa ol 'thorc. • Cross stceet/d #rectl4tls tajoh site k7: S .Err Al:1't r A ----' + recrf fine W,ME "IEN. ` dtv a single. Or mula;l- family dwelling nom Includes atta ched giant..., 5uildiVisi•r)' Lot no,; 1,000 aq, fa, or Lesa 14515 MEW Tex map /fin ce1 no °- Ea. m14'1500 54- £t. or . oriion MI 33,40 I� „ . :1,.:., 7; Ge'kt/xA1ld1�t '( '' .- ' : w:i,;'.'''3 ,',),` „� i.rn I • r m,* a. residential J '� ' •�• , > •'.a:;r;' r: , w d • Dse t. a. 79.00 2 IIII I iteito4 allergy, oaultl -lam • residential wItllibovt ,ft. 75.00 Services or ltedern insts Al. a smilax) and /or relocation i f' O K V "y ' y , 200 amps 0r Icsa - p :� a , ;;d ,.. • -. : l t' gip' m - tr^:r 90,30 2 • c ''' ... , '(' 201 am, to 400 am .s 7 /0615 a ai ae: 4 01 amps to 60a amps 150.60 2 p�gd 601 • to i amps 240,60 2 • 41 t 1 000 amps or volts 454.65 2 City /State /Zip: Temporary services or feeders iatstadlgti 's, alteration, and/or relocation Phone: ( ) ;"c ) 200 (Imps of lays � 66.8 5 1 _ • Owner ln3req plion: 'Me fin a.lia old l3 btibs made oft property that 1 ooVn wllichds Rot 201 em. s to 400 amps MI 100.30 © intended f a r sale, 1eas0, r* , or excltatagc, according t o ORS 447, 449, 670, and 701. 400 amps to 59.0 s ups 189,7 2 Owner Signature! _ Date; Staue4 circuits - nary, Alteration area Nokia.. i .sees >' { ",� . •i '`,..',!,''..'',;..1:1;.:7,,;', „ i PA. Fee far branob eirouits with CA ; ...,- ri ? ;, ;" . t1't?fik �bbi: noats dlattJeV x :a, 'hove serviec ar fender ito, - mob !munch ailynit Susl 6 , . E, Fee ref branch ctrcuita COAteictnem: wit /t0 /fteOtvlee or',''cederfr'f, I 4 d• $ ., first branch circui Address: Eabh ndrt'i breach circuia t{ 6.65 ki.,Iiii® City /Stalta/Z1P Miscellaneous serveepp edernori>retuded Saoil nit.uttootnretl ormodu ar /'sync: ( ) "— Xra x: ) dwellin_ nerdoe and/or food= 90 M© &mnii: 1Zaa0nnCCt onl 66,85 CISIV77+4 t7k2' Pump Rr ltrl@iatinn cirola 0.40 13usincss }� ' � y �{ � � � . t: Si-. orDOUineli? ting 53.40 � e: �` 1. aC:hd Signal por t(s) or limited - Address energy panel, alteration, or . • v 0 , ..., extension. DeNcribe: PAP 2 0 City /3tutTp; ` —'. AI ' . i t . w . r f Each p adiaoaal ins _e_e' oa over ul)awabl , e in any of the nbo y na; ,,,,,k,,, i, Z i • Frat: ). t 4$ Per 62.50 • ?'bo CCU 1.1c.: i k+.eaatigeetian per /tout (1 hrm6r) _ 62.50 �� 46 �l statrical Lic,: ( SuprJ. T.ic P q p16ustr9al lout par roar ani Sttpre.Electricians# signature, ' ' ' k ?�XFCTRicA.L P _ cc '' ,, --�� > RIYA< YENS . PAM name: ff r w Subtotal:��� i I rbi ✓1 i 99aee: o 2 Plan eevtos. (25%4l`pcmtttry; Authorized signature: g usto mcharge (12% ofprrroitfee): ii),1 • - COQ pL PERIsd17 FEE: Pristt name: ]-dare This perm e aPpra -'•M expire; if s anntat ea Rau 1'11014644m P anor,o Ma edIn ,eases, San aacepteA rgmpletn �ePe F[. 9543/06 44e.. o.s7'(IHCS/COsdwsa Narnber afolsaeebaos &flawed per Imre11.