Permit CITY O I TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00407
COMMUNITY DEVELOPMENT DATE ISSUED: 6/15/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S13600-04500
SITE ADDRESS: 07501 SW DARTMOUTH ST 100 WINCO ZONING: C -G
SUBDIVISION: PP1995 - 013 LOT : JURISDICTION: TIG
PROJECT: WINCO
Project Description: (1) branch circuit for oven in deli department.
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: 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:
WAREMART INC ABC ELECTRIC
BY BURKE + NICKEL 135 NE 9TH AVE
3336 E 32ND ST #217 PORTLAND, OR 97232
TULSA, OK 74135
Phone: Contact #: PRI 503 - 233 -7551
FAX 503 - 233 -7552
FEES •
Description Date Amount Reg #: ELE 161501
[ELPRMT] ELC Permit 6/15/2007 $46.85 LIC 26-1226C
[TAX] 8% State Surcharge 6/15/2007 $3.75 SUP 5096S
Total $50.60 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 952-001-0011 rough 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 B . tW. Permittee Signature: 9R.t. 7 1 /071
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.
JUN -15 - 2007 10:13R FROM: TO:81P5035981960 P.2
' Ele c tr ical Permit Application FOR oiiici, USE o:vl.v
C�h• lip Tigard �• \ Received
Penult t
13125 SW Hall Blvd., Tigard, OR 97223 �� " DateB : i ►� L L' _Li �A�0 ,
g Plan Review
/, .
Phone: 503.639.4171 Fax: 503.598.1960 JUN 1 5 � t-ry 4 In Date/B Other Permit:
Inspection Line: 503.639.4175 ∎'i L, Date Ready/13y: j is: El See Page 2 for
Internet: www.ci.tigard.or.us Cf i i OF rr e ti Notified/Method: Supplemental Information
Meal ..,. •;Jl:. ;:i: si•� � "�' � " ' ':1� ... /:' �jy�l. t; ?Y.tt�f �c� - . &:Lir..Y".,�y,r,?.'q
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r �• - `its I .i J. � i::�•1:. vt!: "'1P!v: � - - °' T .�' .. ...r _ .. . � � r .•t N. ..rif: C - •�•.YI„ 1_ r 4'.i...:.:,�t',�' i_• �.. . � . � .tT:: r . 5
:5,.6?3Ylif3•.'!rtl. r ....1:. ... f z: {! :i.• .... t .... __.. .. ... :. -.r. . i .... , r
. ., rn Pt:li.....:Y. -.. t� zr:, i.! r, r ..r .r ., n r enA i...:,. i; „ � ! . .a. ' T. ,� ...' . �. - ! _. -. -�.
❑ New construction \ Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑Other: ❑Service over 225 amps, comm'I ['Hazardous location
3 ? i p •,,t < +' ,. { :' ;! '. a:, - t. , •� : * i: �� ['Service over 320 amps - rating ❑ Buildng over 10, idential 000 sq. ft„
- `' i r ="` ` 1, ! P' f' x;;`:': ' - of 1- and 2-family dwellings s
it_1' `l'�• k'11,;=•� _r =� .� '1?E 0� `Olrt Q1V TItIIC�PlO ,r �S'P_i?ii: 6 t I , Y &s 4 or more new re
s h •err:
?urt •3ti �:rt j:7i-(u _: :.. ".. %t Sn, r tier: =n am- ar;:•._:.r••�•: ,rv:- � . »_,.w1 ..ur, tr:,.' - t'":.).iiirr. -rr'.•,.
❑ 1- and 2- family dwelling VII Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Multi family ❑ Master builder ❑ Other: 0Building over three stories ❑Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
i ' { i, I . } �::�ifii' __ 1�' _ '•:q ; s_ 'F :' ak' =!.. .,• •.�.
.:5;J� 1" ,.,..:: ir`i "'r.
!_ , 'ir=k':; _ i , r0_p 110 41:0F(1p,1�' Otit(:;A C4,T10 " "i',. ;E� t.;.:,,�r-'s:i1(:.at; ❑ Egress/lighting plan RV park
ter• ..�;.:, tr,r.. �'',4,t,l.r.+:..7:c .�:: e�:..:::ae. n.,.K,.......:- ..,�.`._... , .:�•sa' &I;.a....- alrtls.L:..knm a.n« . ,....Fr��3.- Z.i..: ., . _ , :: .,.
Job no.: ❑Health -care facility ❑der:
-
C - • ., _D Job site address: �, � ',./. ■� Submit." sets of plans with any of the above.
The above are not applicable to temporary construction service.
no.: !, roject name: ■ R ' >, ". ana l'r '�n��`Ea tdiR :..Q 1. ' 40 i r': 1 4 - 1 4
- . III 6 Description I Qty. I Feu I Total I `*
Cross street/directions to job site: New residential single - or multi- family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
tier e . � •t . + e, s il..;,., ,l xi.:
.�+w iiaf ,i- _ a!a ci 1 Pa t. } ,DES,ait 'T�''1, *' 0 . : 0,7:: •1 t :; :_: �i 0 fi; ,"" ; , rt lt�' Each manufactured or modular
dwelling, service and/or feeder 90.90 2
� r 1 1 // 1 L ` J Services or feeders Installation, alteration, and/or relocation
' / 200 amps or less 80.30 2
L L o , l ®N c p ra tr 201 amps to 400 amps 106.85 2
'. - • _ ijr < _ 4 ifB1 ?;} ' . 4 f7 4 P. '. - If '1 ,,4 ' t .... _ ?' 'r'' - 160.60 2
401 amps to 600 amps
601 amps to 1,000 amps 240.60 2
Over 1.000 amps or volts 454.65 2.
Address: '
Reconnect only 66.85 2
City/State/ZIP: Temporary services or feeders Installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 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 1 00.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
a F, .&rr. 'tl t: 'eg; C ` i i - 'F, t ipu . � 11111'( E
; , t, n A. Fee for branch circuits with
service or feeder fee, each 6.65 2
I . ^ _ branch circuit .
G B. Fee for haunch circuits
Contact name: t h,. 4 ,/_ ,a ,„ without service or feeder fee, 1 46.85 4 2
each branch circuit _
Address: Each add'i branch circuit 6.65 2
City/ State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( ) Sign or outline lighting 53.40 2
E -mail: Signal ircuit(s ) or limited
t i12 '�i�� a � •. �,. 't' " t t. •'",�{.;��3 at ,7:57 r rl energy panel, alteration, or
:`TM.bii _.3' . wi .:t.1Td l.,lk .,� td,: �fi
' 1'33+4:3?'-..• Yr.�':�'s ... :::: -s ': ;f en
extension, Describe: Page 2 2
Business name: A . I '
Each additional inspection over allowable in any of the above
Address: in .. 4 11 1. \ • . ' Per inspection 62.50
City/State/ZIP: Z ■ \ ' • 7 Investigation pe hour (I hr min) 62.50
Industrial plant per hour 73.75
ri; E P' .;i'• E .�t.; =t it it
Phone: (`�� c: 2 - Fax ( �. . ':;rtc�t� ua�ERMf�1?'� i,� �e
CCB Lic. :) , /3 ) Electrical Lic. .06 _/ , Suprv. Lic.: - 10 t , Subtotal /-io .
Suprv. Electrician signature, required: Plan review (25% of permit fee)
State surcharge (8% of permit fee) (3, 7 5-
` I 1. • • t • Date: / TOTAL PERMIT FEE
•r Authorized signature: _. 4 .- This permit application expires if a permit Is not obtained within 180
days after It has been accepted as complete
Date: iff • Fee methodology set by Tri - County Building Industry Service Board
_ 111. _ 1♦ . _ " Number of inspections per permit allowed.
i:\ Bui lding\Permits \ELC- PermitApp.doc 12/03 440.4615T(10/02/COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00407
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/15/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 F. ..
INSPECTION WORKSHEET FOR DATE: 6/29/2007 TIME: 7:00AM PAGE: 49
SITE ADDRESS: 07501 SW DARTMOUTH ST 100 W1NCO CLASS OF WORK:
SUBDIVISION: PP1995 - 013 LOT #: TYPE OF USE:
PROJECT NAME: 1WWNCO
DESCRIPTION: (1) branch circuit for oven in deli department.
OWNER: WAREIVIART INC, PHONE #:
CONTRACTOR: ABC ELECTRIC PHONE #: 503 -233 -7551
Inspection Request Scheduled For: Date: 6/29/2007 Pour Time:
Code # Inspection Description __Confirm # Contact # Message
199 Electrical final 0511714i' 503-2337551 Y •
Corrections /Comments /Instructions: � q"( J- WY1
0 :3 PASS n PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
F L I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
,Inspector: 6 v LT Date: (zi 2 (f) Phone #: (503) 718- VALK)