Permit CITY OF TIGARD ELECTRICAL PERMIT
11 1 7. COMMUNITY DEVELOPMENT Permit #: ELC2011 -00559
Date Issued: 10/11 /2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503 718 2439 Parcel: 1 S136DC00500
Jurisdiction: Tigard
Site address: 11626 SW PACIFIC HWY
Project: Tigard Cinema Subdivision: HUNTER POLLOCK NO.2 Lot: G
Project Description: (4) branch circuits for exit signs
Contractor: STONER ELECTRIC Owner: TOM MOYER THEATRES
1904 SE OCHOCO 805 SW BROADWAY #2020
MILWAUKIE, OR 97222 PORTLAND, OR 97205
PHONE 503 - 462 -6500 PHONE
FAX 503 - 659 -4968
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo /Purchase 10/11/2011 $78 44
Specifics: Service or Feeder
1 ea 12% State Surcharge - 10/11/2011 $9.41
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $87 85
.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 OAR 952- 001 -0090 You may obtain a cosy of the rut questions to OUNC by calling 503 232 1987 or 1 800 332 2344
1
Issued By: - - mittee Signature: — _y
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.
Oct. 10. 2011 2:55PM Stoner Electric Group No. 9946 P. 1
Electrical Permit A rf)rl clrrlf l I IS1•; Gila'
. �
CIry o f Tigar ECEN �_ slued Data/13 : i0 �1 .[�
13125 SW Hall Blvd., Tigard, OR 97223 2O I I Plan Review
:IN Phone: 503.639,4171 Pax: 503,598.1960 OC i 1 Date/By: Other permit:
1 ft i,\1L13 Inspection Line: 503,639.4175 Date Ready/13y. tuns' El See Page for
Internet: wavw.tigard or.gov CiTy OF TllGNa $ Notified/Method. Supplemental Informadsn
.,' - = TYPE =:Oj+ }YO : ( 111.pt G u PLAN •RE41EVi!' ' =.. • J! ; '- -'r,' fit:
C) New constrs'Clion C41 Addition/alteration/replacement Please check all that apply (aubmil ado of p1 tv/items checked below):
❑ Service or feeder 400 amps or more ❑ Puilding over three stories.
❑ Demolition ❑ Other: arbors the available fault current ❑ Marinas and boatyards
CATEGORY: OF CONSTRUCTION '' ' ' " exceeds 10,000 amps m 150 volts or ❑ Floating buildings,
leas to ground, or exceeds 14,000 ❑ Commercial -use ngdeulturol
❑ I- and 2- family dwelling El Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
�� �. JOB ,$1 l C X PORt1NAmX0�Y A D L0 mION ❑ Emrrgency system. larger separately derived system
- ^- ::i i . . ,$. �. i,.: ..� ❑ Addition anew motor load of ❑ A '<E , l_2 'l_3 ",
Job no.: a. k Job site address: I I Cot le SIM /h-c4 Fr ,' f'k lwA 100 or or 11 re° occupation,
Y ❑ S iz or more residential units. ❑ Recreational vehicle parka
❑ Healua -care facilities. ❑ Supply voltage for more than
City /Stale /ZIP! / 8 e Iq "� p R 9 7 u3
/ 7-.0 !D1 ❑ Hazardous locations. 600 volts nominal
Suite/bldg. /apt,no.: I Project name: -t G I QevI 65 Liscry i coorfeeder600 amps ormore.
k*r�-2.55- c': "yt- _: "Sr;- : ", At. SCHEDULE
Cross streei/directions to job site: Description I QrT. 1 Fee. I 'rot,t I
New residential single- or multi - family dwelling unit.
_ Includes attached garage. _
Subdivision: Lot no.: ►,000 sq, II. or less 168 54 4
, Ea. add'1500 sq. IL or portion 33,92 1
Tax map/parcel no.:
�; _ r " _ r -,: . __ x � r � - �� - -; �� �, Limltedenergy,resltlenital 75.00 2
., '-:$):' c1 ir>"6 eti,Yi i M e'" �- `^Y (with above sq. ft.)
r � Limited energy, multi- family 75.00 2
=�� " �•' �• ;s._? �e;,Cti:�`= . , -+�. �.a _:!3, ;l �fpaL'� ;: r. ^:$ "°ft : - ,
REPLAC t l'b`r)A/6 g $I t4 15 i 13 UG / bJJ 771 residential (with above sq. ft )
- Services or feeders Installation, alteration, and /or relocation
c�1 AI/E- 200 amps or loss 100.70 2
x��+ ?:-f 0 p Y, 60. ,Yt: ,e: _`_ _ ,: o f r , N+a'_l 201 imps lc 400 amps 133,56 2
401 amps to 600 amps 200.34 2
Name:
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552 26 2
C /5tate/LIP. ` Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) I pax: ( ) 200 amps or less 59,36 1
Owner installation: This installation is being made on property that I own which is not 201 amps l0 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits • new, alteration, or extension, per panel
Owner signature: Date: A. Pee for branch circuits with
N:;r•-c_.. ' CI APPLICANT I LI CONTACT PERSON' ' ' above service or feeder fee, 7 42 2
each branch circuit
Business name: B. Fee for branch circuits wi//to e
service or feeder fee, first I 56.18 54, I e 2
Contact name: branch circuit
- --- Each ndd'I branch circuit '3 7.42 z2.2 -40 2
Address: Miscellaneous (service or feeder not Included)
City/State/ZIP: /StatelZlP: Each manufactured or modular 67.84 2
y dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail: • _Os '3= -'.. -1: ".Co rBACx'OIt - - - - -F Stgn or outline lighting 67,84 2
� �f ,� - .,�� ''' -- =, � =` =:G�' %°� ";; �; Signal circuit(s) or limited-energy
Business name: STONER ELECTRIC, INC. panel, alteration, or exlenslon, Page 2
Each additional inspection over allowable in any of the above
Address: 1 904 SE OCHOCO Additional inspection (1 hr min) 66.25/ hr
City /State/ZIP: M I LWAU KI E OR R 9 Investigation (I hr nun) 66.25/ hr
Industrial plant (I hr min) 78.18/ hr
Phone: ( 503) Fas; ( 503) 659 -4968 Inspections for which no fee is 90.00/ hr
specifically listed (Yz hr min)
CCB Lie.: 44823 Electrical Lie.: 26 -122C Suprv. Lie.: 3496S - LLEMICAL PERMIT PEES
Super. Electrician signature, required: a� ,,-C o Subtotal ____"7$ , r� ¢
Plan review (2 5 /o of permit fee): 19."
Print mine: MICHAEL FALCONER Date: lc, JIbII if State surcharge (12 %ofpemutfee): 9 ,•4 I
1---- TOTAL PERMIT FEE; 437 • $
Authorized sIgnatllre: This permit application expires if a permit Is not obtained within 180
Pint name: Date: • days after It has been accepted as complete.
Number of inspections allowed per permit
1. 1 1 3 ui 7 di „ g\Penaheakr.C.PonnitAOpdoc 07/01/10 ' 0- 4611T(1t/Qt /COM/WO9