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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2011 00666 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/30/2011 Parcel: 1 S136AD040o1 Jurisdiction: Tigard Site address: 11539 SW PACIFIC HWY Project: Burger King Subdivision: VILLA RIDGE Lot: 7 Project Description: (5) branch circuits for appliances. Contractor: FIVE STAR ELECTRIC, INC. Owner: PACIFIC TERRACE COMMERCIAL LLC PO BOX 555 BY SMITH, EDITA M BANKS, OR 97106 833 NW 170TH DR BEAVERTON, OR 97006 PHONE: 503 - 324 -0948 PHONE. FAX: 503 - 324 -0973 FEES Quantity Description Date Amount 5 crt Branch Circuits wo /Purchase 11/30/2011 $85.86 Specifics: Service or Feeder 1 ea 12% State Surcharge - 11/30/2011 $10.30 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $96.16 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 co• of the r - • - - • uestions to OUNC by calling 503.232.1987 or 1.800.332.2344. s Issued By: — — —/ •ermittee Signature: • ER 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. Fax: Nov 29 2011 10:20am P004 007 City 'of Tigard e D . Received • Date/B I - P en: • . B Tig rd, OR. 97223 . are nrt No. '� _ ; 13125 SW Hall iwd., ' - Phone: 503.718.2439 Pax:. 503.598.1960 NOV 2 9 2 Q � 1 A tV q ew . Other ?emit: i ,.rte'::' 1 i'•) ' insp®ction Liue: 503.639:4175 Date'ReadyiBy: Juds; Pi See Patty far ' • Internet: www.tlgard•or.gov • - °�. Notified/Method: CIT`d OF Ty G �� a� / ter, Supplemental lullornaation n ...: .r. a,Y , ✓r,n,Y!l r!! w, r r. r+ l...! . «._....�: :...�....,.,, • .:..: ... ...:: v,:., r,� "�r:x r r. -r -., .....^..,,' ' „ r,.,r.,•rr, ,•„r:. /r:! / /n ,.... /,r / /.i/ I.r /rr,, ,. ,.. r t ,. tr r : r,, .r•...r r,:Ylr „r,�,,.ra > ,,. r .r, /r,,, r r r ,f (� , r •..,., ,,' .. n.,i r...7'r ll .. / /.<. r.,..r r. !'7.,:. r! a,r. I('a Vnn,li'.,'.11rr.r: ! i,,:,r „rlr,J "° ri': Yliu -z<r�aiu.: % „ ... .. ,v.//,.:, •,,. . - <. .. r: .r.¢„ .; : ,;. n:, �:: ^ 1:. ..r. �,. r�,`.. c.� . r,: f, ,.Y', [., ^.'"i: ••.l..l /. i. 3'. rc, „i5t/ ,r! x. �C .n ,r . /,1. ,Yr:. . /. rr. .,h 1. C.1 , •U• l . ,,,r -�:. re. ..,# -// r.,S, r _/ f 1.. .,,G. ,Jrr. (, c, - a /,..: d.T ,. r,:, _�l; :. 1: ,l...J ,✓�r rya. r. rr:^� .':✓.r:IF�S �f . .d, „/ 'rLH /.,l.,n:. ,! , l. /!a ,:/'• .r f, 1. .J, .r:fr /r. ,,'.;/ , l::v, <.r : r/.. '.�„ >)� r.:- >.,/ .nt / . ,;r::�:' /,. / '. / -.1 .,' l,: .I v,n /.. r /:! „r,a t..cf,.. �:f,rrlr. r. .Nl, tf.n� ?2.r .1�!•. /., / /.rG �'" .� ✓/: `>f. ,' :gJi�,,'i'n J•..1...! r ,:,r`'�7•;. l.: 6f` :• /f `<// 1 / ,:r.: r. � "rLr,Yirv,. - r, .f.r:•. ,f,,...., :n.•., !;r,;9v,.x.,, /,. aa:.,,, c! c: v.:. ut /,,.,::...:1.,,,,.c,:nr�?1,J..� .. r:r. , ..,5,. ,.: � ,f �. .�r//rrf� t r., ,: ,,..:, � .:.. ,.,,, ,..: . k ): ..l;� r rc .// ,l ;: /: . ,/.. In6.,/. l,. M. w.,.,, rr.,, rM ,.YaI,�,.^r.,.,xr_r?'dr,.2.:.. ... rt. yF...,M „<d <,.., S tr ror,:u u7w,. I/uu / = : »[,.,, :r,.u. r_.'r �.. Fiii[r ,,.�',;;;i•.).. ,lF �x;,,.: �r : • 0 New construction ®; Addition /alterataon/repaacement • Please check sll that apply (submit 3 sets of plans w /ttetns checiced•below): 'Ill ❑ Service or feeder 400 amps ormore J B over thre sr e grfes. '.1.•;l. DettlO titi On 0 Other ". • • r:. /, J ! r/ y , '•'t / >:� 4 z . ,< r a o where tlae�aczalable faun current '0 Manilas sod'boatYacds. ,,, , , ( ' +�':!r„ ,. �,, : rr'• %r• ' %,9. �r/'.0 %',! /; r ri ! > r lgl ,, ✓ ? R i rY, z :Yg' %' : l:�,r." "; f/∎ ;.! i r 4:57, - „ "`� �i m 'i� r �1 f / u � f v / c rr / > P r �/ ,�r� ( �� „f . / !F f1 �y �il exceeds 10.000 amp* at 150 Volta Or ❑ fleeting buildings, • .0 -1 - a n d 2-family dwelling ' Coratnercisl/industrial ❑ Accessory b u i l d i n g' s 1 0. ❑ conorncrcial -uae agricU}futal amp' a for sll other ins4a11ations buildiLga. 7 Muit;i- family • • , 0 master builder' , • . • Q Other': ' 11 pomp. ❑ installation o£ 75 1(vA or : ,.srl n /��' / /tr A,rrcr, ,•r { +r /%; r.: i /.n.e :SA,.. ':r Xr; 'i✓' "l;:r;::l ".S .�-<R::.�. /r;,r:r r ,i;;$'9n,"r:�s(:7 % :r/i..L r;S,1•'.,,.,:, ...d. r..FrH :=^ ., S tanc. .fit!': - T �L..< ,1t.'r .f,. ..r,?C�V: , ,_Y %'6. , .i..r , 6 .r��•:'• 6rv/r::' ❑FIDCI C larger .r.a'-.': ,s. . -o-; •.a: r`7% :"kr fiFn X Ya separately dnved system .� i ! [/ 1 f r (, rr ri ts, / r( , I f i < f � . f F: , r /, t. [ f r . F � / 4 e ff ,�,� P y c sy EP17 :,.�?.:, r r r, ,:,;:: u, . f . r . .. : � 7 • rf r Prr :,. � ..., if ..r. r' ` _s. 'Y; .i xf ❑ Addition of new motor load of • ❑ "A " ", 1 - • «1 Job no;: F'S2611 -6 Job site address: 11539 SW Pacific Hwy 1001 - n■ ormon: ' • • 'oc • • © Six or more residential units. - . ❑ Recreational vebuole packs.. • City/State/ZIP! Tigard, OR 97223 • ❑Health -care £aeilities. q . Supply voltage for more than . • © Hardous locations. • 600' •volts nominal. ' Suite/bldg./apt. no Project e ❑Servic r feeder 600 ran or more. j name'. Burger King v � .. �rl :`rri�! ? „'(;rnl;'�s..•4'�, °.ri , CrOSS str'eet/direction5 to job site /(k "fr,:: / SF / �,,,r�. dk 7�✓[t,..u:M .C? : ,.,! H/r �J.. ,.[ 1 rf/,4�94 4, • �criP ?ir Qtr.. Fee. • Total • . ' . New residential single -or multi- fawailY dwelliing unit. • Includes attached garage. L • Subdivision: hot no • 1,090 'sq. ft. or less • , 168.54 • , • 4 • Tax map /parcel no -: . Ea. add'I.504 sq, :ft. orporrion . .33.92 1 • Limited hrte 4 residential 'N'., .'.'llr. o/r ,�.r, :' {G'r 'hY „�• v'f7<i;.' %Gil dC ;'::r %:rm ,:'C:' 'f:i:':"�7T;:.;'+i: S^n +' N ;, ; c :n',r:' a„ S:.c :.f.: rr :3,% � / ! ;:ia l.. 4,a..r, ,>••, `,Fir'ri,ro:5 ?? WiTh above a 9 tl 5.00 2 :) use.,. r.o . r r i'%4' . �'l•:i ..1, . . „si ° ''i:G'cr:: r, �, ,.;;��h....,,:::rsr;,(.. ^'r,,,• r e'; :'�: F I ^iz. . '?` - •�Z.r... „ .r4,.,._v r cr. M:, frm`G %1.< e... r< c:' S ?•r:7. :7r' 1.inaited energy,. multi - feebly A liance Circuits . • • 75.00 2 PP iesiderttia (wAitt sq. ft;} , Services or feeders installation, alteration, and/or relocation . r .. 200 amps or less '100,70 2 ,..n,S.S �•,r,. .v' ifi %'ar',:�r, aJ' . r, f.,'Y,. ,..4 'f'cn5ri�' &':Y•Y /,9rw';'Yb -.°,Yq !' ,:r,�r 1•r tf r „ f ?t , '{,. , i;;/!,v 'r1'" :4: .:, r. ,l ri : •: - ,: �, f i 'S. lh e :4. eCr::f " :!*` rn. s �a y d :ra.. ff <,fi r • „- cc` % r . i: : ,r, r ,. / r•f, 20 [ 4 0. ,,,( f,,•'f.:i. p %F•: :.rs;. r ,. : F.:/. .h o' /f "Pt ..tr.�f s� :r ; • 1 s o 0 amps • 13.3.56 • 2 • !i!`P.i;nss . . ✓th ?, ", " ' ; sy ,:f: + �;.r. �:: .. /,: : �: „ -� , .1 f, 1? p ✓ [h •h �• i ; , , , ,.. r.., .,.1I�ir;Til,,.:,,:flf�i�, ,.1 f0 ,. /,l., /r r l!;,r:;,x t,�1, e ' „r f ^` tF 1, • Ntun�: 401 amps to 500 amps 200.34.. • 2 • 601 amps to 1,000 amps. 301.04 2 Address; Over 1,000 arrips orvolts ' • 552,26 ' • 2 City/State/ZIP: Temporary services or feeders installation; alteration, and/or . • . re Phone: ( • ) Fax; ( )' . . . . • .200 amps or less .59,36 1 Owner installation: This installation is being made on ro that I own which is net 401 i . to 400 amps 125.08 ` z P P 401 amps to 59 amps 168, 2 inteAded for sale, lease, rent, or exchange, according to ORS 447, 449,'670, and 701 :. • Brandt circuits - new, altera or ea>;tet lion, per panel • Owner signature; . • . • Date: A. Fee for branch circuits with • . ' ,�..: ai /nz :Y; rr>: _ 1IY2::ffrr R'r' y2r"r *n. -. rr .. r, vi' "` ..ri° r. Y ^ ,J ?•vuy A.7 f � r,.. a. ,S "• "�: p.�J r� arr�zrrn sg'%'i n- >: /rent, rylr;:f;; ,Yroa. r,Cj, n,, /, , %s^ %`r %`�'k'�'' , s1.•. i 4r/ rr,;" rl�f� "'�s''%%`7�(;`r�r:k ^! „r,;�. 'Lf,. .f..'�. [ 'sa" aboveservieeoroedcrfee � k &. ///(/ //A 1 n r�llpL .f?:.._t', i,4 ,ic ,r�; , l NtY1�i;1�`:.iai'!<vM /;i:3f ,7 . n�.3'"v s/.:T::�"i �r,�"�� ea 7.42 2 h branch cilFcufit • . RuSiltIeSS rlatlle: . 13. Fee for:branch circuits without service or feeder fee, first I 56.18 ' 56.18 . 2 Contact name: . • . branch circuit . Each,add'I branch circuit 4 7.42 29.68 .2 Address: Miscellaneous (service Or feeder not included) . City/State/ZIP: F,aoh maaufacnnod'or modular • 67:84 • • dwelling, service and/or feeder . . • . . Phone: ( ) Fax :: ( ) Reconnect only • • • 67.84 ' .1 Fump or irrigation circle • 67.84 • ":,:. n 'Si or outline lighting 67.84 +re,; ::r,s. rut,. ,%n,- � :;rr:.r:r�..r:•ra:r, i�'<:�.v<,.,.r.., 'au:,;n vrn -:;. r .�. N �. :; _.- : „ „;;... ., ..,., m':r: rr, ors,. ,, • ymr ..,r 1 c A ! S, r : 6. '' .,/ ? r " r- nw r • ;, r.rirr:#1 _kr,Yir /^ �'i I ,! ' "!Y (: / .� ', 7n%il � $rr th J:'� "'v'!i.'` Sri''.: , y, M,:w, ^ , q': >i✓' /! 'n:l,; .N�>. % :a: r . rF .Yt 2 t' 7 �1i �f,,.y,1 $ . r n t _ �f�!yrf, �Y,,k y ,� ;; • • . ' ,r' ` � Sagnalcilruit (s)orlimited- enerBY _,.�is:� /i,.' l` G:ir s.::�k! �,.�', kr7�% ' zs,�x' /J I; ",r � ?'�ir %F y , Business name: •1^ ive Star Electric,•I,nne: panel, alteration., sot extension. . Page 2 1~acia additional inspection over allowable in eny'of the above Address: PO Boa, 555 . Additional inspection (1 hr min) • 6625/ hr City/State /ZIP: Banks, OR. 97106 investigation (1 fir min) • 66.25f hr Industrial plant (1 hr m 78.18/1u Phone: (503) 324 -0948 . Pax: (503) 324 -0973. • . Inspections for which no fee is • 90,00/ hr _ -- s ificall listed. Yr hr mm ' .. ,�' °'l''iY "Ji;'tiS " :.v.:- x ":'la: iii:. ls, xwn.,,,.;✓ 3v r> x' nr;,: w' iry;, rr .,.,,,q,:r „f;s7`:ir?:,.`'•' ":' ^'tilt /',<l'nira r:va�:i;';:} CCB Lic.:. 156231 i of !1. Electrical Suprv. • Liu.: 46225 r ,} r x.,11, �,z' "'' "'' ^�;''.,�.r �::':zt.;::.r,,;l ,,,' ,,.:.,r, r,., '�L� �� ffi�lr: [�','�''+iG! <fN (r:- r:f:lRei•:rt <: "_,: *s: /.�::�:: r;c'Y !(..e ...,,....,r'r�c::-ifi::nx`ri,: _- ::_rr,, r.r,:ra�4r,.v'a:Bo-�i:R.� Subtotal: • 8 • Suprv. Electrician 5igr1ature, required: Plan review (25% of z5 of foe) Print name: Royal Stearns Date: 11/29/11 ' , ' State sn (12"/° of permit fee): , • 10.30, Authorized signature: PERMIT FEE: • . 96.16 Phis permit application expires if a permit is not obtained within'780 • Print name! Date: days after it has been accepted as cout�ple -' • • . " Number of inspections allowed per pertnit. I:1 Bui ldioglP•rmits1121GPentitApp.d°e 07/01/10 440- 4515T(11 /05 /COM/WT8