Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2008 -00580
COMMUNITY DEVELOPMENT DATE ISSUED: 10/10/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S 126CA -01000
SITE ADDRESS: 09009 SW HALL BLVD 142 ZONING: C - G
SUBDIVISION: WASHINGTON CIRCLE PLAZA LOT : JURISDICTION: TIG
PROJECT: SUSHI HANA
Project Description: Altering (9) branch circuits.
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: 8 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:
WASHINGTON SQUARE PLAZA HUNGNAM OH ELECTRIC
BY THE CAFARO COMPANY 10580 SW 82ND AVE
P 0 BOX 422 TIGARD, OR 97223
FLORHAM PARK, NJ 07932
Phone: Contact #: PRI 503 - 381 -4910
FEES
Description Date Amount Reg #: ELE 34-461C
[ELPRMT] ELC Permit 10/10/2001 $100.05 LIC 126274
[TAX] 12% State Surchar 10/10/2001 $12.01 SUP 43755
Total $112.06 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 4111 Permittee Signature:
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.
Electrical Permit Application FOR OFFICE. USE ONLY
City of Tigard � D ate B lv i /7l� /_ .
Permit No ' • 5,
- :
° 13125 SW Hall Blvd., Tigard, O'.= Plan Review
��. Pli
. Phone: 503.639.4171 Fax: 503. .: l o ' d , Other Permit: �
^Q�U Date /By: �uJ �J 5
TI GARD_ Inspection Line: 503.639.4175 1 % t. Date Ready/By: suns. ® See Page 2 for
Internet: www.tigard or.gov Oc: P co Notified/Method• 0 Supplemental Information
t = , ' 1 , �� E7OrWO 4 ° O . , � ` S� ® �. - ' . . ` ;PLAIV ,REyIEW ,a
❑ New construction A Addition /alteratl r ' 1, Please check all that apply (submit 2 sets of plans w /items checked below):
CO ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑Other: V where the available fault current ❑ Marinas and boatyards.
--,:i'.,;:,,=, „" °m'/. ' _ " exc eeds 10,0 amps at 150 volts or Floating buildings.
>� ,'�` - ° �_�,;' -', CATEGO OF,� EONSTRUCT'ION' :,�� z�� �'�_�. :. °-' � " ��r.�a «.,,�. � ° P g
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ['Fire pump ❑ Installation of 75 KVA or
3 ❑Emergency system. larger separately derived system.
'' ? d °JOB 'SIT INFORMATION'AND °LOCATION = a , Y.
�,� . ,-
,- ' , ❑ Addition of new motor load of ❑ "A ", "E ", "l - ", "1 - 3',
Job no.: Job site address: Q I I + IOOHP or more. occupancy,
I ,k) t v� ( L\ 1 U� 0 or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: "7 x ❑ Health -care facilities. ❑ Supply voltage for more than
0 ❑Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: i el-2. Project name: L bi [ [I1 ` I-.} &II & ❑ Service or feeder 600 amps or more.
; ; ' '' ' '' ' ,j. '':. : ' ,:;-*" : _FE `SCFIEDU1— a : , 4'': li ;i
Cross street/directions to job site: Description I 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'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.:
Limited energy, residential 75.00 2
" +,,,. �DESC OF`,WORKT •�: ,a, , '' ' ' ,. (with above sq. ft.)
4 �� Limited energy, multi- family
�5 A 14 ,4. f •-70 .r residential (with above sq ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
. ®- PROPERTV OWNER . - , ' y vi ❑ .TEINANiy 201 amps to 400 amps 106.85 2
Name: 5 �� 401 amps to 600 amps 160.60 2
}{ 601 amps to 1,000 amps 240.60 2
1
Address: nog S ., , ` L -�- _ 13 t VA- . ` 4: t 4 . Over 1,000 amps or volts 454.65 2
City /State /ZIP: 1 I 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 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
° ' "` .APPLICANT'; - : -, -' , - -❑ CONTACT,-PERSONa , above service or feeder fee,
l ' 1 each branch circuit 6.65 2
Business name: -I-(4 v� Ll vll n V 1 ',.pad-{ c_, B . Fee for branch circuits
�/1 (_ yv r� without service or feeder fee,
14 n rx a. n U first branch circuit 46.85 l./ ` �C 2
Contact name: 111 111 l
Address: 1 10 15 c � t � 1 t � E add'I branch circuit 6.65
(O 2J 53.
) 2
_ Miscellaneous (service or feeder not included)
City /State /ZIP: l - A- -zk. d r< °I I') ZZ2 Each manufactured or modular 90.90 2
l LI dwelling, service and /or feeder
Phone: ( --- 3) 3 EL — 41 1 0 Fax: : ( ) Reconnect only 66.85 2
E -mail: 4011 .Q..-1 € * ry C 0 p.,� V 0 141 Pump or irrigation circle 53.40 2
�, . �' 'CONTRACT Sign or outline lighting 53.40 2
Business name: �] ���� � Signal circuit(s) or limited -
L t 1' & WI J � r C � energy panel, alteration, or
Address: I, It () c ` G� G! yt, ,,Q_ extension. Describe: Page 2 2
City /State /ZIP: -- I" : 4 y" i 0 K 1 '12-2-3 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) 3 Si ( —4/.10 Fax: ( ) Investigation per hour (1 hr min) 62.50
CCB Lie.: 1 /� Electrical Lie.: ;4 - 4( 1 C.Suprv. Lie.: 1- 39 S S Industrial plant per hour 73.75
=` : " ._ -, ', .,ELECTRICAL - PERMIT ,FEES ' ' ... - - : .
Suprv. Electrician signature, required: L - Subtotal: ((X-) . 05
Print name: 1.--1 I/v n Q/►1 Q, M 0 Date: p Ct . t 1, , C) 8- Plan review (25% of permit fee):
(J State surcharge (12% of permit fee): 1.). .0
Authorized signature: TOTAL PERMIT FEE: ( i a 6G
(/vr1 l 1 ^ � This permit application expires if a permit is not obtained within 180
Print name:
a tnh 0 ' Date: o vl , t 0 t O days after it has been accepted as complete.
• 1 * Number of inspections allowed per permit
I:1Building'Permits\ELC- PermitApp doe 05/23/06 440- 4615T(11 /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
l RESIDENTIt1I ONLYs ; : ��
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
n Burglar Alarm
n Garage Door Opener*
n Heating, Ventilation and Air Conditioning System*
n Vacuum Systems*
❑ Other:
COIVIMERCIA;I,WORK`ONL T _ :', " "� ° >�
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
n Audio and Stereo Systems
n Boiler Controls
❑ Clock Systems
n Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
n Medical
❑ Nurse Calls
n Outdoor Landscape Lighting*
n Protective Signaling
n Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
P\ Building \Permits\ELC- PermitApp.doc 03/23/06
, I '
CITY OF TIGARD
4,
BUILDING DIVISION PERMIT #: FLC2008•00c80 ,
,
13125 SW Hall Blvd., Tigard, OR 97223
DATE ISSUED: ion wow
Phone: (503) 639-4171 ,_,/ititill
Inspection Requests (24 Hrs.): (503) 639-4175 IL
INSPECTION WORKSHEET FOR DATE: 1 ins0008 TIME: 7 PAGE: 28
•
SITE ADDRESS: 09009 SW HALL BLVD 142 • CLASS OF WORK:
5)--
SUBDIVISION: WASHINGTON CIRCLE PLAZA .LOT #: ' TYPE OF USE:
0
PROJECT NAME: SUSHI HANA
DESCRIPTION: Altering (9) branch circuits.
OWNER: WASHINGTON SQUARE PLAZA, PHONE #:
CONTRACTOR: HUNGNAM OH ELECTRIC PHONE #: 503-381-4910
Inspection Request Scheduled For: Date: 11/25/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 078474-01 503-381-4910 N
Corrections/Comments/Instructions:
I r ei • ■ S S 1 PARTIAL APPROVAL H CANCEL EI NO ACCESS
1 I FAIL 1 I CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
/
Date: -S
Inspector: t Phone #: (503) 718-
. ,
- -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008-00580
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/10/2008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 11/21/2008 TIME: . 7 : 00Am PAGE: 9
SITE ADDRESS: 09009 SW HALL BLVD 142 CLASS OF WORK:
SUBDIVISION: WASHINGTON CIRCLE PLAZA LOT #: TYPE OF USE:
PROJECT NAME: SUSHI HANA
DESCRIPTION: Altering (9) branch circuits.
OWNER: WASHINGTON SQUARE PLAZA, PHONE #:
• CONTRACTOR: HUNGNAM OH ELECTRIC PHONE #: 503-301-4910
Inspection Request Scheduled For: Date: 11121/2008 Pour Time:
Code # Inspection Description • Confirm # Contact # Message
199 Electrical final 078388-01 503-381-4910
Corrections/Comments/Instructions:
OS led- Qr OPE recios‘i•es
e-ef-44 cce , 0-1 ct- cte ere ed /Q-6
U L. c -g• eid. c.941-4-4-C-icct4--)
e es A
PASS 7 PARTIAL APPROVAL 7 CANCEL El NO ACCESS
I I CALL FOR INSPECTION 1 ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-
IP ,
CITY OF TIGARD tr-,
BUILDING DIVISION PERMIT #: Fi.c2008.00590
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/10110013
Phone: (503) 639-4171 kodolv
Inspection Requests (24 Hrs.): (503) 639-4175 ,A-JAI. ■ 'T.....
INSPECTION WORKSHEET FOR DATE:
10/21/2008 TIME: 7:0 PAGE: 24
SITE ADDRESS: 09009 SW HALL BLVD 142 CLASS OF WORK:
SUBDIVISION: WASHINGTON CIRCLE PLAZA LOT #: TYPE OF USE:
PROJECT NAME: SUSHI HANA
DESCRIPTION: Altoring (9) branch circuits.
OWNER: WASHINGTON SQUARE PLAZA, PHONE #:
CONTRACTOR: HUNGNAM OH ELECTRIC PHONE #: 603-381-4910
Inspection Request Scheduled For: Date 10/21/2008 Pour Time:
Code # Inspection Description # Contact # Message
120 Electrical rough-iii 076974-01 503-381-4910 N
Corrections /Comments/ Instructions:
- TWig 't S 6potzvokc pa( /s Isi.ii - rmastc 14(z-%
•--______/ v
601-_ - c.:1(k-c--k)11' Ap., tr 6 -7 1 `p 1 I 0 6 LAB,
* PASS 7 PARTIAL APPROVAL El CANCEL NO ACCESS
n F 0 CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector: r, N 06 tE Date: 11 'I 01) Phone #: (503) 718- ifil
.. .. . ,. ., .,
CITY OF TIGARD
BUILDING DIVISION PERMIT #:
RG2008-00580
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/10/2008
Phone: (503) 639-4171 / M.
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
lama/2008 - 7:00AM • 6
SITE ADDRESS: 09009 SW HALL BLVD 142 CLASS OF WORK:
SUBDIVISION: WASHINGTON CIRCLE PLAZA LOT #: TYPE OF USE:
PROJECT NAME: SUSHI HANA
DESCRIPTION: Altering (9) branch circuits.
OWNER: WASHINGTON SQUARE PLAZA, PHONE #:
CONTRACTOR: HUNGNAM OH ELECTRIC PHONE #: 503-381-4910
Inspection Request Scheduled For: Date 10/13/2008 Pour Time:
Code # Inspectio • - ation Confirm # Contact # Message
115 Electrical ser " 076628-01 503-381-4910
Correctio , s/Comments/Instructions:
•
•
•
I PARTIAL APPROVAL LII CANCEL I I NO ACCESS
Li FAIL pi CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: , I * 4 Date:/ - 13 --- Phone #: (503) 718-