Permit CITY, OF TIGARD ELECTRICAL PERMIT
q PERMIT #: ELC2008 -00314
COMMUNITY DEVELOPMENT DATE ISSUED: 6/5/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 102AA -00904
SITE ADDRESS: 12060 SW MAIN ST ZONING: CBD
SUBDIVISION: RITE AID SHOPPING CENTER LOT : 001 JURISDICTION: TIG
PROJECT: VALUE VILLAGE
Project Description: Installing (1) branch circuit for battery charger.
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:
NORTHWOOD REALTY CO INC STONER ELECTRIC
BY ALBERTSON'S INC #6518 1904 SE OCHOCO STREET
PO BOX 20 • MILWAUKIE, OR 97222
BOISE, ID 83726
Phone: Contact #: FAX 503 - 659 -4968
PRI 503 -462 -6500
FEES
Description Date Amount Reg #: ELE 26 -122C
[ELPRMT] ELC Permit 6/5/2008 $46.85 LIC 44823
[TAX] 12% State Surchar 6/5/2008 $5.62 SUP 3496S
Total $52.47 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.
•
/2 75
Issued By: � � _ �� - Permittee Signature: ›..12... G,� /
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.
06/04/2008 08:26 FAX 1jj001
� Iectrical Permit Application FOR on 1(.:t: ( ONLY
City of Tigard ' �hf�
II 13125 SW Hall Blvd., Tigard, OR 1� E a- ktY1e I /� ��
Phone: 503.639.4171 Fax: 503.598.1960 Date,Bc. Other Permit:
D Inspection Line•. 503.639.4 Date Rr :•By Mao: ® Page 2 for
See Po
T i G A P JUN 0'f 100'- Notifiedleled od. Supplemental Information
�
e I I� n S t -� ernet: wg.vw.tigard- anger
! � : p.� 'rj� ; ��1; '.x e:`- . raj : �.1 �.�,�,_�Y, .. f .. �. Fes a,- ,w vs:...t. .,� ;._ �yor.�,�:�.1- .�.n�� `��b,,r,� 7�,y�,.� i� _ .:.�`;r;3��.�:1. ::r
�F:'. ns'iFad.'f%.,°ltf✓,V%'-ra^'.t.� a¢ •;,`;P:Fl�' 'hh/,<P''','.fie g- - ,r''a d-., *r"• r i R;V :�7'.t4'2:iJ' aim ='at4WS' ;)'{ a ',
❑ New construction �Addition/81� , I .� , � 1
., p qP t T Plesc check all that apply (submit 1 sets of &ens ti %items checked below).
. 1 ... � � , . . P ❑ ding over three stories.
❑ Demolition ❑ Other �+Y 1 � � � (1 � . ❑ Service or feeder 400 am a or more Buil
where the available fault current ❑ Marinas and boatyards.
',e ," ! ,r ..'. r. :e�.ar .r -��. .-+:. xkc
'"'y it,,, d;' ' ickin�.';'. ! ., ' ti ritrj„ ` !�` 4 kq "1"f exceeds 10.000 amps al 1 50 colts or ❑ Floating buildings.
i ' .v.).;,- '�" . ` -0,r ' e� l .,., .,'"° " o less to ground, or exceeds 14,000 ❑Commercial -use agricultural
❑ 1 - and 2- family dwelling . Commerciaifindustial ❑ Accessory building amps for all it installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other 0 Fire pump. ❑ Installation of 75 KVA or
i1 `�'''. r, .�� rt r >z,.. , xa k]! t: • YI L i'•1!� ['Emergency sy P
Itmo . ;, ` Y5 __ [ t ' y � „ {a i :.: 'i Add stem. larger separately derived system
���:i2• tL? ,I..`�u •rt i Mik •". ���, d�,.��� ❑Addition of new motor load Of
Job no.: 7$9.b I Job site address: /01 r O Std , YL I r wA�QyA1 001IP ormore. occupancy. eroccupancy. y.
❑ ❑ Snc m mate residential unity. Recreational vehicle parks.
City/State/ZIP: 1 9 7 3 ❑Reslrhtare facilities. ❑ Supply volt y e for reeve Mon Hazardous locations, 600 robs nominal.
Su itelbldg• /apt.no.: Project uame: ❑Service or feeder 602 ampsorMare.
11 1 4 Lt.1 v L LL f b f: ? 7.4e, "'a`ra P ' 1, z ..� : - ,; ' ;
Cross street/directions to job site: Description 1 r e 1 T tat za:' t
I Om'. Rem •''' Total I -
New residential single- or multi- family dwelling unit.
Includes attached garage.
-
Subdivision: I Lot no.: 1.000 sq. ft or less 145.15 4
Ea. add - 1500 sq. 11. or portion 33.40 1
Tax map /parcel no.:
E ,• i tr K t y - c , . , y . * . «. K cIK,• Limited energy, residential
.` ;� irk :�}� -� ?t77f? C `• r i T � 2 7f `U a : r t } .`�
(with above sq d.) 75.00 2
t= < ,1W000 114.'.' :J! ?b AT ieii}fS:!rHf°_='.'n?+n�1 7
Limited energy. mol6- family 2
K7f,_f j a Fp �X L.zPT 6r4 TT k� 75.00 1 residential (with above sq. ft) • t
n ^ Sersicea or feeders Installation, alteration. and /or relocation
/� 200 amps or lets 80.:0 2
' r ++�:+? 64 4 � a r.•�•- s;.sc..rr•r, > }t
u
!;< o,-s Fi':Y`rx:F. i a �;_, mr c 2..' =°s`f4
{ ,�,a� '' ' ; 1� ,i t , i( 201 amps to 400 amps 106.85 2
Name: 40l amps to 600 amps 160.60 2
• 601 amps to 1.000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City / State/ZIP: Temporary services or feeder* installation, Aeration, and /or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 2(11 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
Owner signature: Branch circuits - new, alteration, or extension, �►er panel .
Date:
-
=r?� fi�*sr� �p� . +: t . .. a'� +, , -,:,�� - .. y,.k,:....�:,,,._ A. Fee for branch circuits with
a
`'�' ? � "ifiF- ���,.5 � ivy' �,`�'.. `tit � �, � =rr4� lure s tn'ice tttfeeder fee,
�• i .,t,.r :�`.:,,. 'f`i, : 1,• C�' 1�. 1= �;'. is.•• n+ rv�!! I<re��cY;��Ev',.vl�...l.,i+tYl_ al 6.Gi 2
each branch circuit _
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee. 1 46.85 I t ./1 2
first branch circuit 1
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State/ZIP: Each manufactured or modular
90.99 2
dwelling. service aod'or feeder
Phone:
( ) I Fax: : ( ) Reconnect only 66.85 2
E-mail: Pump or irrigation circle 53.40 i 2
��::a'I r Ni' li L`'7i• LYY•'�'' IS =r, IC' YaY,'
`� . 5'`x1;3} "n -: ,may,,, >%�I �, t 3^aisi.n3W E , _r- 1 ,x, Si �n or outline lighting 53.4 2
�.Ef s s r'.`:'I.+'•`ctx• 4 `> ���,. �= ,K'k.y ?'f�'lrri�t; ruin% f3� * „��,r3� 'q: =�� Pm Pal )
Business name: STONER ELECTRIC Signal circuit(s) or limited
energy panel, alteration, or
Address: 1904 SE OCHOCO extension. Describe: Page 2 2
City /State/ZIP: MILWAIJIdE, OR 97222 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 462-6500 I Fax: (503) 659 •
Investigation per hour l I la ruin) 62.50
CCB Lic.: 44823 I Electrical Lie.: 26-122C Industrial plant 73.75
2 I Suprv. Lie.: 3965 P _
Supra. Electrician / €E E WC A Ott � f �� ,
signature, required: A " =+ i ( ,... fir
Sup
rn o..e / .v+r++ Subtotal: � .4 L
Prue name: MICHAEL FALCONER 1 Date: fal3 /n4 Plan review (25e. o of permit fee):
I f Stain surcharge (12x. of permit fee): bp Authorized signature: (, ` � z / TOTAL PERMIT FEE: 2. . i 7
F This permit application expires it a permit is not obtained alIbin 180
Print nailer. I Date. days after it has been accepted as complete.
B ' tP>m:mV t c - wy,ni • Number of inspections allowed per permit.
[:s
��8 tApp• a5/23/O6 440- 4615T(ti/05/COM/NEa
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008 -00314
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/5/2008
Phone: (503) 639- 41714i�4pgg I �I
Inspection Requests (24 Hrs.): (503) 639 -4175 1
INSPECTION WORKSHEET FOR DATE: 6/10/2008 TIME: 7:01AM PAGE: 39
SITE ADDRESS: 12060 SW MAIN ST CLASS OF WORK:
SUBDIVISION: RITE AID SHOPPING CENTER LOT #: 001 TYPE OF USE:
PROJECT NAME: VALUE VILLAGE
DESCRIPTION: Installing (1) branch circuit for battery charger.
OWNER: NORTHWOOD REALTY CO INC, PHONE #:
CONTRACTOR: STONER ELECTRIC PHONE #: 503 - 6500
Inspection Request Scheduled For: Date: 6/10/2008 Pour Time:
Code # Inspection Description - onftrr - Contact # Message
199 Electrical final 071123 -01 329.1971 N
orrections /Comments /Instructions:
i
N
v0l
IA PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 3• 1 `t Oca lz Date: 4 1101% Phone #: (503) 718 - Vital