Permit A y _ CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00649
1 DEVELOPMENT SERVICES DATE ISSUED: 10/8/2004
' 11 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S136DC-00500
SITE ADDRESS: 11626 SW PACIFIC HWY •
•
SUBDIVISION: ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: (1) service and (21) branch circuits for box office remodel.
Job No. 71507
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: 1 W /SERVICE OR FEEDER: 21 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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:
REGAL CINEMAS E C COMPANY
BY ACT III PO BOX 10286
7132 COMMERCIAL PARK DR PORTLAND, OR 97296
KNOXVILLE, TN 37918
Phone: Phone: 503 - 220 - 5377
Reg #: ELE 26 -45C
LIC 49737
FEES SUP 4040S
Description Date Amount Required Inspections
[ELPRMT] ELC Permit 10/8/2004 $219.95
[TAX] 8% State Surcharge 10/8/2004 $17.60 Elect'l Service
Rough -in
Total $237.55 Elect'l Final
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 se rttr i e e R 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -069 or 1 -800- 332 -2' , , .
Issue By: k .. 1 , ' .1 0,Ced_ /) i Permit Signatur
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 - �Z.LIM DATE:
LICENSE NO: '7`i'/ a
Call 639 -4175 by 7:00pm for an inspection the next business day
10/07/2004 19:38 5032205347 PAGE 02
y. :Aac
le xical Permit C V h/ C l („t c 1, II( I: I I': ■ r I.
City 'of Tigard 11"'ii G G Ftecermd
13123 8W Hall Blvd., Tigard, OR 97223 PI �� g0� • Permit No.: ,, , :
Phone: 501639.4171 Fax: 503.598.1960 J CT 8 1 . - ,, Plan Review Atha Permit
Inspection Line: 503.639.4175 I l pp r
_ -- : Y: Jane - P Z or
Internet: www.ci.dgand.or.us vITY OF Tie.- . _ ,`. - Notifed/Mediod: supplemental Information
, ( 4 J
0 New construction ddition /altetat;on/replacerrtent P ease check all that app y:
❑ Demolition Other; ❑Service over 225 amps, com n'i ❑Flazalydous location
+ "t; i ' ,, ; y� � ['Service over 320 ' — rating ❑ Buildng over 10,000 sq. ft.
-x,;; , , r , 1 �?r'r' ; , f ....: ' f „ , t ', 1, e' of I- and 2-family dwellings 4 or more new residential
0 1 and 2 family dwelling Commercial/industrial 0 Accessory building ❑System over 600 volts nominal units in one structure
Multi family Q Faster builder 0 Other ❑Building over three stories ❑Feeders, 400 amps or more
�Ji (�iir i' [5 Jr r Z , ✓ l �„ f ar r , r r s - P F ❑Occupant load Over 99 persons ❑Manufactured structures or
1lry , ) r i 17 f,' ❑Egrcasllighting plan RV park
Job no.: '\ \So1 Job site address:,, G ` SL cA C % 1c- ❑Health facility ❑Other:
Submit 2 sets of plaits with any of the above.
City / State/ZIP: The above are not applicable to temporary construction service.
e
Suite/bldg./apt. no.: '. 1 �, J ,�i(si'. l 1
Project Hartle: R � \ � G tom r. Qty. s F � :,,.cl: Fo ul ,. dr „l,.-•
Doolittle's 1 1 eta..
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: • 1 Lot no.: Ea. addl 500 sq. ft. or portion , 33.40 l
Tax map/parcel no.: Limited energy, residential 75.00 2
• 75.00
� ' �. � Pi „_ @`, o ft + f i r r f a Turd energy, non-residential 7 2
�l.0 1
••',
,' :. : .?• ,, mIi :' ,J 1 'I r t , f : P � t j;; C .. t„ !`, Each ttmnufactured or nodular
.1 :., .I. I : `e;, , N :. t f 4 :�� .� r: ,! r r7 , , c.t � L,” , 4' . ., r . aE
N -- k - ■ GQ�C �0 0-1- dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less % 80.30 IVQ 2
: : .1^ ,'11�}It' i � � ( F :. 201 apps to 400 amps 106.85 Li
1Y ik i r.. l , r � , �1! L . ' ^ ' J � )i M 7 � � � �
Name; 401 amps ro 600 amps 160.60 2
O� rn0y2 GS 601 amps to 1,000 amps 240,60 2
Addresd: \ 0 BB SL., a - 4 wM � SI ..4m %G S® Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City / StateZIP: a \\ 0f C't , CLS cmpor s ces or
ere seders Installation, alteration, and/or
Phone: (ON ) n � t9,-0�� I Fax: ( ) relocation
200 amps or less 66.85 l`
Owner Installation: This installation is being made on property that I own which is not 201 artgrs to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 s to 600
Owner signature � �s 133.75 2
Date Branch circuits— new, alteration, or extension, per panel
: . , ',. i . . -. . .
t t i , , 1, , . t . , l vi i .- t ' i r l *' i i a i 15.11,',1,0 ' , .- each
service or feed fee Fee for branch circuits with ` t
,: „r . . _ . , . . s. , 1 . ,:., 1. S... krv•';.,11” er fee,
Business name: r.\. 6.65 \g‘, 2
branch circuit
Contact name: • B. Fee for branch circuits
without service or feeder fee, 46.85 2
Address each branch circuit
.. Each add', branch circuit 6.65 2
City /State/ZIP; Miscellaneous (service or feeder not included)
Phone: Y Pulnp or irrigation circle 53.4Q 2
Fax Fax. ( ) Sign or outline lighting 53.40 2
Email Signal circuit(s) limited-
' �1 � f ){[R l
i
Ign clrcut s) or imited-
rr i � s � .1�� 11,.i,Ibleit' � it ` .^ } t, ... ';'.':',:'.'',..,,'/:.''';‘,:', "c' ? ": ,, ,t ; .,, ), ,`, energy panel, alteration, or
extension. Describe: Page 2
Business naive TC c O 8 2
•
Address: po Qx' (y Each additional Inspection over allowable in any of the above
` , Per inspection 62.50
City /State/ZIP: • \'L71 6e— . C \1.) L7 Investigation per hour (1 hr rain) 62.50
Phone: k5 )0.D6 - -ri - - --- Fax: (,S 1)) �S' 3 a 12
lndusalal plant per hour 73.7 $
Cr tn h (11 [1 li lid [1 r ; 11 � i[ �(}{;
...
J , { e[,I I n ril. 2 .r i 5 :I :'PiUtlSi? :i��tit t
13 Lic.: l.to 11 �1 Blectric:� ic.:a � S Lic.: , .
Suprv.
i C' . 7s' S - Subtotal k q -°1S
Electrician signature, required: v4 . I J _ 16 i 7—...— Plan review (25% of permit fee)
s ��'r is �► r .
Print name: TK - �" � _ _ , rz . Daz n� TOTAL PERMIT surcharge (8% of permit fee) ' l - V
c� U - TPERMIT FEE o r - S S'
Author i2ed signature: - This permit application expires Ira permit b ant obtained within 180 - -
days after it has been accepted .s complete
Print name: I Date: • Fee methodology set by Tri- County Building Industry Service Board
7// /4 ea Number of inspections per permit allowed
i tBuilding .PetmiatELC•PemitApp.doo 11/09 !/ ...6151.00/o2/COM/wea
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line:' (503)"639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received / Date Requested / Ft g AM ✓ PM BUP
Location 1( Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR T ll // p
•
BUILDING Tenant/Owner /'- ?-4» , Q! A1i -71 � ELC 6ZO 6' 7 L ( — 66
Footing
Foundation ELC
Access:
Ftg Drain p �� � 1Y1 ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall /
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage /1/)(/ r
Alarm
PA - PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE 0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line -
ADA
Approach/Sidewalk Date • 4-- Inspector 7 liter y Ext
Other:
Final DO NOT REMOVE this inspection record from the ob site.
PASS PART FAIL
•