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Permit W. C ITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00308 �� DEVELOPMENT SERVICES DATE ISSUED: 6/2/2004 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 PARCEL: 1S136CD -00100 SITE ADDRESS: 11701 SW PACIFIC HWY ARBY'S ZONING: C -G SUBDIVISION: BLOCK: LOT : JURISDICTION: TIG Project Description: (2) panel changes.( 7/8/04 added (1) circuit to this perms ezer -- 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: 2 W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 1 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: PACIFIC CROSSROADS PROPERTIES, I GARNER ELECTRIC BY WYSE INVESTMENT SERVICES CO 2920 SW 247TH AVE #A 200 SW MARKET ST STE 345 HILLSBORO, OR 97123 PORTLAND, OR 97201 Phone: Phone: 503 - 648 - 4552 Reg #: LIC 121159 SUP 3707S FEES ELE 34 -305C Description Date Amount Required Inspections [ELPRMT] ELC Permit 6/2/2004 $160.60 [TAX] 8% State Surcharge 6/2/2004 $12.84 Elect'I Service [ELPRMT] ELC Permit 7/8/2004 $6.65 Elect'I Final (additional fees not listed here) Total $180.62 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: ,Ae Li ,,,, — Li / *by Permit 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 639 -4175 by 7:00pm for an inspection the next business day 084/22/NO2 01: . 19 6427925 PAGE 01 ,., l',.• . ., ,�.. -y. , :,.._.,.. •, - it ,. Electrical Permit A, licatiori FOR OFFIC :.E IISF - ONI .V City of Tigard IVEDA Received PermuitNo -: y�Q� Date/By: 13125 SW Hall Blvd., Tigard, OR 97223 Plat Review Omer Pertain plume; 503.6398171 gar: 503.598.1960' 1 " it j @ 1:;111'' patter. ® gee p age z for ) Lane: 503.639.4175 J V L , �` j 2UWt a, . _ Data Ready/ay: Supplemental Information Internet: www,ci.tigard•or.us NotifiedlMemad: y , rr- �t'1 �; � i'� � ;`y n r }t r �' � cq - ,, , . F. r r R1 �, .'ter } 7.;, b 11 , . 1 r 1G:• , �•�„ ..- i"ti )vfy j }. Ini..,h ", »t t l il t . r ,d tll '1 1 t t;' t t t tl i _ a lr i t � lt i � a +` , t � v A k , r . he . . to • a I t t ll .�1 " ,5a' 2 '�W'r. ; z• , i;;✓. �. . �v. s2 4.2-:- is ef, Ji.t�fi .i u t ,�, ,, ,_1._,,,i[:..�...a:?.: .•. :1!r's :4_. . : a _I fee!. � ' ❑Now construction t:, • • e. r anent Please check all that apply: ❑service over 225 amps, cotrerr'1 ©}iazardoub location ❑ Demolition ❑ Other: ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., E'i ttl{;�` it I` t P' 3 r - . r.' '�'�u r 7 t 1 - J ,,,, t \' 7i. ,">t�4 .. r 1 r , l .� r t a t t4 9.W ' „ti l • 4 or more new residential y' r1 y fi} e .ij titi41'il ... +4 ' .., .• ".. �... 1 .: Y ' i ` , ) , 1:P": " � %i=.:X4;;:i ^t ' I ;[ .,{ o l - and 2- familydavellings El 1 and 2 dwelling : • dal/industrial ial ❑ Accessory building O Syatem over 600 volts nominal un i n one structure y g ❑Building over three stories DFeeders, 400 amps or more ❑ Mulct fbaatly ❑ Master builder ❑ Other Occ ant load over 99 persona ❑Manufactured structures or ..g, ,,'4' }'f N �r . , , r , ., 4 '' a,J a 70 T 1{�N.r�+-.. 3 ,7 i 1 4�'Mtf .,'r)e7 t . 4 ,,, a . tli f} , I tl t t J4li . � iu r 1 , . 7 4 , Ir' l b l ! 1) C ! fF .31t i ,'c y 9 1_1 1 l plan RV park S EL4U. ,.:..L,.,I_ t?1'.r,., +..,., . ��J ?...,f t�a,+ _ �,. .. L .��.91- .r,,Sci\s QOther: '7 01 SW / ❑Health -care facility 1pb no.: • Sob site address: I I q,U G Submit 1_ sets of plans with any of the above. • applicable construction service. City /State/ZIP: i 0" / The above are not s r rl i plicable to : temporary T Suite/bldg. /apt no.: Project name: f °" f . Decertption Q ty. I 1+ „ • I Total I •• 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: Lot mo -: Ea. add'l 500 eq. ft. or portion 33.40 1 • Limited energy, residential 75,00 2 Tax nnap/paroel no limit energ non residential 75.00 2 ''1 ri .1 ,}} a t r : t,r r h` - • :., f' ' r tt. i-,� SwC�S4 r"l I , �, Y t f7f v �•,Er' t - ,:41 l� 1, 1 4 :1 k 4 r , , � ly t :l : , l + 3 A 7 tl I t V. 1) 1 l l 1 1 , I�11I.V Ar + s ; 5 , Ea ch manufactured or modular :It...- I..HLfw..vltLXll �;•Li' -- -. _ ■,.t;. , n -ui' t..ra`•'.. `s. f :,. 'Wu. y�...F 'V nl1 1- ' y,tiL. .�.�._+.� 2 / - - dwelling, service and/or feeder ` 90.90 0� Services or feeders installation, alteration, and/or relocation / f .� - �( G ?�b�� - QD3 Q. 200 amps or leas 80.30 _ 2 i + s 106.85 2 , ,r. "I -. ' Y w ;-, , n n n.a , I ,,- �sai�' ;4r rr r) 201 amps to 400 amp _ , I y1� •�.1 < -a=,'',., � ' ' r t 4 - t , i , t 7 i1 L f' t , eit y{ .6. v ` • t.: •Z�'l i',r ,F 2 .,t t ... �,;; :m :,�_ r.J ' � i .._a...+� , :...�,... �.., - 't c:f , _ �• 401 • amps to 600 amps 160.60 Name: ■ f 601 amps to 1,000 amps 240,60 2 Address: Over 1,000 amps or volts 454.65 2 Reconnect only 1 66.85 , 2 City/State/ZIP! Temporary services or feeders installation, alteration, and/or relocation ---�- Plaone: ( ) • ',. . _ • Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is .eing 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 600 amps 133.75 2 Owner signature: _ Date: . Branch circuits - new alteration, or extension, per panel ll t, Y s 0 1 T, �- b 1 1 ' let t � . f , t as a->~ .tat tc 1 A Fee for branch circuits with i.I i, f, rtr1 ° :d.. . CY.sv . . ,7 , ilsJl N � a :1-i z l )1 a, u 't s.. -.1,l i r: , f,: 1:^7 ),,, l .. t 1aY . :2 lr..i2,• ,' C service ar feeder fee, each 6.65 2 Business cattle: _ branch circuit - _ B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 2 each branch circuit Address: • Each addi branch circuit 1 I . 6.65 I (0.6 2 City /State/ZtP. Miscellaneous (setvlce•or feeder not included) Phone: ( ) Fax:: ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 B- ��uasil: Signal circuits) or limited - v "id :a .6).f z :, 1:'G �'.; ti. l r n ;�: . _ 4 . q I (f'(I icc . . 4S 4" tti � 14 P1.Z.r,,..._. 44. rid:'' 2?s7'7 energy parcel alteration, or ,1-aa_ _a yi- W�v� .Hwr14��U!;lit'w�tSf�r::'�4ti ° ' s name: extension. Describe: Page 2 2 Business: 1 N a' = `z - ! L. Address: -' CI 2.C> SIAJ 2 • ' 1 4-- Ale. . 44 _ Each additional inspection over allowable in any of the above Per inspection 62.50 C /Z1P: (I Uie Q - G f Z j Investigation per hour (1 hr min) 62.50 Phone: ( ' \) ( u t-( S'� � h lndusD Mal plant per hou 73.75 VAg`! Subtotal 6, Suprv. Electrician signature, required: / / W :'. Plan review (25% of permit fee ) � P .� e 53 • Print name: 4 C ,- 1 - r .Zt c Dat `7 8 Y State surcha (8% of permit fee) TOTAL %L PERMIT FEE ' . Authorized signature: t This permit applicadon expires if a permit is not obtaineA within 180 Print name: Date: • Fee methodology after it has been accepted as complete set by Tri County Building Industry Service Board • •• Number of inspections per permit allowed. Opuddingwarrn i at n .P Ayp•Qae IWO 7 . w u �. 440-461Fr 1 M/WEB I/ CITY OF TIGARD 24 -Hour BUILDING; . • Inspection tide: (103) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date uested / S AM PM BUP Location /) 7 / Suite AV-113 ' MEC Contact Person Ph ( ) PLM Contractor Ph ( ) ZD SWR BUILDING Tenant/Owner ELC .==.3e0 d 636 8 Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors - Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing FirewalI Pt ` I O� n ` � V 65 CIA/A.1/ Fire Sprinkler f' T� L.� 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 Fire Alarm 010 PART FAIL 111 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA I 19 -� LI Approach/Sidewalk Date Inspector ii AWLIQIP. Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL