Permit r
CITY OF TIGARD
ELECTRICAL PERMIT
^ ��. �i �A, DEVELOPMENT SERVICES PERMIT #: ELC98 -0064
Tigard, OR (503)639-4171 DATE ISSUED: 02/11/98
PARCEL: 15135DD -03301
SITE ADDRESS...:11945 SW PACIFIC HWY #250
SUBDIVISION •HOFFARBER TRACTS NO.1 ZONING:C —G
BLOCK • LOT •002 JURISDICTION: TIG
Proj ect Description : Add five (5) branch circuits to an existing commercial bldg.
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS • 0 0 — 200 amp • 0 PUMP /IRRIGATION • 0
EACH ADD'L 5O0SF...: 0 201 — 400 amp • 0 SIGN /OUT LINE LTG..: 0
LIMITED ENERGY • 0 401 — 600 amp • 0 SIGNAL /PANEL • 0
MANF. HM/ SVC /FDR..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (10)...: 0
- - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- -
0 — 200 amp • 0 W /SERVICE OR FEEDER: 0 PER INSPECTION • 0
201 — 400 amp • 0 1st W/0 SRVC OR FDR.: 1 PER HOUR • 0
401 — 600 amp - 0 EA ADD'L BRNCH CIRC: 4 IN PLANT : 0
601 — 1000 amp • 0 PLAN REVIEW SECTION
1000+ amp /volt • 0 > =4 RES UNITS • > 600 VOLT NOMINAL..:
Reconnect only • 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: FEES
SAFEWAY STORE type amount by date recpt
11945 SW PACIFIC HIGHWAY PRMT $ 55.00 GEO 02/11/98 98- 303228
TIGARD OR 97223 SPCT $ 2.75 GEO 02/11/98 98- 303228
Phone #:
Contractor:
ELECTRICAL DIMENSIONS INC $ 57.75 TOTAL
PO BOX 12146
3961 SW WILLAMS AVE REQUIRED INSPECTIONS
PORTLAND OR 97212 Ceiling Cover Underground Cove
Phone #: 282 -7255 Wall Cover Elect'1 Service
Reg #.. 000440
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001 -0010 through 952-081 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calltng ( )246 -1987. / ,f,
Permitt Si nature: / I ssued By • 0 i ,. .
9 Y
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 : er DATE: - —
LICENSE NO: ,R S
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
al
CITY OF TIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD. Rec'd By
Date Rec'd
TIGARD OR 97223
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print or Type Permit #-E--------q-0-161
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
4 .
Name (or name of business) See-C - -, 4 383 Service included: Items Cost Sum
I
Address / / 9 YS S t - , / t Y 99 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
City /State /Zip - 7 - 17 45z C1
! / 9 7,1z.3 Each additional 500 sq. ft. or
Commercial 0 Residential El Limited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all current licenses) . 4b. Services or Feeders
Electrical C ,tractor _( �cc, vt c... t >I�y....ev. s t cv5 I Installation, alteration, or relocation
, ss l 1Z1'{ So 201 amps to 400 amps $80.00 2
200 amps or less $60.00 2
Addre
, s
City Ydrt(a .4 State C9✓ Zip 9 7Z ( Z 401 amps to 600 amps $120.00 2
Phone No. 2_82., - 7 Z 5 601 amps to 1000 amps $180.00 2
Job No. 7‘15-V Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. 24 3Z C Exp.Date lot t l4 /
OR State GCB Reg. No. flit CO S! Exp.Date / ' ' 4c. Temporary Services or Feeders
COT Business Tax or Metro No. Exp.. - te LWa Installation, alteration, or relocation
f / 200 amps or less $50.00 2
Signature of Supr. Elec'n i� + / I 201 amps to 400 amps $75.00 2
401 amps to 600 amps $100.00 2
�3
Over 600 amps to 1000 volts,
License No. .2.q �y -- S Exp.Date /Elei b see "b" above.
Phone No. 2_1C 2 -7 2.5S
4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address Each branch circuit $5.00 2
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee. 7 cp
First branch circuit / $35..00 ,35 2
The installation is being made on property I own which is not Each additional branch circuit I $5.00 2_0 °° 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required):'` Signal circuit(s) or a limited energy
panel, alteration or extension $40.00 2
-
Minor Labels (10) $100.00
Please check appropriate item and enter fee in section 5B.
4 or more residential units in one structure 4f. Each additional Inspection over
Service and feeder 225 amps or more the allowable in any of the above
System over 600 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00
as described in N.E.C. Chapter 5 In Plant $55.00
* Submit 2 sets of plans with application where any of the above apply. 5. Fees: `! ap
Not required for temporary construction services. 5a. Enter total of above fees $ J J
5% Surcharge (.05 X total fees) $ 2. b
NOTICE • Subtotal $
5b. Enter 25% of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account # $ 5 7 7
Total balance Due
I: \DSTS \ELC96.APP Rev 9196
■
F
Page No. 1 CASE HISTORY FOR CASE NO.: ELC98 -0064
SAFEWAY STORE
11945 SW PACIFIC HWY Unit: 250
11/18/98
. Action Description Req/ Schd/ End/ Action Disp By Update Upd
Code Sent Done Done Date By
---- --- - ------- - --
ELCC001 Application received / / / / 02/11/98 RECD GEO 02/11/98 GEO
ELCC003 Permit created / / / / 02/11/98 DONE GEO 02/11/98 GEO
ELCC500 (F)Issue permit / / / / 02/11/98 PASS GEO 02/11/98 GEO
ELCC799 Elect'1 Final 02/11/98 ./ / / / 7/31/98 sent inspection request to Chuck 07/31/98 JT
D. /research "since we are going out lets
check this one for completion"
ELCC799 Elect'1 Final / / / / 08/04/98 hook up coolers PASS CD 08/04/98 CD
ELCC800 Case Finaled / / / / 08/04/98 - PASS CD 08/05/98 J *H
ELCC920 Miscellaneous action / / / / 08/03/98 checked job site, unable to inspect. FAIL CD 08/03/98 CD
left message for elec.'contr. to meet on
site to clarify work done.
•
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•
•
•
•
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM hhPM BLD
( 13 - ,�
Location (�, 1 _ Suite dS MEC
Contact Person d Ph PLM
Contractor r / -� SWR a
BUILDING (.11V Owner ELC 0 — 6 °
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing i _ o .`
Firewall ,
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: — ,
-
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
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
Fi
ASS PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA -' 4 ` Q, G Inspector ns
Approach /Sidewalk Date - 9d I W!/"../Z [ -i Ext
Other C� p
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION E1-‘_ 97 - 04Pc)
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
BUP
Date Requested AM PM BLD
1 1 q 5� p — '
Location � 'te —2SO MEC
Contact Person PLM
Contractor / Ph SWR
BUILDING T ?6?-606.5z o wner ELC
Retaining Wall q 47U p
(�9� 676
Footing Access: l cl �l 7 ,- / ( I - FPS /
Foundation
Ftg Drain ari14A '"' A • SGN
Crawl Drain Inspection Notes: �
Slab — ir�. SIT
Post & Beam
Ext Sheath /Shear - C(
Int Sheath /Shear
Framing
Insulation -
Drywall Nailing � ... _ _An-.
Firewall 7 , ,
Fire Sprinkler
Fire Alarm ,�
Susp'd Ceiling tJ 41 � ( d
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
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
Fi
SS PART FAIL
SITE
•
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA G / /
Approach /Sidewalk Date r� - 7 1 �' Inspector �C ' <c / Ext
Other p
Final
PASS PART FAIL . DO NOT REMOVE this inspection record from the. job site.