Permit CITY OF _TrI GARD , ELECTRICAL PERMIT
PERMIT #: ELC2005 -00590
�.. DEVELOPMENT SERVICES DATE ISSUED: 8/15/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 639 - 4171
PARCEL: 2S 10X6 -02500
SITE ADDRESS: 13090 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: FREW INGS ORCHARD TRACTS LOT : 007 JURISDICTION: TIG
Project Description: Circuit for toaster.
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: SIGNAUPANEL:
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:
CNL APF PARTNERS LP BOONES FERRY ELECTRIC INC
BY FOODMAKER INC PO BOX 628
9330 BALBOA AVE WILSONVILLE, OR 97070
SAN DIEGO, CA 92123
Phone: 503 - 624 -9594 Phone: 503 - 682 -4936
FEES Reg #: SUP 4918S
Description Date Amount LIE 88482,
ELE 3 -223C
[ELPRMT] ELC Permit 8/15/2005 $46.85
[TAX] 8% State Surcharge 8/15/2005 . $3.75 REQUIRED ITEMS AND REPORTS
Total $50.60
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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: z z " Permittee Signature: ,.e, \k'.
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.
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1,Aug. 15. 20051 • BOONES FERRY ELECTRIC No. 6776 P. 1
Ci of Tigard V:J l FOR OFFICE USE ONLY
13125 SW Han Blvd., Tigard, OR 97223 Dates ; i .- � PenaitNo•16 / �j
t)�lj� ryry nn : : . _ , Pim Revia
Phone: 503.639.417( Fax: 503.598•196
Inspection Lite: 503.639.4175 L � - , + • -;' Date/e ' Other Permit:
ltetnet: WWw.Gi.tigerd.Or.ua -' I Date Reedy/By Jura: Al Sea Page Z for
I V F T r No ed/biatbod; £
f ' s — ■ u5 ( Supplemental Information
['New const ddition/alterationhe ]ace } :!
i! check that . a I •`' ` l { I � .. !tiJ Y1 . , j f? r, ,.........,:i
p mart ! Please check all tat apply: '
❑ Demollhan Other:
['Service over 225 amps, comm'l
< 320 [(Hazardous location
' at o r 0Service over amps - rating
v . '' .. r `' i r ' - 1' 1 ,',� ^r l : " 2 11 r `r e of 1 -and 2•fa mP 8 ❑ 4 or oilers over residential
� ; rnily dwellings 4 more new
❑ 1- and 2- family dwelling ,Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
I] Multi -family ❑ Master builder CI other ❑Building over three stories
c , qj , a „ s ❑Feeders. 400 amps or more
. i t ['Occupant load over 99
_.t,. i ` .., r ,iU fwI � t rill 7 „ persons ❑
- ❑figress/lighting Plan RV, park
Job no.: 6 2g Job site address. .._ /
City/State/: lie r } 3 Q 9 S p � c 1 e IL II facility ❑Other:
Submit 2 sets of plant with any of the above.
Su The above are not applicable to temporary construction service.
ite/bldg. /apt ao.: [Project name: . 1 ,
d• c ! h - / c. ` j r i ' `= r' � , 1 I , i ` ; Tai , l t ` 2 � S_, t 1: .
O Aescriptl ,
Cross atreet/directions to job site: Qtr re. I Total I ••
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New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision:
1,000 sq. ft. or less IMI 145.15 MI 4
Lot no.: Ea. add'l 500 sq. R. or portion _ 33.40 111=11 1
Limited
Tax map /ptucel no energy, residential
, 75.00
,Ii .,. a_ , :ft'' , :"..;; Y �, . 5 , ` ` i Y. � =r 1 1 r
�, Ilt:... -- :, , P ; ` y, { Limi ener no n - res id ential 2
• . ._. .':',•':'1.i.',-,,:., .U•I' 75.00 2
q� ; ... ,.;; .:: E manufactured or modular ■
1 CJ" f C fi l n • , service and/or feeder /, lefl `/ 0 a s i-c r I dwellj 90,90 MI 2
_ Services or feeders installatioo, alteration, and/or relocation
200 amps or less 11111 80.30 "- • i •�1 -0° i g(II� - -i . . _' l 1 i , 7::,"1:E.,;;',:...,'7,',1":•7•,.. t, l� uI 201 amps to 400 arnps 106.85 MN MN
2
Name: _.. _._ l; 401 amps to 600 amps 2
_ 160.60 2
.address: 601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts - 454.65
City/State/ZIP: 2
Reconnect °illy 66.85 MI
Phone: ( Temporary services or feeders installation, alteration, and /or
Fax: ( ) _ relocation
Owner installation: This installation is being made on property that I ovvn which is not 201 amps or less im 66,85 1
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.: 201 amps to 400 arms a 100.30 2
Ovmer stgnatttre Date 401 a ,.a to 600 amps _
s 133.75 MI 2
_ � - � 13raaeh circuits - new alter
�-p�1 ,n ,. 3 ,f�1 ,, . 1 + _S . i i 7 c .,t i h �. � nF ,, r atl°Q or extension, per panel
`
,.u,., i P l?
° . . . . - __ ." , - .. t � A Fee fo b ranc h circuits with
�{ . , . ) 14 ). •
✓ 4•..0 k - ; ' • - service or feeder fee, each
Business name:
�1R branch circuit 6.65 2
• Contact name: B. Fee for branch circuits
Address: without service it or feeder fee, 8 III
each branch circuit 46.85 2
City/State/ZIP: • Each add'I branch circuit III 6.65 r 2
Phone: ( ` • 1VBscellaneous (service or feeder not included)
• . 9 Fax :: ( i Putm or irrigation circle 53.40 2
, 13 mail: Sign or outline lightin
_ _ „.., `, l { { Signal circuit (s) or $3.4 -,
1) 2
�''.. }:i s . -i:2, , } 6 :i:;. fr' ;r:l �' Describe • '' energy panel, alteration, or
Business name: Boortt3S Ferr E _... extenaion.: Page 2 2
e LY C
Address: p , 0 . Box 628 •
Each additional Inspection over allowable in any of the above
city/StatelZlp: W i l s o n i l e OR 97070 Per spection 62.50
Phone: (5.03) 682-4936 g investigation per hour (1 hr min) MI 62.50 (5 0 3) 6 8 2 — 7 9 4 6 Industrial plant per hour MI CC$ Lic.: 73 75 MI E lectrical Lie.: 30 p :iiY ;,150 _ a'� �j i.11,Ya 1 ''- 111C 17, 54i l 1 .
3— Su rv. Lic.: Lip S ... -'. 1�i
Suprv. Electrician signature, required: /4 S ubtotal s
Pont name:
r� ^I f Plan review (25% of permit fee)
� a h H $ O n Date: S )s e 4--
State surcharge (8% of permit fee) • -7.....- Authorized signature TOTAL PERMIT FEE .5 , - 6 0
o,
Print name' Thu per applicatio expires if a permit is not obtained within 180
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Date: days alter It has been accepted as complete
ensits�Et C •
P • Fee methodology set by Tri -County Building Industry Service Board
ilkaette ermitApp.doe 12/03
" Number of inspections Per Permit allowed.
440-461 rr(loro2/coeyvrFa
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V.
CITY OF TIGARD A r No
BUILDING DIVISION PERMIT #: ELC2005 -00590
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/15/2005
Phone: (503) 639 -4171 � u� l�
Inspection Requests (24 Hrs.): (503) 639- 4175
INSPECTION WORKSHEET FOR DATE: 8/22/2005 TIME: 7:10Am PAGE: 69
SITE ADDRESS: 13090 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: FREWINGS ORCHARD TRACTS LOT #: 007 TYPE OF USE:
PROJECT NAME: JACK IN THE BOX
DESCRIPTION: Circuit for toaster.
OWNER: CNL APF PARTNERS LP, PHONE #: 503.624 -9594
'CONTRACTOR: BOONES FERRY ELECTRIC INC PHONE #: 503 - 682 -4936
Inspection Request Scheduled For: Date: 8/2212005 Pour Time:
Code # Inspection Description C. 1 • Contact # Message
199 Electrical final 014001 -01 503-682 -4936 N
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Corrections /Comments/ Instructions:
. . . .. . . . ,. i
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 3 • YV 6 8 Date: 'L Phone #: (503) 718- 2)-14,b