Permit •
CITY OF T ELECTRICAL PERMIT
•�an .,�ha'' ' di .,, i DEVELOPMENT SERVICES PERMIT #: ELC97 -0556
I �'I'
_.. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 08/14/97
PARCEL: 251O2BD -00701
SITE ADDRESS...:12785 SW PACIFIC HWY
SUBDIVISION •NO.TIGARDVILLE ADDITION AMEND. ZONING:C —G
BLOCK • LOT •8 JURISDICTION: TIG
Project Description : Add first branch circuit to 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/O SRVC OR FDR.: 1 PER HOUR • 0
401 — 600 amp • 0 EA ADD'L BRNCH CIRC: 0 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
FRED SPADA type amount by date recpt
72907 BEL AIR ROAD PRMT $ 35.00 GEO 08/14/97 97- 298293
PALM DESERT CA 92260 5PCT $ 1.75 GEO 08/14/97 97- 298293
Phone #:
Contractor:
BOB'S ACTION ELECTRIC INC $ 36.75 TOTAL
5512 NE 109TH COURT
STE A REQUIRED INSPECTIONS
VANCOUVER WA 98662 Ceiling Cover Underground Cove
Phone #: 360 - 254 -7200 Wall Cover Elect'l Service
Reg #..: 000531
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 OAR 952 -001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (503)246 -1987.
Permittee Signature: Issued By.
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: 5"
LICENSE NO: � S
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
1111111111111111111111111111111111111111111111111111 .�. 111. L� ..iiii�i.i.�����'��� +�"F'�"'E'�
Community Development ELECTRICAL PERMIT APPLICATION
AI 13125 SW Halt Blvd,
Tigard, OR 97223 Permit # 5-GC ' 4 -D 5
Date Issued
b'v' Phone (503) 639 -4171 •
FAX (503) 884 -7297 •
CITY OF TIGARD TDD No. (503) 884 -27 • •
Inspection (503) 639 -4t75 i
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development : ,..' . , _ . _ �_ . _ ... ., Number Of Inspections per permit allowed
Address 12785 SW Pacific Hwy. Service Included: Items Cost(ea) Sum
City /State /Zip Tigard, OR. 97223 4a. Residential . per unit 1
Leagjeld Construction 1000 sq. f. o ieu 3110.00 4
Name (or name of business) Wendy' $ International each eddltionsl soo se. n. at .
portion thereof 125.00
-
Commercial El Residential ❑ Limited Energy $25.00 - f
Each Manufd Home or Modular
•
• Melting Service or F eeder 666.00 2
2a. Contractor installation only:
4b. Services or Feeders
Electrical Contractor Bob's Action Electric • Instillation. NW/Won. or relocation 56000 2
•
Address 2700 NE Burton Rd. 7 A" 201 amps a
seo.00 2
101 IMP. to $00 *imps 5120.00 2
City Vancouver State Wa Zip 9866E 601 amps to 1030 amp. $130.00 2
i Phone No. 360- 254 -7200 over 1000 arrps et v,6, 5340 2
Job NO. . ReOtrinett any $50.00 2
contractor's license NO. 17-411s • 4c. Temporary Service* or Feeders
--- Contractor's Board Reg. / Insten er
anon..a.tten, or reaocenon •
Signature of Supr. El8c j ,. ,�. /�� em s a ss a 2
License No. 4322S Phone `o. 360- 254 -7200 �'' 'lo • 150.00 2
1 5.00
Over 600 .mps to 1000 volts $100.00
2b. For owner Installations: '0e e above. •
4d. Branch Circuits •
Print Owner's Name . New. alteration or extension per pane
Address *) The tee to branch cicubs with
' City State Zip purchase , he , ieatied.'n 2
a. 35.00
Phone No. e) The lee for branch circues without
, The Installation is being made on property I own which is purchase er service or feeder Ma 2
2
not Intended for sale, lease or rent. FMi branch ctreue 1 1135 00 35.00
Each additional branch ebeuit $5.00
Owner's Signature _ 4e. Miscellaneous 2
(Service or feeder not included)
, 3 Plan Review section (if required): Ea ch pump or Inlgation circle . 540.00 2 -
Each son ce ouMne $gMing $40 00
Signal cicult(s)or a tinned energy
Please check appropriate hem and enter fee In section 5B. • panty, alteration or extension MAX
4 or more residential units in one structure minor Labels (10) $100.00
t Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional inspection over .
1`: • Classified area or structure containing special occupancy the allowable In any of the above
i as described In N.E.C. Chapter 5 Per inspection $35.00
. Per hour $$6.00
-
In Plant $55.00
• Submit 2 sets of plans with application where any of the above
I apply. Not required for temporary construction services. 5. Fees:
i;' Via. Enter total of above fees • s 35.00
NOTICE 5% Surcharge (.05 X total fees) $ 1.75
i : PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal s �� 7 S •
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 6b. Enter 25% of pre A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review If required (Sec.3) s
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS MENCED. S ubtotal s
I COM ..«p narw.e ❑ Trust Acc ount
I
rem _
Balance Due $ 36.75
'I •
•
Page No. 1 CASE HISTORY FOR CASE NO.: ELC97 -0556
WENDY'S INTERNATIONAL
12785 SW PACIFIC HWY
12/01/97
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
---- - -- -- - --- -- ---
ELCA800 Case finaled / / / / 09/09/97 PASS BRP 09/11/97 J *H
ELCC001 Application received 08/14/97 / / 08/14/97 08/14/97 GEO
ELCC003 Permit created 08/14/97 / / 08/14/97 08/14/97 GEO
ELCC500 (F)Issue permit / / / / 08/14/97 PASS GEO 08/14/97 GEO
ELCC799 Elect'l Final 08/14/97 / / 08/20/97 Work is approved. Conduit securing does PASS BRP 08/20/97 B *P
not comply with article 350 -18 NEC.
ELCC799 Elect'l Final / / / / 09/09/97 PASS BRP 09/11/97 J *H