Permit ' CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2001 -00408
--- , �y DEVELOPMENT SERVICES DATE ISSUED: 08/08/2001
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S102CC -00500
SITE ADDRESS: 13560 SW PACIFIC HIGHWAY STARBUCKS
SUBDIVISION: ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of (2) service /feeders. 65 branch circuits.
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: 65 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:
STARBUCKS COFFEE COMPANY ST JOHNS ELECTRIC INC
2401 UTAH AVE S 4415 NE MINNEHAHA
SEATTLE, WA 98134 VANCOUVER, WA 98661
Phone: 206 - 318 -1575 Phone: 360 - 693 -5100
Reg #: LIC 43135
SUP 3024S
ELE 37 -350C
FEES Required Inspections
Type By Date Amount Receipt Ceiling Cover
PRMT CTR 08/08/2001 $592.25 2720010000( Wall Cover
Elect'I Service
5PCT CTR 08/08/2001 $47.38 2720010000( Elect'I Final
Total $639.63
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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -6699 or 1 -800- 332 -2344.
Permit Signature: a J Issued By:
411 / I , •
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: 6) I a - DATE:
LICENSE NO: 3
Call 639 -4175 by 7:00pm for an inspection the next business day
1 •
• • E l trical Permit Applicat
iE CEIVEJ PE ', Date received 7/D I Permit no.:EL -
:.•� City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 134 6Vtliall Ny Tigard, OR 97223 Date issued: By: ge I Receipt no.:
Phone: (503) 639 -4171 UU
Fax: (�J�8y1• _,; r, Case file no.: Payment type:
r • !'.: 4
;
Land use approval: ' '
TYPE OF PERMIT
❑ I & 2 family dwelling or accessory ACommercial/industrial ❑ Multi- family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial
JOB SITE INFORMATION
Job address:13500 SW Pacif is HWY Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: I Block: Subdivision: Bldg. Permit # BUP 2001 -00258
Project name: I Description and location of work on premises:
Estimated date of completion/inspection:
CONTRACTOR APPLICATION FEE SCIIE1)111.E
Job no: Fee Max
Business name: St. Johns Electric, Inc. Description Qty. (ea) Total no.insp
New residential - single or multi- family per
Address: 4415 NE Minnehaha St. dwelling 'mil Includes attached garage.
City: Vancouver I State: WA I ZIP: 98661 Serviceincludesh
Phone:3606935100 I Fax699 -1345 I E -mail: 1000 sq. ft. or less 4
CCB no.: 43135 I Elec. bus. lie. no: 37-350C . Each additional 500 sq. ft. or portion thereof
Limited energy, residential 2
City /metro no.: IV _ Limited energy, non-residential 2
../-..e1.-4' g/0/ Each manufactured home or modular dwelling
Signature of supervismT: trician (required) Dat Service and/or feeder 2
Services or feeders — installation,
Sup. elect. name (print): lean R. B ' ur
Licenseno:30245 alteration or relocation:
PROPERTY' OWNER 200 amps or less 2
Name (print): 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: I Fax: 1E-mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders- . .
which is not intended for sale, lease, rent, or exchange according to ltatlon, alteration, orrelocation:
200 amps or less 2
20
ORS 447, 455, 479, 670, 701. 201 1 amps to 400 amps 2
Owner's signature: Date: 401 to 600 am s 2
Branch circuits - new, alteration,
Name: or extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: • I ZIP: B. Fee for branch circuits without purchase
Phone: Fax: E -mail' of service or feeder fee, first branch circuit: 2
Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
❑ Service over 225 amps - commercial ❑ Health -care facility Each pump or irrigation circle 2
❑ Service over 320 amps- rating of 1&2 ❑ Hazardous location Each sign or outline lighting 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
❑ System over 600 volts nominal more residential units in one structure alteration, or extension' 2
❑ Building over three stories ❑ Feeders, 400 amps or more *Description:
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egress/lightingplan ❑ Other er inspection
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $
❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $
' Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $
Expires accepted as complete. TOTAL $ .
Name of cardholder as shown on credit card
$
Cardholder signature Amount 440 -4615 (6r00/COM)
i
Electrical Permit Fees: Limited Energy Fees:
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
p Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
, Service included: Items Cost Total `1' Check Type of Work Involved:
Residential - per unit
1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40 1 ❑ Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular ❑ Garage Door Opener
Dwelling Service or Feeder $90.90 2
Services or Feeders El heating Ventilation and Air Conditioning System*
Installation, alteration, or relocation I
200 amps or less 2. $80.30 /40.4(3. I=1 Vacuum Systems'
201 amps to 400 amps $106.85 2
401 amps to 600 amps $160.60 2
601 amps to 1000 amps $240.60 2 ❑ Other
Over 1000 amps or volts $454.65 • 2
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each system $75.00
200 amps or less $66.85 2 (SEE OAR 918-260 -260) .
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75 2 Check Type of Work Involved: /
Over 600 amps to 1000 volts,
see "b" above. 1Z1 Audio and Stereo Systems
Branch Circuits Boiler Controls
New, alteration or extension per panel
a) The fee for branch circuits
with purchase of service or n Clock Systems \
feeder fee.
Each branch circuit toy $6.65 y�'1a. q c 2 VI Data Telecommunication Installa Ion
b) The fee for branch circuits
without purchase of service ❑ Fire Alarm Installat n
or feeder fee.
First branch circuit $46.85
Each additional branch circuit $6.65 n HVAC
Miscellaneous ❑ Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40 ❑ Intercom and Paging Sy ems
Each sign or outline lighting $53.40
Signal circuit(s) or a limited energy
panel, alteration or extension Z $75.00 /52,2_011 Dn ❑ Landscape Irrigation 4 ntr I
Minor Labels (10) $120.00 ❑
Medical
Each additional inspection over
the allowable in any of the above ❑ Nurse Calls
Per inspection $62.50
Per hour $62.50
In Plant $73.75 ❑ Outdoor Lands - •e Lighting
Fees: �❑-I I Protective Sig .t ling
S'
Enter total of above fees c2 , a5 $ 2 i ' I Other
8% State Surcharge / ' ' 3 ? $ —lSlA Number of Systems
25% Plan Review Fee
See "Plan Review" section on $ No licenses are re. fired. Licenses are required for all of er installations
front of application.
Fees:
Total Balance Due 4, 56/. 0 $ Enter total of - • ove fees $ s v
❑ Trust Account # 8% State S charge • $ - T)
Total Ba ance Due $ e . , ' " "
i:\dststfonns\elc- fees.doc 10/09/00 •
bITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
/ BUP
Date Requested l b AM PM ✓ BLD
Location / 35 (g 21-1--- Suite MEC
Contact Person Ph PLM
Contractor - j-. c T L/ 4 /.� i C Ph SWR d
BUILDING Tenant/Owner � ELC 4U/ e / 3
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: S SX
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear / ,n
Framing SC 0
Insulation Drywall Nailing C � F //z C 7v ��� p
Firewall
Fire. Sprinkler 0-0 7 es! t ff
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING .1---e1,42() ppc 64,
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains ,
Final y
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
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
Approach /Sidewalk / /R / / r'i 6 t t Ext
Other Date h 6 t Inspector
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.