Permit ELEL, I niCAL PERMIT
PERMIT #: ELC95- 0519
CITY OF TIGARD
DATE I SSUD ; �y9�96,
PARCEL: 2S 1'1ODC -0O0 100
COMMUNITY DEVELOPMENT DEPARTMENT
SITE 31r2s- W WeItiBNd,.Tigard.O epo7972bi6f9e1C p):839- 4171Y
SUBDIVISION • WILLOW BROOK FARM ZONING:C -G
BLOCK • LOT •11
Project Description: 54,142 sq. ft. single story grocery store
" „ 04 8 ( 4.
- -- 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 • 4
MANF. HM/ SVC /FDR..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (10)...: 0
- - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- -
0 - 200 amp • 6 W /SERVICE OR FEEDER:43O PER INSPECTION • 0
201 - 400 amp • 5 1st W/O SRVC OR FDR.• 0 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 • 2 > =4 RES UNITS • > 600 VOLT NOMINAL..:
Reconnect only • 0 SVC /FDR >= 225 AMPS..:X CLASS AREA /SPEC OCC.:
Owner: - FEES
TUALATIN ELECTRIC type amount by date recpt
PO BOX 655 PRMT $ 3750.00 CJS 11/02/95 95- 272471
PICK $ 937.50 CJS 11/02/95 95- 27:471
WILSONVILE OR 97070 SPCT $ 187.50 CJS 11/02/95 95- 272471
Phone #: 683 -2955
Contractor:
TUALATIN ELECTRIC $ 4875.00 TOTAL
PO BOX 655
REQUIRED INSPECTIONS
WILSONVILLE OR 97070 E.lect'1 Service
Reg #..: 65650
This permit is issued subject to the regulations contained in the _ / 7114 &d - � - - - --
Tigard Municipal Code. State of Ore. Specialty Codes and all other Permittee igha ure
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 l80 days. I sued 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:
LICENSE NO:
Call for inspection - 639 -4175
To /Vl IkE e v // -. -9s
f Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd. I -7
Tigard, OR 97223 Planck/Rec. # I - t
/� A rr i; *, a Permit # i5 /Cqs- OS79 EL C93
'l Phone (503) 639 -4171
_�� 1 '' Date Issued //- FAX (503) 684 -7297 - �s
CITY OF TIGARD TDD No. (503) 684 -2772 Issued by
Inspection (503) 639 -4175
1. Job Address: i S5 v PC 4. Complete Fee Schedule Below: • Name of Development pp ,,, " J V � (( p � � Y1r1 � Q�(� ( X J ., Number of Inspections per permit allowed
Address ��d� p , (TO rte. (J1,k7CC�V ryt Ax i C1 Service included: Items Cost(ea) Sum
City /State/Zip \ 1 CJ) I..- 0 9, 4a. Residential - per unit 4
1000 sq. ft. or less $110.00
Name (or name of business) Each additional 500 sq. N. o 1
portion thereof $25.00
Commercial Residential Limited Energy $25.00
Each Manuf'd Home or Modular 2
Dwelling Service or Feeder $68.00
-
2a. Contractor installation only:
4b. Services or Feeders
Installation, alteration, or relocation 2
Electrical Contractor �f .III •C�YZ 200 amps or less $60.00 2
Address C .(),_ 1301c (p :c- 201 amps to 400 amps $80.00 c�A -
Cityi. : \Sa State Na. Zip Q Zi q r1() 401 amps to 00 $120.00 2
`7 rivii110. 601 amps to 1 1000 amps $180.00 2
Phone No. (055.9 -aq SS' Over 1000 amps or volts 7 $340.00 • - 2
Contractor's License No. ''L - (i)% C. Reconnect only $50.00
- Contractors Board Reg. No. • Ab ■ 4c. Temporary Services or Feeders
•
Signature of Supr. Elec'n 1! Installation, alteration, or relocation 2
200 amps or less $50.00 2 -
License No. ?) 3 5 Phon i o. 201 amps to 400 amps $75.00 2
401 amps to 600 amps $100.00
Over 600 amps to 1000 volts
2b. For owner instal/atio s: see •b• above.
Print 4d. Branch Circuits
rint Owner's Name
New, alteration or extension per panel
Address a) The fee for branch circuits with
City State Zip purchase of serv1Ce or feeder Ise. 2
Each branch circuit N 3() $5.00 91 50 -
Phone No. b) The fee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder fee. f 2
not intended for sale, lease or rent. First branch circuit $35.00 2
Each additional branch circuit $5.00
Owner's Signature 4e. Miscellaneous
(Service or feeder/not included) 2
3. Plan Review section (if required): Each pump or irrigation circle $40.00 2 - Each sign or outline lighting $40.00
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension 1 4 $40.00 , (en
4 or more residential units in one structure Minor Labels (10) $100.00
Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.C. Chapter 5 Per inspectio $35.00 -
Per hour $55.00
-
In Plant $55.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees: n
NOTICE 5a. Enter total of above fees $ ISO -
5% Surcharge (.05 X total fees) $ i S
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ ^iq � 7, �(J
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $ q 3
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ R 1 S.t!
COMMENCED. ❑ Trust Account # $
Balance Due $ L [SS r iS.CO
we comdwMMo-pm.app
1/21/00 • Activities for Case #: ELC95 -00519 •
4:21:47 PM
•
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
. ELCC003 Permit Created 11/2/95 CJS PEND TMP 1/3/96
.ELCC001 Application Received 11/3/95 11/3/95 CTR 11/3/95
ELCC115 Routed to Plans Examiner 11/3/95 CJS PASS CTR 11/3/95
ELCC920 Miscellaneous action 11/6/95 MJR SLAB MJR 11/8/95 grid E -5
ELCC920 Miscellaneous action 11/14/95 MJR SLAB MJR 11/14/95
ELCC920 Miscellaneous action 11/20/95 MJR SLAB MJR 11/20/95 NE corner approved
ELCC920 Miscellaneous action 12/1/95 MJR SLAB . MJR 12/1/95 n.e. corner
ELCC500 (F)Issue permit 11/9/95 CJS PASS TMP 1/3/96
ELCC730 Elect'l Service 1/4/96 MJR - PASS MJR 1/4/96
ELCC510 (F)Reprint permit 1/5/96 JMH SENT J*H 1/5/96 Requested by Jessica at
Tualatin Electric, claimed not to
have original.
ELCC520 (F)Print ELC Signature form 1/5/96 JMH SENT J*H 1/5/96
ELCC720 Wall Cover 1/26/96 • MJR PASS MJR 1/26/96 bath,offices, and flower shop
ELCC720 Wall Cover 2/12/96 2/12/96 • MJR PASS MJR 2/12/96 S.E. corner •
ELCC720 Wall Cover 2/20/96 2/20/96 MJR PASS MJR 2/22/96 deli walls
ELCC700 _Ceiling Cover 2/22/96 2/22/96 MJR ' PASS MJR 2/22/96 south half approved
ELCC700 Ceiling Cover 3/4/96 3/4/96 MJR PASS MJR 3/4/96 entery canopy
•
ELCC799 Elect'I Final 3/26/96 3/26/96 MJR DIS • MJR 3/26/96 1. front entry lights not
complete 2. open boxs and exit
• lighting open 3. generator &
' transfer SW not listed 4. no
state label on Hussmann Envir.
Center 5. signs not complete
Inspection not complete
ELCC799 Elect'I Final 4/3/96 4/2/96 MJR PASS MJR 4/3/96 need low voltage permit and
corrections
ELCC800 Case Finaled 4/3/96 MJR YES MJR 4/3/96
•
ELCC510 (F)Reprint permit 3/3/99 - B PASS CTR 3/3/99
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