Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00349
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DEVELOPMENT I r S ER 9ES (503) 639 -4171 DATE ISSUED: 6/14/2004
PARCEL: 1S126C0-01403
SITE ADDRESS: 09300 SW WASHINGTON SQUARE RD
SUBDIVISION: ZONING. C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: (3) 200amps servs, with (1) feeder (200amp), 229 branch circuits.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 1 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: 3 W /SERVICE OR FEEDER: 229 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:
MAY DEPT STORES COMPANY, THE KEC ELECTRIC INC
ATTN: PROPERTY TAX DEPT 1281 NE 25TH AVE UNIT K
611 OLIVE STREET HILLSBORO, OR 97124
ST LOUIS, MO 63101
Phone: 314 - 342 -6227 Phone: 503 -439 -0904
Reg #: LIC 99267
SUP 4489S
FEES ELE 34 -426c
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 6/14/2004 $1,830.60
[TAX] 8% State Surcharge 6/14/2004 $146.45 Elect'I Service
Rough -in
Total $1,977.05 Elect'I Final
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 -0699 or 1 -800- 332 -2344.
Issued By: /5 ajj � j( 4t4Z. 1.5 ,, Permit Signature:
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 639 - 4175 by 7:00pm for an inspection the next business day
Electrical Permit Application FOR OFFICE USE ONLY
Clay of Tigard Received
: ' / 0 Permit No.: . / ) U _ et.)
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review /
Phone: 503.639.4171 Fax: 503.598.1960 0�. i'y11411 pang Other Permit:
Inspection Line: 503.639.4175 ! Date ReadyBy ® See Page 2 for
Internet: www.ci.tigard.or.us Notifed/Method: �/� Supplemental Information
TAE OF WORK - PLAN REVIEW
❑ New construction , LI — S , A /alteration/replacement Please check all that apply:
❑ Demolition ❑ Other: ['Service over 225 amps, cornm'I ❑Hazardous location
['Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
;.'` - CATEGORY OF CONSTRUCTION . " of I- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwellingmmercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Multi family ❑ Master builder ❑Other: ❑Building over three stories ❑Feeders, 400 amps or more
['Occupant load over 99 persons ['Manufactured structures or
' ' ,": ' ' 'JOB SITE INFORMATION AND LOCATION ['Egress/lighting plan RV park
Job no.: p[.�_ 10C, ( Job site address: 9 3 00� 44e S p„S� ❑He Submit 2 -care facility ['Other: e.
Submit 2 sets of plans with any of the above.
above.
City/ State/ZIP: C The above are not applicable to temporary construction service
Suite/bldg. /apt. no.: U r Project name: kf 0 iS' Fi .FEE° SCHEDULE
/--/ 1 e/ 77 F 6.. 16.hc� Description I Qty. I Fee. I Total I **
Cross street/directions to job site: /t, 4S 4 f ,rTOr , c 9 m,p,„( New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 I
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
` ' r: " ' DESCRIPTION OF WORK Each manufactured or modular
/ A / dwelling, service and /or feeder 90.90 2
A440c t e i ?i i L O.O/ .. " Services or feeders installation, alteration, and/or relocation
200 amps or less 1 3 I 80.30 I A11O,` * 2
� � 201 amps to 400 amps 106.85 2
a,_'- IH 'pROPERTY ?OWNER I , :� "i. _� k _ f ❑ TEI Of
401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 1 66.85 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
Phone: ( ) I Fax: ( ) relocation
200 amps or less jt 66 85 A cp 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
B APPLICANT • I _ .0 CONTACT PERSON . A. Fee for branch circuits with
service or feeder fee, each 6 65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
each branch circuit 46.85 G
Address: Each add'I branch circuit 1 1 6.65 j�S,? F
City/State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax: : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
..CONTRACTOR a energy panel, alteration, or
Business name: (C ELEG lC T-n1G extension. Descnbe: Page 2 2
Address: Iasi N E a 5th !-EVE Lam i T le_ Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: 1-4 I LL.S Slog° 01Z ' 9 Ala U Investigation per hour (1 hr min) 62.50
Phone: ( 503) co q— )q (Fax: (5D3) /c)-3g3 S Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: 99a4 Electrical Lic - !J -ya4C, Suprv. Lic.: yyggs Subtotal I i 30 c,
Suprv. Electrician signature, require P lan review (25% of permit fee) /
� ` / State surcharge (8% of permit fee) (!.i (
61
Print name: tSE 7 NM roA Date: b/!�(O TOTAL PERMIT FEE �
Authorized signature: ' This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board
ate/ ?it ' •• Number of inspections per permit allowed
\
i \BuildingPam \itsELC- PemutApp doe 12/03 440 4615r(10/02/COM/WEB
-
Electrical Permit Application - City of Tigard
Page 2 - .Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENL!WORK ONLY: — _ - —
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
El Burglar Alarm
El Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
El Other:
ft:CO:1001 i -_ ';O' tONLY: ,, _ � . <<<, ;'r
Fee for each commercial system $75.00
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
El Audio and Stereo Systems
❑ Boiler Controls
El Clock Systems
❑ Data Telecommunication Installation
El Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
El Landscape Irrigation Control*
El Medical
El Nurse Calls
El Outdoor Landscape Lighting*
El Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
i:�Building\ PeTnuu\EELC-PrnnitApp doc 04/03
CITY OF TIGARD
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: -C2004 -00349
Phone: (503) 639 -4171 VIi 6114!2004
Inspection Requests (24 Hrs.): (503) 639 -4175 _ -__ �+�-
INSPECTION WORKSHEET FOR DATE: 9/29!2005 TIME 7:OBAM PAGE: 30
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: 09300 SW WASHINGTON SQUARE RD LOT #: TYPE OF USE:
PROJECT NAME: MEIER & FRANK
DESCRIPTION: (3) 200amps servs, with (1) feeder (200amp), 229 branch circuits.
OWNER: MAY DEPT STORES COMPANY, THE, PHONE #: 314 - 342 -6227
CONTRACTOR: PHONE #:
KEC ELECTRIC INC 503 - 439 -0904
Inspection Request Scheduled For: Date: 9/2912005 Pour Time:
Code # Inspecti Description Confirm # Contact # Message
199 rical final 017004 -01 503-209-9033 Y
Corrections /Comments /Inst ns:
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F 1 N (oI._._ it CA 406 c
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CaD IANASS PARTIAL APPROVAL ❑ CANCEL El NO ACCESS
❑ A LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
/ a I
Inspector: /' Date: 1 2 T Phone #: (503) 718- ZkO b "'