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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00033 4; DEVELOPMENT SERVICES DATE ISSUED: 1/22/04 ..� �! 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 PARCEL: 1S126C0-01403 SITE ADDRESS: 09300 SW WASHINGTON SQUARE RD ZONING: C -G SUBDIVISION: BLOCK: LOT : JURISDICTION: TIG Project Description: Alteration of (2) branch circuits to new display lights. 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: 1 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 PENDY'S ELECTRIC INC ATTN: PROPERTY TAX DEPT 20836 NE LAUGHLIN RD 611 OLIVE STREET YAMHILL, OR 97148 ST LOUIS, MO 63101 Phone: Phone: 503 - 550 -2144 Reg #: ELE 34 -122 L1C 55601 FEES SUP 2733S Description Date Amount Required Inspections [ELPRMT] ELC Permit 1/22/04 $53.50 [TAX] 8% State Surcharge 1/22/04 $4 Rough -in Elect'I Final Total $57.78 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 Not cation Center. Those rules are set forth in 952 -0' -: ! a through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246-6699 or 1 -80 32 -2344. • Iss d By: i 1.4�T (! / ! Permit Signature:) 2 f l � 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: /In i ' 1 '' /'/ 4 DATE: LICENSE NO: A'7,3 Call 639 - 4175 by 7:00pm for an inspection the next business day FROM : PENDY'S ELECTRIC INC. FAX NO. : 503 662 3122 Jan. 20 2004 08:31PM P3 01/20/20/1 12 :48 FAX 6038981060 CITY OF TIGARD l� 001 . earl I Perllnit,c I ED 1,0,, iil:l'IL.'I'. usE ONl,1 City of Tigard q ( � a / 13125 SW Ball Blvd., Tigard, OR 972IA 21 200 Darla : Al Od �.�' IMI, �f 0 .3 Phone; 503,639,4171 Fax: 503,598.1 O t, r ,, ; , - Plea Review < Other flamers Line: 503.639.4175 QTY OF TIGAA -y ' ' , .. Data asadymyr IIEMI W flee '' age a Aar inteRlet; WWw•oi.dprd.er.Ue - , I a . C • 1 :ICY Nt•tit>od/atahodt kpplotacatal Information 1. :F • ,., I' ':!r {�. : ;:: 7�i I • ! a :l �I I•L�:,i " f 1'I• I' I I 'p'f t Vii!► , . i I .: ,II i b1►i A hl i ■ New construction ►: • . dition/alte adon/replaccment Please check all that apply: [] Demolition ❑ °dun': ['Service over 225 amps, comm'l ❑Hazardous location . ^ . r• . , , - . , 1 , ❑Service over 320 amps - rating ❑Sulldng over 10,000 tq, ft„ r- ;,;,,. r y; ' EL . rX r '. . � a'g; r ' ti O D4 r0 I • ,q . y : a >_�: ,4 . ' . v ,i 1.;;i of 1- and 2- fu dwellings 4 or more new resldentI41 El 1- and 2- llimily dwelling '. Commercial /industnal [1 Accessory building ©System over 600 volts nominal units in one structure ■ Multi-famil ❑ Master builder ❑ Otbet: Osuttd n over throe stories OFesdiei, 400 amps or more ,ir , ❑Oooupant load owr 99 parsons DMaatuthotured structures or ,. i 'I ' a : r 1 .. sI I• l r r 0 �Qp , .� ` ! "•I r�• D g ' ' t � '��`' : . � i s ,�' Jil� " io -,' t! '� -' , •'.• 1, }i�ass/l[ ti RV n Am ptot • ❑Health -care facility °Oter: _ lob no.: Job mite addreSS: "' o D wy, jq ON ir . Submit 3 sets of plans with any of the above, City/State/ZIP; , am- A / The above are not applicable to temporary confirmation am'vlce. Suite/bldg. /apt. no.: ' Prgject name: MG/ 02 40 3 ,e',•� t•t ' 8 21:. ,a� yir y►iA� t6 er ? 1, :•, :; • : : r . ��s�r Qty. M+M Pm 'rota ~ Cross street/directions to job site: / e , 1 4 . 44 A g s'r0 , New residential Giggle• or multi - family dwelling uult. Includes atteehod Sar is a. 1,000 sq. $ or less 145.15 4 _ Subdivision: Lot no.: pa add'l 500 sq. 1L or portion 33.40 1 Tax warp/panel no.: Limited energy, raatdentiul ^.1. 7500 Z l . I Limited mow non-residential 75,00 2 ,,, • i r '!, i . lit #4 :', l • I n = ' w ' � l ii �� o a t Each rnanuOmtured or modular dwelling, service and/or feeder 90.90 2 7 i,aN ore - . O - t Gcrtecl as TS i Services or feeders Installation, alteration, andor relocation pp (�y�fi�rr at���.1w''l 200 amps or less 80.30 3 _ 'i :iP , I' 1�11d1 �11;p! +Iql ' 201 amp' to 400 amt a 106.8$ a l � i" 401 turps to: amps 160.60 2 Name: / f e « it . if :4 _ 601 aeys to 1.000 ontps 340.60 a Address: - 3 Q 0 cafes ' s' III • t • tJ , a 1.4444C L: rj Over 1,000 amps of voila 454.65 Z [reconnect only 66.85 2 City /State/ZIP: --1;:. . • I .- _ , Temporary service. or feeders Inataliatioa, alteration, and/or Phone: (003) 0 -3 I. Fax: ( ) relocation 603 200 amps or lase 66.85 1 Owner installation; This installation is being made on property that I own which is not 201 amps to 400 100.30 a intended for sale, lease, rant, or exchange, according to ORS 447, 449, 670, and 701. cal amps to 600 amps 133.75 2 Owner Si anire: Date: Broach circuits- new, alteration, or isxtensioe, per panel .._ sue; War ( I,r LL . . , : { , 'I J -. : • • ,;;, . A . Fee for branch circuit') with ;u,.t:,{r .. ... . i' :; service or Rader fee, mach 6.65 2 Business name; branch circuit 0. Fee for branch circuits Contact nwmp: without tlervioe or feeder fee, / 44.As 4, it 2 Mich brunch eirouit Address: peat trdd'l branch circuit / 6.65 kiL 2 Ciry/13tate/ZIP: Miscellaneous (s or f eeder not included Pump or irrigation circle 53.40 • 2 Phone; ( ) Fax; : ( ) Sign or outline lighting 53.40 2 &•snail; • Signal circuit[) or limited- CT e : L • , ; u PI 0 I II ' :(i t i �• ' ells 11 I ' I I' crgy Pang keratlon, .',n. •E•, I, •a'r 1 .�P •i li ..t ,• #::: .i••.�. • ,.1741 ■ 5. extension. txacnbe: Page 2 2 Business anti= Each additiaaal inspection over allowable In any of the above Address: 4 , , , ,1,� .�� a Per inspection 62.50 City/State/ZIP; L � z_ • at ; Investi . don • or hour (t re nth) 6150 � , / / Indurtrlal •lout • • hour 73•75 MEI Pbona: 603 ) / Fa>c i7� /�� fPtly~ ��il: � 1 ., , ..',! ! 0 -1 " -.1 : dr •'1: c- .-,!• .. CCB Lic.: 640 Electrical Lie.' -1,,,,c.... Suprv. Lima 733 • S subtotal ✓ 5. 0. id Suprv. Electrician signature, required: t � P Plan review (25% of permit fee) � State surcharge (8% of permit fee) 9 29 Print name: 4 - . _ 11, . , _ Date: - - -p 7'olrr , PERMIT 8J� f 77 Authorized j i orized signature: .. /��� , ' j , _ . This pet applintioa a *. if . permit 4 cot et+4Jaa� wCt610 190 - dim otter It has been accepted us complete Print nine: Date: • Fee methodology cat by T - Cautvy Building Industry Service Board •• 4__._.1irwrw. -- ter..,, -....., CITY OF TIGARD 24 -Hour E I ILDI G Inspection Line: (503) 639 -4175 MST INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested - S AM PM BUP Location 5'300 Lc/ * • S 62. R. Suite MEC Contact Person /'Y1 '27 Ph ( ) SSD- Z 1 L i t t PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC 006. 3 Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Anch Ext Sr Sheath/ors ea th /Shear Srs /nee ) Ext ea/ Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line • Smoke Dampers Final PASS PART FAIL ELECTRICAL ServiceCta d � e/� Rough -In UG/Slab Low Voltagedit et ' Fire Alarm Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. r1 RT FAIL SI E Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date . 0 Inspector i(j244-1/ Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL