Permit . CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2002 -00274
A- o DEVELOPMENT SERVICES DATE I 6/18/02
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 1 S126C0 -01107
SITE ADDRESS: 09785 SW WASHINGTON SQUARE RD D -12
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Proiect Description: Install 4 branch circuits: Store lighting, display and back room lighting.
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: 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: 3 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:
PPR WASHINGTON SQUARE LLC CAPITOL ELECTRIC CO INC
P.O.BOX 21545 12810 NE AIRPORT WAY
SEATTLE, WA 98111 UNIT 1
PORTLAND, OR 97230
Phone: Phone: 255 -9488
Reg #: LIC 048748
SUP 3132S
• ELE 26 -496C
FEES Required Inspections
Type By Date Amount Receipt Wall Cover
PRMT CTR 6/18/02 $66.80 2720020000( Elect'I Final
5PCT CTR 6/18/02 $5.34 2720020000(
Total $72.14
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 gy 1 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: 0-70_10 . DATE:
LICENSE NO: 31 3a S
Call 639 -4175 by 7:00pm for an inspection the next business day
Electrical Permit Application OFFICE UtiF. ONLY
Date received: , - , .Q Permit no.: �' _ / /03 I
rr ' �i Projcct/appl. no.: Expire date:
ail J. City of Tigard I _ J ��]
.411 j l� Date issued: By .. Receipt no.:
CITY OF TIGARD Address: 13125 SW HALL BLVD, TIGA D, OR 97223 Case file no.: Payment type:
Phone: (503) 639 -4171 Fax (503) 598 -1960 SUN 1 Q 2002
Laud use approval: D` ` N- 4 .1v,_ * 2$2 - X9 8
�Y>� 11� �7"Q
❑ I & 2 family dewlling or accessory X Commcrcta industrial p Multi-family ❑ Tenant improvement
❑ New construction ❑ Addit ion /alteration/replacement [] Other: ❑ Partial
.10R SITE INFORMATION
Job address: 9785 SW WASH. SQ RD City: TIGARD Bldg. No.: Suite no.: Tax map/tax lot/account no.:
Lot f Block: N/A (Subdivision:
Project name RADIO SHACK (Description and location of work on premises: STORE UGHTING, DISPLAY AND BACK ROOM LT
Estimated date of completion/inspection: 6130102
Job n0: 22478 Fee Mal.
Business Name: Ca pito l E ectric Co., Inc. Description Qty. (en.) Total no. imp
Address: 12810 NE Airport Way New residential - single or multi- family per
City: Portland State: OR ZIP: 97230 -1029 dwelling unit. Includes attached garage.
Phone: 503 - 255 -9488 IFax: 257 -7121 If mail: darreu®cepdx.com Service included:
CCB no.: 48748 'Elec. bus. lic.no: 28-496C 1000 sq. ft. or less $ 145.15 4
—
- ity><s ctro lic.no • Each additional 500 sq. ft. or portion thereof S 33.40
1 6/14102 Limited energy residential S 75.00 2
Signature of supervising electrician (required) Date Limited energy. nontCSidential $ 45.00 2
Sup. elect name (print): Darrell McNeal License no.: 3132 -S Each manufactured home or modular dwelling
- P120I'I:I('1'v OWNER Service and/or feeder s 9090 2
Name (print): Services or feeders - installation,
Mailing address: alteration or relocation:
City: State: 1212: 200 amps or less S 110.30 2
Phone: JFax: IF,-mail: J 201 amps to 400 amps S 106.85 2
Owner installation: The installation is being made on property [ own 401 amps to 600 amps $ 160.60 — 2
which is not intended for sale, lease, rent, or exchange according to 601 amps to 1000 amps $ 240.60 2
ORS 447, 455, 479, 670, 701. Over 1000 amps or volts S 454.65 2
Owner's signature: Date: Reconnect only s 66.85 1
ENGINEER Temporary services or feeders -
Name: installation, alterations. or relocation:
Address: 200 amps or less a 66.65 2
City: State: ZIP: 201 amps to 400 amps S 100.30 2
Phone: Fax: E -mail: 401 amps to 600 amps s 133.75 2
PLAN REVIEW (Please f heck 1111 that apply) Branch circuits - new, alteration,
0 Service over 225 imps-commercial ❑ Health -rye facility or extension per panel:
❑ Service ever 320 amps- rating of I11k2 ❑ Hazardous location A. Fee for branch circuits with purchase of
tiredly dwellings o Building over 10.000 square It. four or service or feeder fee, each branch Circuit S 6.65 2
❑ System Over 600 volts nominal more re,idential [Mire in one stnleture B. Fee for branch circuits without purchase
O Building over three stories ❑ Feeders, 400 :unps or more of service or feeder fee, first branch circuit: 1 s 46.65 twin, 2
O Occupant load over 99 person ❑ ManUfeCtures atrlumea or RV Pork Each additional branch circuit: 3 $ 6.65 19.95
ligrcu/Indumg plan C Other. Mille. (Service or feeder not included):
Submit sets of plans with any of the above. Each pump or irrigation circle $ 53.40 2
The above are not applicable to temporary construction service. Each sign or outline lighting S 53.40 2
Signal circuit(s) or a limited energy panel.
IL alteration, or extension" $ 75.00 2
"Description: •
\)\ct.t Ea ch additional inspectionover if; allowable in any of the above:
Per inspection p� I I $ 62.50 I I
investigation fee
Other
,(Visa q MasterCard _ Permit fee $ 66.80
Credit card numb= 4833-4960-0532-4657 03/d 3 _ Notice: this permit application Plan review ( ) $
GARY STEIBRT B expires If a permit is not obtained State Surcharge 8% ) $ 534
Name or am it Caro
6 72.14 wimtng 180 days after it has been TOTAL $ 72.14
sia6uute A mount accepted as complete.
l - d klOdd . WdZV:l Z00Z -17 l -9
CITY OF TEGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 6.1 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
` BUP
Received Date Requested �` Z AM PM BUP
Location LC) / S Q aDSuite Padl 0 0 MEC
Contact Person Ph ( ) S! gJ 3 703 PLM
Contractor 1*2/ f"4c7 Ph ( ) SWR
BUILDING Tenant/Owner ELC OZ a 7 9
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam r� d,'0 SA GLP.i‹
Ext Shear Sheath/Shear Anchors
J X7 Si�2C
Ext eah/hear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof (/ CO cb
Other:
Final
PASS PART FAIL
PLUMBING r ( c/
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
R
Gy-
ain Drains v -� l! LIB
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
Service
9
ra
U
Low Voltage
Fire Alarm
Fin Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE 1=I Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA � � /�f
Approach/Sidewalk Date � � 6 / � � Inspector
Pinar: DO NOT REMOV � nspecti� r cord from t h Jo Ext
Job sito.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING'' Inspection Line: (503) 639 -4175 -.
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 7// AM PM BUP
Location q_ 5 WA Suite MEC
Contact Person Ph ( ) — 7Vh? PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ' ELC - � O a 7
Footing
Foundation Access:, ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear —
Int Sheath/Shear
Framing
Insulation
Drywall Nailing I
Firewall
Are Sprinkler
Are Alarm
Susp'd Ceiling
Roof
Other:
Anal
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
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
1 PART FAIL
S El Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA p-/a_. Approach/Sidewalk Date 0 Inspector fir • ��� Ext
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL