Permit CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2001 -00147
:r� DEVELOPMENT SERVICES
DATE ISSUED: 3/13/01
'�' I - �' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S126C0-01107
SITE ADDRESS: 09585 SW WASHINGTON SQUARE RD
SUBDIVISION: MISIEDIMIOMMERRE ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of one 200 amps or less service and 4 branch circuits. Job No. 01322
Location of work is a food cart in the Summit Food Court.
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 HMI SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: 4 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:
PPR WASHINGTON SQUARE LLC DRYER + SONS
P.O.BOX 21545 5536 SE WOODSTOCK BLVD
SEATTLE, WA 98111 PORTLAND, OR 97206
Phone: Phone: 774 -1606
Reg #: LIC 00001114
SUP 2311S
ELE 26 -43C
FEES Required Inspections
Type By Date Amount Receipt
Ceiling Cover
PRMT CTR 3/13/01 $106.90 2720010000( Wall Cover
5PCT CTR 3/13/01 $8.56 2720010000( Elect'l Service
Elect'l Final
Total $115.46
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 o - - - . - or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE % ,c�� ISSUED :Y: ,/ -
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 INSTAL ATION ONLY
SIGNATURE OF SUPR. ELEC'N: 4 5 Z /d----L- DATE:
LICENSE NO: €;dq /-
Call 639 -4175 by 7:00pm for an inspection the next business day
03/06/01 TUE 09:47 FAX 503 598 1960 CITY OF TIGARD 01002
ElectricalPermitA /,
- ® Date received: g O/ Permitno.: f&r;�AO/-ODl 7
it,iAi I' City of Tigard P rojectUappl.no: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tiga d, OR 97223 nv;. Date issued: By: Receipt no.:
Phone: (503) 639 -4171 ' • • • p, .
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: C0a ..lit.1� pEVELO MEN l
TYPE OF PERMIT •
Ci 1 & 2 family dwelling or accessory IP.Commercial/industrial ❑ Multi -family ❑ Tenant improvement
O• New construction ❑ Additi,n/altcration/replaccment ❑ Other: ❑ Partial
.1OB SITE INFORMATION
•
Job address: Sg 5W W A541 I per 9 p • Bldg. nt .: Suite rio.: . Tax map /tax lot/account no.:
Lot: Block: (Subdivision:
Prgject name: ( .Um a Desc I I ltion and location of work on premises:
Estimated date of core i'letion/inspection: •
CONTRACTOR APPLICATIOi' FEE SCHEDULE
I Job no: O i 31,2 Fee Max Description Qty. (ea-) Total no. insL
Business name: DR_ —RA- SOfJS E1FZlR VC New residential - single tamtlypet
Address: S5 b _ ..) The i L 0 - dwellingunitb cludes'attachcdga agc.
4,::) City: 'Or :, j State: Oa :DP: 9.7 -2,2 Servicelncluded: •
."-,.... Phone: 1314-i Fax: 77q -10Lib E -mail: _ 1000 sq. ft. orless 4 •
Each additional 500 sq. ft. or portion thereof
CCB no.: i i li Elec. bus. lic. no: .2..(,- c Limited energy, residential 2
City/Meti• no.: ne0o 36 Limited energy, non- residential 2
,/,,,,/,/,'/,' ?-12-01 Each manufactured home or modular dwelling a. 5wiceandlorfeeder 2
Signature o supervising e ectrici . (required) Date Services or feeders—installation,
1 Sup. elect name (print): it, p, t, g . '. - Li tense no: I alteration or relocation:
PROPERTY OWNER 200' amps or less I SO. lc 2
201 amps to 400 mops 7-
Name (print): 401 amps to 600 amps ' 2
Mailing address: ' - 601 amps to 1000 amps 2
City: I State: I : P: Over 1000 amps or volts 2
Phone: 'Fax: I E -mail: Reconnectonly 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
Installation, alteration, or relocation:
which is not intended for sale, lease, rent, or exchanl a according to 200 amps or less 2
ORS 447, 455, 479, 670, 701, .. . • ,. ._ _. 201 amps to 400 amps • 2
Owner's signature: Date: 401 to 600 amps 2
ENG INFER. Branch circuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of •
Address: service or feeder fee, each branch circuit II 6," 21,1e 2
City: I State: I :ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E-mail Each additional branch circuit:
PLAN REVIEW (Please check all fira apply) Mho. (Service or feeder not included):
Cl Service over 225 amps.coznmczcial Cl Health-care faciliy Each pump or irrigation circle 2
2
Cl Service over 320 amps -rating of 1&2 0 Hazardous locatit a
fanuly dwellings 0 Building over 10.000 square feet four or Signal circuit(s) or a limited energy panel,
CI System overall) volts nominal more residential1 nits in one st,ueture alteration, or extension* t 2
Cl Building over three stories 0 Feeders, 400 amt s or more *Description:
0 Occupant load over 99 persons 0 Manufactured str rctures or RV park Each additional inspection over the allowable in any of the above: .
O F, gressFighlingplan Cl Other. Pcc inspectioo I I I I
Submit sets of plans with any of tb4 above. Investigation fee .
The above are not applicable to temporary coast ruction service. Other
Permit fee • $ 106 40
'Not all jurisdictions =opt credit cards, please call jurisdiction for mere int srmation. Notice: This permitapplication Plan review (at _ %) $
• Cl Vera Cl MasterCard expires if a permit is not obtained
Credit card Dumber / / within 180 days after it has been State surcharge (8 %) .... $ t) • S6
. Q Fxr in accepted as complete. TOTAL $ I I •
Name of cardholder as shown on credit card • • $ -
Cardholder signature Amman • . 4404615 (6/00/COM)
RECEIVED 06 -MAR -2001 08:58AM FROM -503 598 1960 TO -Dryer & Sons Electri PAGE 002
•
Z.c 19'
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour inspection Line: 639 -4175 Business Line: 639 -4171
. BUP
• Date Requested . 7 AM PM BLD
Location Q , $'S $ cf-9G:> it I A/. Suite MEC
Contact Person SuMm t 16,,j rP Ph 5 7i y 3 PLM
Contractor �-J-� � Ph SWR
BUILDING / Tenant/Owner ELC 0200, 6 ' / C 2_
Retaining Wall ELR
Footing Access:
Foundation �J ; FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam -)6 0/ 3ZZ
Ext Sheath /Shear re--s S u
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall 11111, _ /
Fire Sprinkler _ : _ .�� /t ' ■ L_
Fire Alarm
Susp'd Ceiling - .r - - -
Roof
iffa
Misc:
Final
PASS . PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Setvic> 4. C Ov-ti-
i ugh In
UG /Slab
Low Voltage
do hir PART FAIL
• E
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
Other Date Inspector iL.✓ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.