Permit CITY OF TIGARD ELECTRICAL PERMIT
1 11- t; -. C OMMUNITY DEVELOPMENT Permit #: ELC2013 -00420
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/24/2013
Parcel: SEG590
Jurisdiction:
Site address: SW NO ADDRESS
Project: Walmart Subdivision: Lot:
Project Description: (1) branch circuit for existing service at SW corner of Pacific Hwy and 72nd Ave.
Contractor: E C COMPANY Owner:
PO BOX 10286
PORTLAND, OR 97296
PHONE: 503 - 224 -3511 PHONE:
FAX: 503 - 295 -3012
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 07/24/2013 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 07/24/2013 $6.74
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OA 52- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: / Permittee Signature: oA/ 7-70,4 /e'9-7749/\)
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' Date:
LICENSE NO. •
Call 603.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept In a conspicuous place on the job site until completion of the project
Approved plans are required on the job site at the time of each inspection.
Jul. 19. 2013 2:14PM R CtCI ! VE No. 0937 P. 1/1 D 0
n1 1
Electrical Permit Applicatio � �,1 ;. t,� � l < 1.1. � ►. 4>.l.\ •
City of Tigard .. Rdxsivod /� EZCap /3 le gal°
III h' JUL 2 2 7u, Da.:. 7 �3 Permitxo .
f • 13125 SW Ball Blvd, Tigard, OR 97223 Plan Review
Phone: 503.7182439 Fax 503.598.1 eie _ ATP �7�/2 - 1O /y
inspection Line: 503.639.4175 ®� I ° U Date Ready/Br hats: ® See Pa 2 for
ilc ; ire
Internet www.tigard -or.gov BURP 1 I r-• 111M 0,10N Notitied/Method: Supplemental information
TYPE OF WORK
^ ❑ New construction ® Addition/alteration/replacement Pl ease check all dint apply (submit $ sets of plans w/iteafs checked below):
❑ Savicc or feeder 400 amps or more ❑ Building ova three stories.
❑ Demolition ❑ Other; where the available fault am= ❑ Mamas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 votes or ❑ Floating buildings.
loam to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1 - and 2 - family dwelling ® Commercial/mdustrial ❑ Accessory building amps for all other installations- buildings.
❑ Multi - family ❑ Master builder ❑ Other ❑ Fee pump. ❑ Installation of 150 KVA or •
.IOS SITE INFORMATION AND LOCATION ❑ Emergency system' Iatger separately derived system.
❑Addition of new motor Iced of ❑ "A", "E ", "1 -3", "1 -3
Job no.: 65469 Job site address: OR 99W ( 72 Ave 100HP or snore. Occumay.
❑ Six or more residential units. ❑ Recreational vehicle perks.
'
City/State/ZIP: Tigard, OR El Health-care facilities. Q Supply voltage for more than
❑ Harardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: Tigard Walmart ❑ service or fide 600 amps or more.
Cross street/directions to ob site: FEE o I
J 1lpertptba I our. Pa I Toed 1
New residential single- or multi -family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4
Tax map /parcel no.: Limited 4 0 Se. itedener sq. ft. or portion 33.92 1
ited energy, residential 75.00 2
. DESCRIPTION OF WORK- (with above sq. ft.)
Limited energy, multifamily 75.00 2 •
Modifications to existing traffic signal residential (with above sq. ft) .
Renewable Energy ❑ See Page 2
6 / STN SGGJZ rie.g 4L-7 -,g 6)g/A/C - Services or feeders installation, alteration and/or relocation •
0 PROPERTY OWNFdt• .. 1 ❑ TPd4ANL ... , : 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
Address: 601 amps to 1.000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City / State/ZIP: • Temporary services or feeders installation, alteration, and/or
Phone: ( ) I Fax: ( ) relocation
200 amps or less 59.36 1
Owner Installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for salt, leas; rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168,54 2
Owner signature: Date: Branch circuits- new, alteration, or extension, per panel
• i APPLICANT . . .1. • 0 CONTACT :PERSON A. Fax: for blanch circuits with
above service or feeder fee,
7A2 2
Business name: E C Company each branch circuit
- S. Pee for branch circuits without
Contact name: Shanna Fullbright service or feeder fee, first 1 56.18 56.18 2
hrnach circuit
Address: P O Box 925 Each add'I branch circuit 7.42 _ 2
City / State/ZIP: Albany, OR 97321 Miscellaneous (service or feeder not included)
Each manufactured or modular 67.84 2
Phone: (541) 926 -4266 f Fax: : (541) 926 -0165 dwelling service and/or feeder
-___ Reconnect only . 2
E - mail: shannaf®e- e- co.com Pump or irrigatio circle 67.84 2
CONTRACTOR . . - ' . Signor outline lighting 67.84 2
Business name: E C Company Stgcal circuits) or limited-energy Sec
panel, alteration. or extension, , Page 2 2
Address: P 0 Box 925 Each additional inspection over allowable In any of the above
City / State/ZIP: Albany, OR 97321 Additional inspection (1 hr min) 6625i hr
Investigation (1 hr min) 66.25/ hr
Phone: (541) 926-4266 I Fax: ( 541) 926-0165 Industrial plant (1 hr rain) 78.18/ Itr -
Electrical Lic.: 22- Sc / /y Su rv. ' c.ejfiiiiL bona for which r maul fee is CCB Lic.: 49737 �/ P apeeificnliy listed (44 6r .
5trprv. Electrician signatiuc, rcquircd: ti � ; EI 4'tRICAL YSRSubto 5 FEE9;;` a..+ Subtotal: 56.18
Print name: William R. Coburn . /51 4 ! • / , 01 •
I State surcharge (12% of permit fee): 6.74
Authorized signature: . TOTAL PERMIT FEE: 62.92
Point name: Date: This permit application expuo if a permit is not obtained within 180
. . . days after tt has been accepted as complete
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
SW NO ADDRESS, TIGARD, OR
Commercial - Electrical
199 Electrical final
PASS - No C of O
August 14, 2014 at 2:48:14
PM
ELC2013-00420
Jeff Grove
Violation Summary:
Inspector Contractor