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Permit CITY OF TIGARD ELECTRICAL PERMIT 111 g � COMMUNITY DEVELOPMEN Permit #: ELC2013 -00422 Date Issued: 07/24/2013 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 parcel: SEG858 Jurisdiction: Site address: SW NO ADDRESS Project: Walmart Subdivision: Lot: Project Description: (1) 200 amp service and (3) branch circuits for new service at SE corner of Dartmouth St 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 ea Services or Feeders - 200 07/24/2013 $100.70 Specifics: amps or less 3 crt Branch Circuits w /Purchase 07/24/2013 $22.26 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 07/24/2013 $14.76 Electrical Type of Const: Occupancy Grp: Total $137.72 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 952- 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: 0A/ 7 ie' O�✓ 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 503.639.4175 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 : 21 PM No. 0939 P. 1 Electrical Permit Applicati G FOR 11FR F r. F I � ()NI , City of Tigard E� JL�I LI _ ��. Permit No ■ 13125 SW Hall Blvd., Tigard, OR 97223 "� 1��/3 6i %.2,z, Phone: 503.718.2439 Fax: 503.598.196d �� 2 2 2013 �,,,, Other Permit :' _ ,ice — / /, /A . r . i (._, .,'IF. I) Inspection Line: 503.639.4175 Date Ready/13y: H See Pane 2 for Internet: www,tigard.ar.gov CITY OFTIGARD Notified/Method: Supplemental lafeematioa ' TYPE OF V DIVISION ' PLAN REVIEW . •. , . ® New construction 0 Addition/alteration/replacement Please check all shat apply (suborit a seta of plans w/rtems checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. El Demolition :Other: where the available fault etarent ❑ Marinas and boatyads. CATEGORY OF CONSTRUCTION . exceeds 10.000 amps at 150 volts or ❑ Floating buildings. less to grotmd, or exceeds 14.000 ❑ Commercial-use agricultural ❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fie pump. ❑ Installation of 15011 VA or ❑ Emergency system. JOB .SITE INFORMATION AND LOCATION lar8er separately derived system. .. ❑Additicm of new motor load of ❑ "A ^, "E", "1 - ", "1 - ", Job no.: 65469 Job site address: Barth mouth St. @ 72 Ave 10o13pormote, occupancy' ❑ Six or more residential units. ❑ Recreational vehicle pads. City /State/ZIP: Tigard, OR ❑ lth-car'e facilities, ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: Tigard Walmart ❑ Service or feeder 600 amps or more. • 11,E , <; ' . i, . > Cross street/directions to job site: - n FE S, stuo I t 9rr. ( Fee. 1 Total l New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. fl or less 168.54 4 Ea edd'l 500 sq. Il. or portion 33.92 1 Tax map /parcel no.: S& ,?5,9 Limited mangy, residential 75.00 2 DFSCR FITON OF WORK (with above sq. ft ) • Limited energy, multi- family Install service for new traffic signal #9 -% .4" 6 6, f �-� residential (with above sq. R) 75.00 2 Renewable Energy p See Paige 2 Services or feeders installation, alteration, and/or relocation ❑ PROPERTY OWNER 1 2 00 amps or less 1 100.70 100.70 2 Q : TENANT 201 amps to 400 snips 133.56 2 Name: 401 amps to 600 amps 200,34 2 • Address: 601 amps to 1,000 amps 301.04 2 City/Slate/ZIP: Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation, alteration, and/or • Phone: ( ) Fax: ( ) relocation - _ 200 amps Or less 59.36 I Owner Installation: This installation is being made on property that I own which is not 201 amps t0 400 amps • • 125.08 2 . intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. aol WOW to 599 amps 168,54 2 Owner signature: Date: Branch circuits— new, alteration, or catcasioa, per papd A. Fee for bran entails with ® APPLICANT ©CONTACT PIER801�1 above service or feeder fee, 3 7.42 226 Business name: E C Company each Bch circuit 2 B. Fee for branch circuits without Contact name: Shanna Fullbright service or feeder fee. first - branch circuit 36.18 2 Address: P 0 Box 925 Each adds branch circuit 7.42 2 1Mtseet� eons sery feeder no t lee or f ee d Included) City / State/ZIP: Albany, OR 97321 _ -- Each manufactured or modular 67.84 2 Phone: ($41) 926 Fax: : (541) 926 - 0165 dwelling, service and/or feeder Recannectonly 67.84 2 E -mail: shannaf @e- c- eo,eom Pump or irrigation circle 67.84 2 CON>TRACI'OR Sign m outline liglrtirg 67.84 2 Business name: E C Company Signal cin i 5) orlimtted.00crq' See panel, altoranon, or extension. Page 2 2 Address: P O Box 925 Each additional inspection over allowable in any of the above Additional inspection (1 la min) 6625/ lit City / State/ZIP: Albany, OR 97321 -- —_. . Investigation (11a min) 66.25 / hr Phone: (541) 9264266 Fax: (541) 926-0165 industrial plant (1 br ruin) 78.18/ ttr Inspections fbr which no fee is CCB Lie.: 49737 Electrical Lic.: 22 -15c I Suprv. Lie.: 3 Is specifically listed (f5 hr min) 90.00/ hr • MZ.0 RICAL PERMIT .: : FEES:a . :' , ': Suprv. Electrician signature, required: t, Subtotal: 122.96 • Print name: William R Coburn Date: 07.19.13. . Plan review (25% of permit fee): Stare surcharge (12% of permit fee): 14.76 Authorized signature: TOTAL PERMIT FEE; 137.72 Print name: Date: This p ermit application expires if a permit m not obtained within 180 ' days after it has lien 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 2:48:38 PM ELC2013-00422 Jeff Grove Violation Summary: Inspector Contractor