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Permit
CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT ©�$ ELECTRICAL ELC2014-00019 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 , Date Issued: 01/14/2014 Parcel: 2S102AC00500 Jurisdiction: Tigard Site address: 12492 SW MAIN ST Project: Spec Space Subdivision: BURNHAM TRACT Lot: 1 Project Description: Install 125 amp subpanel and(14)branch circuits for remodel.4/21/14,reprinted to change contractor of record to Willamette Electric.6/18/14,reprinted to correct project name to Spec Space for landlord work anyIlizziect address to 12492 instead of 12490 SW Main. Contractor: WILLAMETTE ELECTRIC INC Owner: WOODARD LIVING TRUST PO BOX 230547 PO BOX 23303 TIGARD, OR 97281 TIGARD,OR 97281 PHONE: 503-624-3631 PHONE: 503-639-1533 FAX: 503-624-2938 FEES Quantity Description Date Amount 1 ea Services or Feeders-200 01/14/2014 $100.70 Specifics: amps or less 14 crt Branch Circuits w/Purchase 01/14/2014 $103.88 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 01/14/2014 $24.55 Electrical Type of Const: Occupancy Grp: Total $229.13 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 a •• •ance with roved pl.ns. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATT-'TION: Oregon law re• res you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-00 0 throu_h OAR 952-001''90. • ay obtain a copy of the rules or direct questions to OUNC by callipg4G3.232.1987 or 1.800.332.2344. Issued B . Permittee Signature: _ etv(r'LC� 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. iI , CITY OF TIGARD 117:o/) Mrs ELECTRICAL PERMIT 11111 ' COMMUNITY DEVELOPMENT Permit#: ELC2014-00019 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/14/2014 T f t:;�R L} 9 Parcel: 2S102AC00500 Jurisdiction: Tigard Site address: 12490 SW MAIN ST Project: Tigard Liquor Store Subdivision: BURNHAM TRACT Lot: 1 Project Description: Install 125 amp subpanel and(14)branch circuits for remodel.4/21/14,reprinted to change contractor of record to _ Willamette Electric. Contractor: WILLAMETTE ELECTRIC INC Owner: WOODARD LIVING TRUST PO BOX 230547 PO BOX 23303 TIGARD,OR 97281 TIGARD, OR 97281 PHONE: 503-624-3631 PHONE: 503-639 1533 FAX: 503-624-2938 FEES Quantity Description Date Amount 1 ea Services or Feeders-200 01/14/2014 $100.70 Specifics: amps or less 14 crt Branch Circuits w/Purchase 01/14/2014 $103.88 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 01/14/2014 $24.55 Electrical Type of Const: Occupancy Grp: Total $229.13 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. ATTENTIO on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 rough OAR 2- -/�09D You may obtain a copy of the rules or direct questions to OUNC by callir 803.232.1987 or 1.800.332.2344. Issued B • • L C/ .I _.L Permittee Signature: / t /(� t 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: �t , LICENSE NO. T;?- 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. 04/21/2014 MON 10:14 FAX 5036242938 Willamette Electric f0002/002 Electrical Permit Appli t.I•r , FOR OFFICE USE ONLY 11,11 City of Tigard �I V c,B: mown Permit No.: G c Z v i y - U u J • I?i 125 SW Hal!Blvd.,Tigard,4' 23 Plan Review is Phone: 503.718.2439 Fax: 503. ��602 1 2014 Date/B : Other Permit: Inspection Line: 503.639.4175 Date Ready/By: runs: 0 See Page 2 for T[GARD p Notified/Method: Supplemental information lnxernet eww ttgard or.gov I 1 n ,,g+ � r,Y.t;k,7_-,:1 . „fry, j�"•�! '�ri,C�' +`1 1-4-Tr ,l*'.�4s ti t' c ,. +o74.-4. GL' ?`s''� oaf r'e FY. `#10tw1 n-� {,.: i '�, :n s ,.,A1:, .i.a: L. s.sn t d A ,r,4rS'h 5.,1 -'A -• sti •w �.. �tr.,...#, - arf., v ; .. .w .,.. . .: r r i ._ c-z'. ❑New construction ! 'Additlo a ra ton replacem nt Please check all that apply(submit j sets of plans w/items checked below): 0 Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards. e 7:* Z t,-x s.iM, f:''F' , .yes.W t exceeds 10,000 amps at 150 volts or ❑Floating buildings. 5 ti �a a �{� ,��.,�,-_ k � ;I' ,, .:,'y .:>a� �a ��?-��a`caF�,£t' a>; .. ,��,4�'s�� '_' .;. less to ground,or exceeds 14,000 Q Commercial-use agricultural ❑ 1-and 2-famtily dwelling 2 Commercial/industrial ❑Accessory building amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other 0 Fire pump. 0 Installation of 150 KVA or ,c,�,� Y ,may., r„,-u _ -,-. ,- i -� Emergency system. larger separately derived system.• 4'Y`t j i, r11,i- F Y�E r 7 0 1 0 \a e :�Fd'1af )5.���..'.5 . _ cr. :a ,c�-',p,.. p '.z.'ia k ❑Addition of new motor load of I00HP or more_ occupancy. Job no.: ~ 4" /F Job site address: /241`9('1 S t.. 1'1 d S b ❑Six or more residential units. ❑Recreational vehicle parks. p 0 Health-care facilities. 0 Supply voltage for more than City/State/ZIP: r h ?i d f Z i 7 Z t 3 600 volts nominal ❑Hazardous locations. Suite/bldg./apt_no.: i Project name: 7,5 e'.J -7i,,,,., S 4 . ©Service or feeder 600 amps or more. Cross street/directions to job site: Description Qty. Fee. I Total New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: ( Lot no.: 1,000 sq.t.or less 168.54 4 Ea.add'I 500 sq ft or portion 33.92 1 Tax map/parse&no.: Limited energy,residential `;""4 4o,`,",r" js"iAt 4•4yl -!p�J0''cc t- x ''%t t";zair" : r,' i ��'1"}'ya b (with above sq.R.) • 75.00 2 Limited energy,multi family 75.00 2 194 c ... -t.-. (6) ? c,,,,,/. 4 di C u/1 coo o/9 residential(with above sq.fl .12t;rt:04;breiE...er Y.W::h;F:1 aageeithggAi,r, .a Services or feeders installationtaltcration,and/or relocation r.<. c , - .;7$" `a y ,, , 200 amps or less / 100.70 /u /� 2 :aY� k a®.t 5�V' - ,fi h�t'x`]� d'4 $ Hai ik'',,'''+,,..ki i . .,::. ��ti:r Y'..Y 1 201 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 relocation Phone:( ) Fax:( ) 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 sage,lease,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 x NQr, v ,lnx. F r•pOtec§ za t r" A.Fee for branch circuits with i 4 :.wt,- i' ., .. e, �:N .z :� .,d,.?': ,mvF1-V4..-Yo...�t -,e above service or feeder fee, Business name: each branch circuit Pi 7.42 /�3 2 B.Fee for branch circuits without Contact name: service or feeder fee,first 56.18 2 branch circuit Address: Each add'1 branch circuit 7.42 - 2 Miscellaneous(service or feeder not included) City/State/ZIP: Each manufactured or modular 67.84 service and/or feeder .84 2 Phone:( ) 1 Fax: ( ) Reconnect only 67.84 2 E-mail: Pump or irrigation circle 67.84 2 3-N tax,Y ` 157e)a try t 6s ll " , ;, I g, i�".�; is Sin or outline 1 htin 67,84 2 Business name: �/ I , t Signal circuit(s)or limited-energy See v panel,alteration,or extension. Page 2 2 Address: p, e I s -1 j7 �',5`� Each additional inspection over allowable in any of the ahoye ` �r Additional inspection(1 hr min) ! 66.25/hr City/State/ZIP: 7' Q F7 ,1 Investigation(1 hr min) 66.251 hr Y Phone:ag) 5 / Fax: ) . _y-�9. g industrial plant(1 hr min) 78.18/hr 'YIJJ p ���� inspections for which r fee is 90.00/fir CCB Lic.:�7 �C' Electrical Lie.. l Su rv.Lic.: s tficatt bated i4 fir mm `' ___.. '.�.c L7A'`�'`'v'.r'''.-i Fl�lL.i 01(',�4;74. e1 RS'r,b.E t u J,,..1_;. :t^..."+i Suprv.Electrician signature,required: Subtotal: 2 o y Si Plan review(25%of permit fee): Print name: � l.. � Date: ` z / /5 State surcharge(12%of permit fee): 2'T rs _ Authorized signature: TOTAL PERMIT FEE: 22, /3 This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. - • Number of inspections allowed per permit. 1::Bui1dingWermitslFLC PeimitApp_ELR ERE.doc Rev 05/21/2013 440.46151(11/05/COMAVEB CITY OF TIGARD ELECTRICAL PERMIT wr 11 COMMUNITY DEVELOPMENT Permits: ELC2014-00019 T IGA.RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/14/2014 Parcel: 2S102AC00500 Jurisdiction: Tigard Site address: 12490 SW MAIN ST Project: Tigard Liquor Store Subdivision: BURNHAM TRACT Lot: 1 Project Description: Install 125 amp subpanel and(14)branch circuits for remodel. Contractor: OWNER Owner: WOODARD LIVING TRUST WOODARD LIVING TRUST PO BOX 23303 PO BOX 23303 TIGARD,OR 97281 TIGARD, OR 97281 PHONE: 503-639-1533 HONE: 503-639-1533 FAX: FEES Quantity Description Date Amount • 1 ea Services or Feeders-200 01/14/2014 $100.70 Specifics:, amps or less 14 crt Branch Circuits w/Purchase 01/14/2014 $103.88 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 01/14/2014 $24.55 Electrical Type of Const: Occupancy Grp: Total $229.13 Required Items and Reports(Conditions) This permit is Js5ued 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 ' accordance 'th approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more th 180 days. TTENTION: Orego law . uir_es you to follow the rules adopted by the Oregon Utility Notification Center Those rules ar set forth in OAR 952- 01-0010 through OAR 95 •r r .. You may obtain a copy of the rules or direct questions to OUNC by calling 503.23 1 87 or 1 800.33 2 44. i V Is ued By: 11 4 Permittee Signature: \ 4/ '— 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: CONTr •CT' - INSTALLAT fNLY SIGNATURE OF SUPR.ELEC' t' /IKMIllIr Date: ( :l _ LICENSE NO. Call 503.639.4175 by 7:00 a.m.for the next available inspection date. Thls 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. Electrical Permit Application FOR OFFICE l.SF.(t♦l 1 City of Tigard JEcEIVED Received / •� City g DateB �® � permit ���t � d� _zoo/ 13125 SW Hall Blvd.,Ti Plan Review • Phone: 503.718.2439 Fax: 50 l Date/B : Other Permit: TI A It II Inspection Line: 503.639.4175 JM IY 1 4 2014 Date Ready/By: kris: Ed See Page 2 For Internet: www.ligard-or.gov Notified/Method: Supplemental Information T 1 .. .L� PLAN REVIEW ❑New construction [i ddition/altcrationIrepTacement PIS check all that apply(submit 2 sets of plans w/items checked below): ❑Service or feeder 400 amps or more CI Building over three stories. ❑Demolition 0 Other: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at l50 volts or ❑Floating buildings. less to ground,or exceeds 14,000 ❑Commercial-use agricultural ❑ I-and 2-family dwelling EK.ommercial/industrial ❑Accessory building amps for all other installations. buildings. ❑ Multi-family ❑ Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system. ❑Addition of new motor load of ❑"A" "E" 1-2", `t-3" Job no.: I Job site address: / L!4 a S W 5� I OOor a more. occupancy, f ❑Six ar more residential units. ❑Recreational vehicle parks. City/State/ZIP: 0...4 (p/- � �7 ❑Health-care facilities. ❑Supply voltage for more than / [ J 7 f- 3 ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: Project name: TGt,,rk 6( A e 0...3 t l ❑Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: V J Description I Qty- I Frr. I Total I New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4 Ea.add'l 500 sq.ft.or portion 33.92 I Tax map/parcel no.: Limited energy,residential DESCRIPTION OF WORK (with above sq.ft.) 75.00 Limited energy,multi-family 75.00 2 Z il t i 2 4t- 5 Lt __`),4� -t - e residential(with above sq.ft.) j T l� �� Renewable Energy ❑ See Page 2 2 C.)4 L C-3 4 C�A.-`7- 2 5-.&4.(-) (`e Services or feeders installation,_alteration,and/or relocation 200 amps or less 100.70 2 Q�ROPERTY OWNER I ❑ TENANT � I f(x?,7� 201 amps to 400 amps 133.56 2 Name. / L & Lai C.C?ek ,.[� 401 amps to 600 amps 200.34 2 Address: /U 2 l t S f . 3 ujeS2.1...w.. S 601 amps to 1,000 amps 301.04 2 • _ 1 �i G� Over 1,000 amps or volts 552.26 2 City/State/ZIP: !` A v [ 7.2.7 3 Temporary services or feeders Installation,alteration,and/or Phone:(503) ( ?-)-2..-.) Fax:( ) /4 relocation / 200 amps or less 59.36 t Owner installation: is installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2 intended for sale,lease,icentr exchang�7 at (ding to ORS 447,449,670,and 701. ��° /- _ { l 401 amps to 599 amps 168.54 l 2 Owner signature: . -- "`�" Date: 4.'I" Branch circuits-new,alteration,or extension,per panel 1721- PLICANT I ❑ CONTACT PERSON A.Fee for branch circuits with _ above service or feeder fee, J Business name: each branch circuit 1 7.42 2 i t �✓ (...,3`,..1€ B.Fee for branch circuits without r Contact name: kft i_ w oin) 6.,,t e. service or feeder fee,first 56 18 2 branch circuit Address: /CO 47 3 5.(-m r t___ V Each add'l branch circuit 7 42 2 City/Stete/ZIP: el �� Miscellaneous(service or feeder not included) C A ( Each manufactured or modular 67.84 Phone:(?/Z,) 36_, //0.5.. Fax::( ) �///� dwelling,service and/or feeder 2 f . Reconnect only 67.84 2 E-mail: Lk)0 p 6,R-y.t q � P� tm_y :� g I Ii L�(E C LD`C� Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name: Reset To ,, 2,61( t �, � ( / Signal circuits)or limited energy See panel,alteration,or extension. Page 2 2 Address: C 4'7g 7 Y , C z(0(2 )(C Each additional inspection over allowable in any of the above City/State/ZIP: J (2) Additional inspection(1 hr min) 66.25/hr fj ©"t — oi,Jl)LSER- c.(ems--trfi( Investigation(I hr min) 6625/hr Phone:( ) I Fax:( ) L t ` Industrial plant(l hr min) 78 18/hr Inspections for which no fee is 90,00 hr CCB Lie.: I Electrical Lie.:Lt.1 tip j Suprv.Lie, f-, specifically listed('h hr min) p� .� '°Z� ELECTRICAL PERMIT FEES Suprv.Electrician signature,required:"Ci't� 1 3 E ,,,x,.r]t,>,t Subtotal: 2.C.(-6 5' Print name: )4,449/1.6._ d\ Date: /i f 4_4) ((J Plan review(25%%of permit fee): `� rJ l ( State surcharge(I 2%of permit fee): mil.(,55" Authorized signature y1,� Ai_ r'C .` TOTAL PERMIT FEE: r f This permit application expires if a permit is not obtained within ISO Print name: D8te: days after it has been accepted as complete.