Permit CITY OF TIGARD ELECTRICAL PERMIT
:11 a COMMUNITY DEVELOPMENT Permit#: ELC2014-00469
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/21/2014
Parcel: 2S 102AA00490
Jurisdiction: Tigard
Site address: 12085 SW HALL BLVD 130
Project: Arellanos Sports Bar Subdivision: TIGARD HIGHWAY TRACTS Lot: 13
Project Description: Relocate service panel and(6)new branch circuits for bar.
Contractor: QUALITY PLUS FRAMING&ELECTRICAL Owner: HALL STREET CROSSING LLC
16037 SW BOWMEN LN BY MR&MRS ROGER W TOM
SHERWOOD, OR 97140 8067 SW RIGERT COURT
BEAVERTON,OR 97007
PHONE: 503-477-0704 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 08/21/2014 $100.70
Specifics: amps or less
6 crt Branch Circuits w/Purchase 08/21/2014 $44.52
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 08/21/2014 $17.43
Electrical
Type of Const:
Occupancy Grp:
Total $162.65
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all o/zr applicable I- All work will
be done in accordance with approved plans. This permit will expire
if is not started within 180 days of issuance, or if w•l' is suspend-' for more the 180
days. ATTEN : Oreg�law requires you to follow the rules adopted by the Oregon Utility Notification Cent: .' Ise r .=s 4 set forth in O:'
952-001-001 through OAR 95$}0 ou may obtain a copy of the rules or direct questions to OUNC by calling 503.232.19: or 1. '0.33 .
Issued /C "� /j't Permittee Signature:
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' ,, e � GJ Date: ���
LICENSE NO. 67)17Z' S
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.
Electrical Permit ApplicRECEIVFD mot.' Ic�1 ��
City of Tigard
{,,,,11 Received permit No.: /�/,^ (/ G�
•� g q Date/By: /� d I i ! y
13125 SW Hall Blvd.,Tigard,OR 9
C Phone: 503.718.2439 Fax: 503.5 60G 1 �O'4
Plan Review Other Permit:
TIGARD Inspection Line: 503.639.4175 CmTYC frypp,l DateReady/By: t i< Supplemental See Page 2for
Internet: www.tigard-or.gov �%. of Il�lnQ{U Notified/Method: Supplemental Information
TYPE O'P PLAN REVIEW
❑New construction IX Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked below).
❑Service or feeder 400 amps or more ❑Building over three stories.
❑ Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ I-and 2-family dwelling IN Commercial/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 "I-2 "I-3",
QQ GG 100HP or more. occupancy.
Job no.: Job site address:
0 O J �Q<< ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: 17.5c0,‘) bg, ill n 3 ❑Health-care facilities.
❑Hazardous locations. ❑Supply voltage for more than
600 volts nominal.
Suite/bldg./apt.no.: `-50 Project name: 2
/] s�4� „ �p0.r5 ❑Service or feeder 600 amps or more
''1 FEE SCHEDULE
Cross street/directions to job site: /574-/2- Description I Qty. I Fee. 1 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 1
Tax map/parcel no.: Limited energy,residential •
7500 2
DESCRIPTION OF WORK (with above sq.ft.)
Limited energy,multi-family 75 no
R, .k- 6104)'4 UL CIAO, �(u $r aMt l,. residential(with above sq ft.)
(� Renewable Enert!y ❑ Sec Page 2
li lW'cky .6 ?),,h Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER ❑ TENANT 200 amps or less I 100.70 mei.40 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
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 sale. 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
❑ APPLICANT ❑ CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,
Business name: each branch circuit ID 7 42 q'Sz 2
B.Fee for branch circuits without
Contact name: service or feeder fee.first
56.18 2
branch circuit
Address: Each add'l branch circuit 7 42 2
Miscellaneous(service or feeder not included)
City/State/ZIP:
Each manufactured or modular
67.84 2
Phone:( ) Fax::( ) dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
, " Signal circuit(s)or limited-energy See
Business name: `4. u5 _-_ k iv
t panel,alteration,or extension. Page 2 2
Address: I to Q 31 J/v.y bow;At". La04- Each additional inspection over allowable in any of the above
} Additional inspection(I hr min) 66.25/hr
5
City/State/ZIP: 1-14C) Investigation(I hr min) 66.25/hr
Phone:(!)p, ) 411 .(no 4 Fax:( Industrial plant(I hr mm) 78.18/hr
`� Inspections for which no fee is 90.00/hr
CCB Lie.: 41 1`'3 `1.4 Electrical Lie.: C 4 a 7 ., .uprv.Lie.: 56 76 CJ specifically listed(%hr min)
+ur J ELECTRICAL PERMIT FEES
Suprv. Electrician sigma ure.required: I'll III Subtotal: /L(S .22
Print name: Pte- 1 t Date: 8-a►_�d Plan review(25%of permit fee): ,1�-
(�1 1 State surcharge(12%of permit fee): I'} 6 -1'Authorized signature: 6tai
TOTAL PERMIT FEE: Rya (5
This permit application expires if a permit is not obtained within 180
Print name: it f �t�k4 Date: g /1 yr C r2! (/ days after it has been accepted as complete.
( 1 • Number of inspections allowed per permit.
I\Building\Permits\ETC_Permit App ELR_ERE.doc Rea 05/21/2011 440-4515T(1 L05:(O\LM1PU:B
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
12085 SW HALL BLVD 130, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2014-00469
Chip Barnett
Violation Summary:
Inspector Contractor