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Permit t'1� �� CITY OF TIGARD r s � '' ELECTRICAL PERMIT 11'' Eff 4; COMMUNITY DEVELOPMENT ��' Permit#: ELC2015-00916 Ir IL. Date Issued: 11/24/2015 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 25101 BA00101 Jurisdiction: TIGARD Site address: 7500 SW DARTMOUTH ST 190 Project: Which Wich Subdivision: WEST PORTLAND HEIGHTS Lot: Project Description: Electrical for TI:(1)400 amp panel and(5)branch circuits. 11/30/15,REPRINTED to add(42)additional branch circuits. Contractor: HALE STONE ELECTRIC Owner: WAL-MART REAL ESTATE BUSINESS TR 1814 NE BRYANT ST BY PROPERTY TAX DEPT STORE 5935-00 PORTLAND, OR 97211 PO BOX 8050 ATTN MS 0555 BENTONVILLE,AR 72716 PHONE: 971-227-1272 PHONE: FAX: 503-289-7816 FEES Quantity Description Date Amount 1 ea Services or Feeders-201 to 11/24/2015 $133.56 Specifics: 400 amps 5 crt Branch Circuits w/Purchase 11/24/2015 $37.10 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea Plan Review Electricial 11/24/2015 $42.67 Type of Const: 1 ea 12%State Surcharge- 11/24/2015 $20.48 Electrical Occupancy Grp: 0 ea Plan Review Electricial 11/30/2015 $77.91 0 ea 12%State Surcharge- 11/30/2015 $37.40 Electrical 42 crt Branch Circuits w/Purchase 11/30/2015 $311.64 Service or Feeder 45 Misc Administration Fee 11/30/2015 $45.00 Total $705.76 Required Items and Reports(Conditions) This permit is is •.ect to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done i• .ccordance with -•proved 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. ' TENTION: Oregon la • requires you to follow the rules adopted by the Oregon Utility Notification Center. Tho e rules are set forth in OAR 952-1.1-0010 through OAR 952-00 -00 o y obtain a copy of the rules or direct questions to OUNC by calling 9 or 1.800.332.2344. Is.ued By: — / / _ 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' 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. 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 7500 SW DARTMOUTH ST 190, TIGARD, OR, 97223 Commercial - Electrical 199 Electrical ﬁnal PASS - No C of O ELC2015-00916 Jeff Grove Violation Summary: Inspector Contractor ' 'y''l� , CITY OF TIGARD ELECTRICAL PERMIT . 1 COMMUNITY DEVELOPMENT 1Permit#: ELC201500916 "' ' Date Issued: 11/24/2015 TIG CRL1 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 25101 BA00101 Jurisdiction: TIGARD Site address: 7500 SW DARTMOUTH ST 190 Project: Which Wich Subdivision: WEST PORTLAND HEIGHTS Lot: Project Description: Electrical for TI:(1)400 amp panel and(5)branch circuits. Contractor: HALE STONE ELECTRIC Owner: WAL-MART REAL ESTATE BUSINESS TR 1814 NE BRYANT ST BY PROPERTY TAX DEPT STORE 5935-00 PORTLAND, OR 97211 PO BOX 8050 ATTN MS 0555 BENTONVILLE,AR 72716 PHONE: 971-227-1272 PHONE: FAX: 503-289-7816 FEES Quantity Description Date Amount 1 ea Services or Feeders-201 to 11/24/2015 $133.56 Specifics: 400 amps 5 crt Branch Circuits w/Purchase 11/24/2015 $37.10 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea Plan Review Electricial 11/24/2015 $42.67 1 ea 12%State Surcharge- 11/24/2015 $20.48 Type of Const: Occupancy Grp: Electrical Total $233.81 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. ATT , o •. • egon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules/-re set forth in OAR 952-00 -'010 through�AOA' '52 %I1-'091 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 5033.232.1987 or 1.8r•.332.23)f Is ued By: l ` /IF Permittee Signature: x ° ,'/ / 1" 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' ci..t ..._o_...e �. , ��J Date: LICENSE NO. T .4-10 5 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 Application 'FOR OFFICE USE ONLY Cl ofTigard R Received Permit#: UPI - 13125 g Date/B l/ Id f ts- " .aLY21/S�-(k)q/( y. 1a SW Hall Blvd.,Tigard,OR 97223Plan Review • Phone: 503.718.2439 Fax: 503.598.19 Date/B : l Related Permit#:Inspection Line: 503.639.4175 ) CiNNI•11 Ready Date/By: funs. ® See Page 2 for TIGARD' Internet: www.tigard-or.gov ��yyyVVV Notified/Method�l / - l Supplemental Information C Q'� TYPE OF WORK J Q 1 / PLAN REVIEW ®New construction 0 Addition/alteration/lacement ,4N Please check all that apply(submit 2 sets of plans w/items checked): �� ® ®,Service or feeder 400 amps or more 0 Building over three stories. ❑ Demolition ❑Other: "Olt_1-1) . where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRt V�y exceeds 10,000 amps at 150 volts or 0 Floating buildings. ❑ 1-and 2-family dwelling ®Commercial/indust 'jl S' Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑ Multi-family 0 Master builder 0 Other: 0 Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: 15-239 Job site address:7500 SW Dartmouth IOOHP or more. ❑"A","E","I-z°',`t-3", 0 Six or more residential units. occupancy. City/State/ZIP:Tigard Or.97223Recreational vehicle parks. 0 Health-care facilities. 0 Suite/bldg./apt.#: 190 Project name:Which Wich ❑Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site:Walmart Parking Lot FEE SCHEDULE Description I Qty. I Each I Total I New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'(500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 Main Panel,Feeder,HVAC,Sign Ckt (with above sq.ft.) Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 0 PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name: 200 amps or les _____ 100.70 2 Address: 201 amps 1400 amp 1 133.56 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: 601 amps to 1,000 amps 301.04 2 Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 ® APPLICANT 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel _ A.Fee for branch circuits with Business name: Hale-Stone Electric LLC above service or feeder fee, 5 742 37.108 2 each branch circuit Contact name: B.Fee for branch circuits without Address: service or feeder fee,first 56.18 2 branch circuit City/State/ZIP: Each add'(branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Fax: :( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name:Hale-Stone Electric LLC Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy 0 See Page 2 2 3 Address:731 N Hayden Meadows Dr #106 panel,alteration,or extension. City/State/ZIP: PTLD Or,97217 Each additional inspection over allowable in any of the above C--, Additional inspection(I hr min) 66.25/hr Phone:(971)200 0965 Fax:(503)289 7816 Investigation(I hr min) 90.00/hr Email: halestoneelectric@gmail.com Industrial plant(1 hr min) 78.181 hr �` Inspections for which no fee is 90.00,1 hr CCB Lic.: 160458 Electrical Lic.: C63 Suprv.Lic.: 4240S specifically listed(V2 hr min) ELECTRICAL PERMIT FEES -Suprv. Electrician signature,required: • Subtotal: 170.66 Print name: Mary Jennings Date: 11/10/15 E1 Plan Review Required(25%of permit fee): - �,-6-71— State State surcharge(12%of permit fee): , : Authorized signature: �a2 �//�� TOTAL PERMITtFEE: �d t This permit application expires if a permit is not obtained within 180 I Print name: Dan Hale Date: 11/10/15 days after it has been accepted as complete. * Number of inspections allowed per permit. (:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-46151(11/05/COM/WEB