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Permit CITY OF T I G A R D ELECTRICAL PERMIT PERMIT #: ELC1999 -00476 L Ai' * ' DEVELOPMENT SERVICES DATE ISSUED: 8/24/99 Ai 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S115BA -00100 SITE ADDRESS: 16200 SW PACIFIC HWY Z SUBDIVISION: ZONING: C -G BLOCK: LOT : JURISDICTION: TIG Project Description: Electrical for the Albertson's expansion. RESIDENTIAL UNIT • TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: • SIGNAL/PANEL: MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: 9 W /SERVICE OR FEEDER: 311 PER INSPECTION: 201 - 400 amp: 3 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: 1 EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: ALBERTSON'S TUALATIN ELECTRIC 250 PARK CENTER BLVD PO BOX 655 BOISE, ID 83726 WILSONVILLE, OR 97070 Phone: 208 - 395 -6283 Phone: 682 -2955 Reg #:. LIC 00065650 SUP 3483S • ELE 3 -26C FEES • Required Inspections Type By Date Amount Receipt Ceiling Cover PRMT GEO 7/30/99 $2,627.10 99- 317102 Wall Cover 5PCT GEO 7/30/99 $183.90 99- 317102 Underground Cover PLCK GEO 7/30/99 $656.78 99- 317102 Elect'I Service Elect'I Final • Total $3,467.78 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -1987. gi PERMITTEE'S SIGNATURE ISSUED BY: 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 1 SIGNATURE OF SUPR. ELEC'N: /9 /U 0r1 DATE _ LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day • CITY OF TIGARD Plan Check # i_�D Electrical Permit Application Recd By •�p 13125 SW HALL BLVD. Date R J �9 TIGARD OR 97223 B Date to P.E. - 40 1 "[ 1 Phone (503) 639 -4171, x304 Date to DST ; " Inspection (503) 639 -4175 ' Print of Type Permit #EL.0 / '- • Fax (503) 598 -1960 Incomplete or illeg will not be accepted Called y -9 / /4, ak . 1.u/ /h.t t /� 1. Job Address: 4. Complete Fee Schedule Below: • Name of Development Number of Inspections per permit allowed Name (or name of business) Service included: Items Cost Sum Address 4a. Residential - per unit City/State /Zip 1000 sq. ft. or less $ 117.75 4 Each additional 500 sq. ft. or portion thereof $ 26.25 1 Commercial ❑ Residential ❑ Limited Energy $ 60.00 Each Manuf d Home or Modular 2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2 (Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders information for COT data base). Installation, alteration, or relocation i c7 , 1 `�// Electrical Contractor 200 amps or less $ 64.25 5 7-D, Z 2 Address 201 amps to 400 amps $ 85.50 Z5, SD 2 401 amps to 600 amps ) $ 128.50 12i;., S() 2 City State Zip 601 amps to 1000 amps $ 192.50 2 Phone No. Over 1000 amps or volts $ 363.75 2 Job No. I Reconnect only $ 53.50 2 Elec. Cont. Lice. No. Exp.Date 4c. Temporary Services or Feeders OR State CCB Reg. No. Exp.Date Installation, alteration, or relocation • COT Business Tax or Metro No. Exp.Date 200 amps or less $ 53.50 2 201 amps to 400 amps $ 80.25 2 °Signature of Supr. Elec'n 401 amps to 600 amps $ 107.00 2 • Over 600 amps to 1000 volts, . see "b" above. License No. Exp.Date 4d. Branch Circuits Phone No. New, alteration,or extension per panel ' a) The fee for branch circuits 2b. For owner installations: with purchase of service or feeder fee. Print Owner's Name Each branch circuit 7 71 ( $ 5.35 � ) �� ∎ 2 Address b) The fee for branch circuits without purchase of service City State Zip or feeder fee. Phone No. First branch circuit $ 37.50 Each additional branch circuit $ 5.35 The installation is being made on property I own which is not 4e. Miscellaneous intended for sale, lease or rent. (Service or feeder not included) Each pump or irrigation circle $ 42.75 Owner's Signature Each sign or outline lighting $ 42.75 Signal circuit(s) or a limited energy • (if required):* panL alteration or extension $ 60.00 3. Plan Review section ( Minor Labels (10) $ 107.00 Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over 4 or more residential units in one structure the allowable in any of the above Service and feeder 225 amps or more Per inspection $ 50.00 Per hour $ 50.00 System over 600 volts nominal In Plant $ 59.00 Classified area or structure containing special occupancy as described in N.E.C. Chapter 5 5. Fees: 5a. Enter total of above fees $ Z (p Z7, 0 * Submit 2 sets of plans with application where any of the above apply. 70,8% Surcharge (.05 X total fees) $ l . GPQ Not required for temporary construction services. Subtotal $ 5b. Enter 25% of line 5a for Nl NOTICE Plan Review if required (Sec. 3) $ (p5 (p, @ PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account # 22 AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ ) 1- 11 1 - 1 , 7g 11 i:\dsts\forms\electric.doc v CITY OF TIGARD Electrical Permit Application Plan Check & y l 13125 SW HALL BLVD. Rec'd By ��/ TIGARD OR 97223 Date Rec'd �/LI / Date to P.E. Phone (503) 639 -4171, x304 Date to DST Inspection (503) 639 -4175 Print or Type # Fax �P+ (503) 684 -7297 -_D Incomplete or illegible will not be accepted Called • - 1. Job Address: / ' 4. Complete Fee Schedule Below: Name of Development .7 I �.�--d3 m -t f A D .4t cFif / Number of Inspections per permit allowed Name (or name of business) A / b C. '- a n 3 Service included: Items Cost Sum 1 Address / 6 ao 0 i L- + (, la k.- 4a. Residential - per unit � City /State/Zip T��R. r d O L 9 7) cl 1000 sq. ft. or less Each additional 500 sq. ft. or $110.00 4 Commercial a Residential 1=1 Limited thereof $25.00 1 Limited Energy $25.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $68.00 2 2a. Contractor installation only: (Attach copy of all current licenses) / 4b. Services or Feeders Electrical C tractor I (.c. u ( of i - id-t. Y.-.- (.. Installation, alteration, or relocation Addres ' 16 ol - G ..c..5- 201 200 amps or less ° a ) $60.00 -S � 2 Milos to - 4 - do amps $80.00 . �� 2 � City (..1 S" vw.l State 0 k Zip rt '701 -0 401 amps to 600 amps $120.00 I .)o 2 Phone No. 2°I ,..5-... 601 amps to 1000 amps $180.00 2 Job No. � g ,..5-... S`I C, Over 1000 amps or volts $340.00 2 Elec. Cont. Lice. No. 3 -.2 C C- Exp.Date 10/ . 9 Reconnect only $50.00 2 OR State CCB Reg. No. 6 ,) a S ° Exp.D • to 4 oj6 ' 4c. Temporary Services or Feeders COT Business Tax or Metro No. / %p.Date Installation, alteration, or relocation /� ��/ 200 amps or less $50.00 2 201 amps to 400 amps _ $75.00 Signature of Supr. Elec'n 401 amps to 600 amps $100.00 2 p / D / O! / / Over 600 amps to 1000 volts, s License No. 3 g3 Exp.Date see "b" above. Phone No. - , . 7 4d. Branch Circuits New, alteration or extension per panel 2b. For owner installations: a) The fee for branch circuits with purchase of service or Print Owner's Name feeder fee. Address Each branch circuit 3 / / $5.00 ) SS.S 2 b) The fee for branch circuits City State Zip without purchase of Phone No. service or feeder fee. First branch circuit $35.00 2 The installation is being made on property I own which is not Each additional branch circui $5.00 2 intended for sale, lease or rent. 4e. Miscellaneous (Service or feeder not included) Owner's Signature Each pump or irrigation circle $40.00 2 Each sign or outline lighting $40.00 2 3. Plan Review section (if required):* Signal circuit(s) or a limited energy panel, alteration or extension $40.00 2 Minor Labels (10) $100.00 Please check appropriate item and enter fee in section 5B. 4 or more residential units in one structure 4f. Each additional inspection over Service and feeder 225 amps or more the allowable In any of the above System over 600 volts nominal Per inspection $35.00 Classified area or structure containing special occupancy Per hour $55.00 as described in N.E.C. Chapter 5 In Plant $55.00 * Submit 2 sets of plans with application where any of the above apply. 5. Fees: «Y SS Not required for temporary construction services. 5a. Enter total of above fees $ ) 2 5% Surcharge (.05 X total fees) $ r NOTICE Subtotal $ 5b. Enter 25% of line 5a for '!3 7 PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $ NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $ IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ❑ Trust Account # $ 3� -� Total balance Due I: \DSTS\ELC96.APP Rev 9/96 04/17/2000 Activities for Case #: ELC1999 -00476 • 9:15:14 AM •Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes ELCC001 Application received 07/21/1999 BON RECD No Hold GEO 07/30/1999 ELCC003 Permit created - - 07/30/1999 GEO DONE No Hold GEO. 07/30/1999 ELCC102 Plans routed to Plans Examiner 07/30/1999 GEO SENT No Hold GEO 07/30/1999 ELCC110 Plans checked /approved by PE 08/19/1999 CD PASS No Hold CD 08/19/1999 . ELCC115 Approved plans routed to DSTs 08/19/1999 CD PASS No Hold CD 08/19/1999 ELCC700 Ceiling Cover 08/19/1999 08/19/1999 09/22/1999 CD PASS No Hold AKJ 09/22/1999 ceiling cover for high ceiling deli . Note: need low voltage insp • • before final ELCC720 Wall Cover 08/19/1999 08/19/1999 09/09/1999 • CD PASS No Hold AKJ 09/09/1999 deli area ELCC725 Underground Cover 08/19/1999 08/19/1999 No Hold CD 08/19/1999 ELCC730 Elect'l Service 08/19/1999 08/19/1999 10/12/1999 CD FAIL No Hold JS 10/12/1999 1. All grounding must be done in service disconect. . - 2. Extend grounding electrode . cordinator to service disconect . instead CT 3. Isolate grounds neutrals in . • surf puned 4. bond all metal piping bakery waling cover approved ELCC799 Elect'l Final 08/19/1999 08/19/1999 11/08/1999 BP FAIL No Hold VT 11/08/1999 no - inspection not ready • ELCC920 Miscellaneous action 08/19/1999 CD No Hold CD 08/19/1999 . - ELCC117 DST Post - Review complete 08/24/1999 , DEB DONE No Hold DEB 08/24/1999 ELCC400 (F)Ready to issue 08/24/1999 DEB DONE No Hold DEB 08/24/1999 All fees paid. ELCC500 (F)Issue permit 08/24/1999 DST DONE No Hold DST 08/24/1999 ELCC700 Ceiling Cover 10/07/1999 10/07/1999 10/07/1999 CD PASS No Hold AKJ 10/07/1999 deli area ELCD700 Rough -in V 10/12/1999 10/12/1999 10/12/1999 CD FAIL No Hold JS 10/12/1999 See Service 10/12/99. ELCA720 Wall Cover 10/25/1999 10/25/1999 10/25/1999 BRP PASS No Hold ST 10/25/1999 Meat & Fish Dept. ELCC720 Wall Cover • 11/01/1999 11/01/1999 11/01/1999- BP PASS No Hold . DGW 11/01/1999 Rough in Pass ELCC700 Ceiling Cover 11/22/1999 11/22/1999 11/22/1999 BRP PASS No Hold DGW 11/22/1999 Fixture mounting method - Pass ELCC700 Ceiling Cover 01/18/2000 01/18/2000 01/18/2000 BRP PASS No Hold AKJ 01/18/2000 floral area ELCC799 Elect'l Final 02/22/2000 02/22/2000 02/22/2000 CD PASS No Hold AKJ 02/22/2000 ELCC800 Case Finaled 02/22/2000 AKJ DONE No Hold AKJ 02/22/2000 Page 1 of 1 • CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 \ / BUP Date Requested /v,/Q_7 AM K PM BLD Location l 2 ,v ' L( Suite MEC Contact Person Ph (D7K - Zi2iZ - 7 PLM Contractor ' , �, Ph SWR n �, BUILDING Tenant/Owner �atAI vi. i _ �) Q [ 9- ° 0 J 7b Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler �i✓c� % �� Fire Alarm Susp'd Ceiling q/� Roof / Misc: / Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL CTRICAt Service Rough In UG /Slab Low Voltage Fire Alarm 4(if?• PART FAIL Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Date A 9 Q Inspector Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.