Permit •
r CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00835
. ° COMMUNITY DEVELOPMENT DATE ISSUED: 12/12/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 115AB -01900
SITE ADDRESS: 16200 SW PACIFIC HWY E ZONING: C -G
SUBDIVISION: TIGARD TOWNE SQUARE LOT : JURISDICTION: TIG
PROJECT: GREAT CLIPS
Project Description: Install (20) branch circuits for TI
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: SIGNAUPANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: 1 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 19 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:
BIT HOLDINGS LTD PARTNERSHIP BOB'S ACTION ELECTRIC INC
BY FORUM PROPERTIES INC 2700 NE BURTON ROAD #A
FIVE CENTERPOINTE DR STE 290 VANCOUVER, WA 98662
LAKE OSWEGO, OR 97035
Phone: Contact #: PRI 360 - 254 -7200
FAX 360 - 254 -8219
FEES
Description Date Amount Reg #: ELE 37-431C
[ELPRMT] ELC Permit 12/12/200' $173.20 LIC 53136
[TAX] 8% State Surcharge 12/12/200' $13.86 SUP 4322S
Total $187.06 REQUIRED ITEMS AND REPORTS
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-Pi • rough OAR 952 - 001 -010 You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
/// ■
Issued By • �� ��� / / f Permittee Signature: et , / ((4 )
7 4 17 /
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'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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 41 . _ , ;ti � I\JE 1 FOR OFFICE USE ONLY
•
City of Tlgard ( Da es , r 10170,111 PermitNo.: LC" // „..69: I
13125 SW Hall Blvd., Tigard, OR 97223 Ut 1 2007 Pl an R ev i ew
Phone: 503.639.4171 Fax: 503.598.1960 `! ,. �' , Date/B : Other Permit:
Inspection Line: 503.639.4175 .1!4. s` ' I� Date Ready/By: Juris El See Page 2 for
��1 Y ter i iv x_
Internet: www.ci.tigard.or.us Notified/Method:
TjQQ V Notified/Method: Supplemental Information
. B l 1 V ISIO . PLAN REVIEW
❑ New construction rn Addition/alteration /replacement Please check all that apply:
❑ Demolition ❑ Other: ['Service over 225 amps, comm'l ['Hazardous location
❑Service over 320 amps — rating DBuildng over 10,000 sq. ft.,
• • CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ 1 - and 2 family dwelling ® Commercial/industrial ❑ Accessory building DSystem over 600 volts nominal units in one structure
❑ Multi family ❑Master builder ❑ Other: ['Building over three stories OFeeders, 400 amps or more
['Occupant load over 99 persons DManufactured structures or
.t. - • ' JOB SITE INFORMATION AND LOCATION " RV park
❑Egress /lighting plan P
['Health-care facility
Job no.:07 - 1 296 Job site address: 16200 SW Pacific Hwy. ❑ Oth
wY • E • Submit 2 sets of plans with any of the above.
e.
City/State /ZIP: Tigard, OR 97224 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: c P T �., l F5 FEE* SCHEDULE - .
Description I Qty. I Fee. Total I ' •
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
. . . DESCRIPTION O WORK . Each manufactured or modular
dwelling, service and /or feeder 90.90 2
20 circuits for tenant improvements Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2 •
'ID PROPERTY OWNER 201 amps to 400 amps 106.85 2 • ❑ TENANT:
401 amps to 600 amps 160.60 2
Name: Great Clips 601 amps to 1,000 amps 240.60 2
Address: 16200 SW Pacific Hwy. E. Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State /ZIP: Tigard, OR 97224 Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( )
200 amps or less 66.85 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
❑.APPLICANT . _I , _ ❑ CONTACT PERSON ' . A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
each branch circuit 1 46.85 4 6. 85 2
Address: Each add'l branch circuit 19 6.65 126. 351 2
City/State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( )
Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited-
,
' - . CONTRACTOR _ - energy panel, alteration, or
extension. Describe: Page 2 2
Business name: Bob's Action Electric
Address: tt tt Each additional inspection over allowable in any of the above
2700 NE Burton Rd. A Per inspection 62.50
City /State/ZIP:
Vancouver. W 98662 Investigation per hour (1 hr min) 62.50
Phone: ( 360) 254 -7200 Fax: ( 0) 254 -8219 Industrial plant per hour 73.75
. ELECTRICAL PERMIT FEES*
CCB Lic.: 53136 Electrical Lic.: 7_ lc Suprv. Lic.: 4322S Subtotal 173.20
Suprv. Electrician signature, requir Plan review (25% of permit fee)
Print name: Date: State surcharge (8% of permit fee) 13.86
Kevin B rose ll e 12/10/07
TOTAL PERMIT FEE 187.06
Authorized signature: This permit application expires If a permit is not obtained within ISO
days after it has been accepted as complete
Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed.
1:\ Building \Permits\ELC- Permi1App.doc 12/01 440.4615T(10 /02/CW4/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007.00836
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/12/2007
Phone: (503) 639 -4171 7114 111 Inspection Requests (24 Hrs.): (503) 639 -4175 . `°'! I ..
INSPECTION WORKSHEET FOR DATE: 12/27/2007 TIME: 7:00AM PAGE: 36
SITE ADDRESS: 16200 SW PACIFIC HWY E CLASS OF WORK:
SUBDIVISION: TIGARD T OWNE SQUARE LOT #: TYPE OF USE:
PROJECT NAME: GREAT CUPS
DESCRIPTION: Install (20) branch circuits for TI
OWNER: " BIT HOLDINGS LTD PARTNERSHIP, PHONE #:
CONTRACTOR: BOB'S. ACTION ELECTRIC INC PHONE #: 360 - 2547200
Inspection Request Scheduled For: Date: 12/27/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 062186 -01 36G 254.7200 Y
Corrections /Comments /Instructions: M
C,S.• I-% n C.JCNSit • -a' /
PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6 IV € t--t Date: 1141 Phone #: (503) 718- U4_
' CITY OF TIGARD
BUILDING DIVISION ; PERMIT #: ELC2007- 00036
I
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/12/2007
Phone: (503) 639 -4171 i
Inspection Requests (24 Hrs.): (503) 639 -4175 "'' �;.
INSPECTION WORKSHEET FOR DATE: 12114/2Q07 TIME: 7:01AM PAGE: 42
SITE ADDRESS: 162.00 SW PACIFIC HWY E CLASS OF WORK:
SUBDIVISION: TIGARD TOWNE SQUARE LOT #: TYPE OF USE:
PROJECT NAME: GREAT CLIPS
DESCRIPTION: Install (20) branch circuits for TI
OWNER: BIT' HOLDINGS LTD PARTNERSHIP, PHONE #:
CONTRACTOR: BOB; ACTION ELECTRIC INC PHONE #: 360 - 2547200
Inspection Request Scheduled For: Date: 12/14/2007 Pour Time:
Code # Inspection Description Confirm ° Contact # Message
125 Wall rover 061530 -01 360-264-7200 Y
Corrections /Comments /Instructions:
•
•
'PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 `' (SG L-e Date: ,'2il,l-fl di Phone #: (503) 718- A__