Permit CITY O F T I^ w^ D ELECTRICAL PERMIT
n
CITY GAR �( PERMIT #: ELC2008 -00167
. COMMUNITY DEVELOPMENT DATE ISSUED: 3/24/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S115BA-02500
SITE ADDRESS: 16200 SW PACIFIC HWY U ZONING: C -G
SUBDIVISION: TIGARD TOWNE SQUARE LOT : 001 JURISDICTION: TIG
PROJECT: 1 -2 -3 FIT
Project Description: TI. Installing (12) branch circuits.
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: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 11 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 INC BOB'S ACTION ELECTRIC INC
PO BOX 20 2700 NE BURTON ROAD #A
BOISE, ID 83726 VANCOUVER, WA 98662
Phone: Contact #: PRI 360- 254 -7200
FAX 360 - 254 -8219
FEES
Description Date Amount Reg #: ELE 37 -431C
IELPRMTI ELC Permit 3/24/2008 $120.00 LIC 53136
[TAXI 12% State Surchar 3/24/2008 $14.40 SUP 4322S
Total $134.40 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 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: _��� Permittee Signature: , eor
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 Application - ! ,1 tP ED FOR OFFICE USE ONLY
City of Tigard Received ? , Permit No E / x-v r o ^00 0 0 i` / 7
2008 Da te/B J v�
13125 SW Hall Blvd., Tigard, OR 97223 „AR 200U P lan Rev
II Phone: 503.639.4171 Fax: 503.598.1960 Date /By: Other Permit:
TI G A R D Inspection Line: 503.639.4175 Fl*.1; J Date Ready /By: kris: RI See Page 2 for
Internet: www.tigard - or.gov x Notified/Method: Supplemental information
,,..,± , r - .:r. r
TYPE OF WORK PLAN REVIEW
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ New construction I Addition/alteration/replacement
❑ 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 ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately derived system.
['Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I -3
Job no.: 0 8_33 Job site address: 1 6 2 0 0 SW Pacific Hwy # U or more. cc
y ❑ Six Six o or r more R
re residential units. ❑ Recreational vehicle parks.
City/ State/ZIP: Tigard, OR 97224 ❑ Health-care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
job site: Desertptton FEE SCHEDULE
Cross street/directions to
J I Qb'• I Fee. I Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.:
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
12 branch circuits for TI
Limited energy, (with 75.00 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 1-2-3 401 amps to 600 amps 160.60 2
Flt 601 amps to 1,000 amps 240.60 2
Address: 16200 SW Pacific Hwy., Ste. U Over 1,000 amps or volts 454.65 2
City/ State/ZIP: Temporary services or feeders installation, alteration, and/or
T i q a rd , OR 97224 relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
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 599 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 1 46.85 46.85 2
first branch circuit
Address: Each add'l branch circuit 11 6.65 7 3.15 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: ignal circuit(s) or limited -
Bob's Bob' s Electric energy panel, alteration, or
Address: 2700 NE Burton Rd., Ste. A extension. Describe: Page 2 2
City/State/ZIP: Vancouver, WA 98662 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (3 6 0) 254-7200 Fax: ( 6 0) 254-8219 Investigation per hour (1 hr min) 62.50
CCB Lie.: 53136 Electrical Lic.: 7 431 C Suprv. Lie.: 4 3 2 2 S Industrial plant per hour 73.75
ELECTRICAL PERMIT MIT FEES
Suprv. Electrician signature, requir j>---2L_____ Subtotal: 120.00
Print name: Kevin Bro s e l l e Date: 3/21/08 Plan review (25% of permit fee):
State surcharge (12% of permit fee): 14.40
Authorized signature: TOTAL PERMIT FEE: 134.40
Print name: Date: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
• Number of inspections allowed per permit.
1: \Building \Permits \ELC- PermitApp.doc 05 /23/06 440 46 15 . 1•(t t /05 /COM/WEB
•
CITY OF TIGARD --
BUILDING DIVISION PERMIT #: ELC2008 -00iE7
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/24/2000
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/22/2008 TIME: 7:00AM PAGE: 13
SITE ADDRESS: 16200 SW PACIFIC HWY U CLASS OF WORK:
SUBDIVISION: TIGARD TOWNE SQUARE LOT #: 001 TYPE OF USE:
PROJECT NAME: 1.2.3 FIT
DESCRIPTION: TI. !Walling (12) branch circuits.
OWNER: ALI3ERTSON'S INC, PHONE #:
CONTRACTOR: BOB'S ACTION ELECTRIC INC PHONE #: 360
Inspection Request Scheduled For: Date: 4/22/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
1 0 0 • Electrical final 068732 -01 360 -2.64 -7200 N
Corrections /Comments /Instructions:
\ :1
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G's: N 68 L Date: 4\ Phone #: (503) 718 - 14%
CITY OF TIGARD i _
BUILDING DIVISION PERMIT #: El .C2008-00167
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/24/2008
Phone: (503) 639 -4171 (
Inspection Requests (24 Hrs.): (503) 639 -4175 °'I �..
INSPECTION WORKSHEET FOR DATE: 4/15/2008 TIME: 7:02AM PAGE: 31
SITE ADDRESS: 16200 SW PACIFIC HWY U CLASS OF WORK:
SUBDIVISION: TIGARD TOWNE SQUARE LOT #: 001 TYPE OF USE:
PROJECT NAME: 1 -2.3 FIT
DESCRIPTION: TI. Installing (12) branch circuits.
OWNER: ALF3ERTSON'S INC, PHONE #:
CONTRACTOR: BOB'S ACTION ELECTRIC INC PHONE #: 360 - 2547200
Inspection Request Scheduled For: / Date: 4/15/2008 Pour Time:
Code # Inspection Description / Confirm # Contact # Message
130 Ceiling cover 068382 -01 360-254-7200 ' Y
Corrections /Comments /Instructions:
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1)o t t AV1.° ■• A N (R. )c ri ) 16 c.Jo nt N , 'Mit 33
cave. wi`�1 0-4Q0 (,cam%w G- e.:40 .
CD v 1V t\ ,tto 3 fttele. P IS s is AL btvewe
•O 5 9 e . OF mF10,L sod on.
J sus - mc. CA Lic 0 fsa1/41 6F
t Fowl 6 p 4% Pte. K4. 310, BO
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
)] FAIL XCALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ( 5 ' N 6e Date: IA ' 1 ' Phone #: (503) 718- j_1446
•
CITY OF TIGARD . ' .
BUILDING DIVISION PERMIT #: ELC2008- 00161
13125 SW Hall Blvd., Tigard, OR 97223 / DATE ISSUED: 3124/2008
Phone: (503) 639 -4171 W
Inspection Requests (24 Hrs.): (503) 639 -4175 I i..
INSPECTION WORKSHEET FOR DATE: 3127/2008 TIME: 7:03AM PAGE: 29
SITE ADDRESS: 16200 SW PACIFIC HWY U CLASS OF WORK:
SUBDIVISION: TIGARD TOWNE SQUARE LOT #: 001 TYPE OF USE:
PROJECT NAME: 1 -2.3 FIT
DESCRIPTION: TI. Installing (12) branch circuits.
OWNER: ALBERTSON'S INC, PHONE #:
CONTRACTOR: BOB'S ACTION ELECTRIC INC PHONE #: 360-2E47200
Inspection Request Scheduled For: Date: 3/27/2008 Pour Time:
Code # Inspection Description �Eo if rm • Contact # Message
125 Wall cover 06742E-01 360.254 -7200 ' Y
Corrections /Comments /Instructions:
(ja
PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 4 1 \166t-E - Date: 3' 1 'v, Phone #: (503) 718- 7-1140