Permit `2 c CITY OF TI G g R D ELECTRICAL PERMIT
PERMIT #: ELC2008 - 00639
COMMUNITY DEVELOPMENT DATE ISSUED: 11/17/2008
'.TIGARE 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S136DC 04500
SITE ADDRESS: 07501 SW DARTMOUTH ST ZONING: C -
SUBDIVISION: PP1995 -013 LOT : JURISDICTION: TIG
PROJECT: WINCO
Project Description: Security offices, (6) branch circuits. Job No. 43988
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: SIGNALJPANEL:
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: 5 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:
WINCO FOODS LLC NORTHSIDE ELECTRIC
650 N ARMSTRONG PL PO BOX 12323
BOISE, ID 83704 SALEM, OR 97309
Phone: 208- 377 -0110 Contact #: PRI 503- 585 -4879
FAX 503 - 364 -0248
FEES
Description Date Amount Reg #: ELE 24 -14C
[ELPRMT] ELC Permit 11/17/2001 $80.10
LIC 80593
[ELPRMT] Investigation 11/17/2001 $80.10 SUP 1877S
[TAX] 12% State 11/17/2002 $9.61
(additional fees not listed here) REQUIRED ITEMS AND REPORTS
Total $179.42
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 • : - - .ccordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspende• •r more than ;0 days. ATTENTION: Oregon law requires you to follow rules adopte• • he Oregon Utility Notification Center.
Those r -s are set forth i . • • s 2- 001 -0010 through OAR 952 -001 -0100. You may obtai -- - oft ese rules or direct questions to OUNC at
503.24:.6699`•r 1.800. •
Issue. By: _ _� . � Permittee Signa • - / e �--�
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: - % '�:'��rr�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.
11/17/2008 13:13 FAX 5033640248 NORTHSIDE ELECTRIC . /"ag
Qn „0e -- �36 y 0 001
Electrical Permit Applicati o
ECEIVE FOR OFFICE USE ONLY
City of Tigard Received
• 3125 S W Hal Blvd„ Tigard, OR 97223 Datom ; / Met ; Permit No,: Z a -lid 4 3?
' e : • Phone: 503.639,4171 Pax: 503.598, IMg V 1 7 2008 Plan Review
Date
T J G A R p and .63 41 75 Dine Ready/By;
; Other Permit:
P Line: g g R luri
(`ITY OF TIGARD Notified/Method; ,�— S Sec Page 2 inspection in 503.639.41
ti
i p . � fi Su information
Internet: www. d6 �IGDI
/ � � �, Supplemental rotor
' Y .'�SI � � ; I I Please check all that apply (submit 3
s ets o
P " 'RE i , ,;
❑ Ncw construction P2 Addition /alteration /replacement •
' a I x�
� f plans whtnms checked below);
❑service sr feeder 400 amps or more 1: $uildtng over three stories,
❑ Demolition ❑ Other:
where the available fault current ❑ Marinas and boatyards.
❑ 1 and 2 tamtly dwelling C o> a C ialhndustrial ❑ ACCesso ce s c de s r e x c at 25 1 oohs m' ❑ loa
C un Commercial-se headings
e
] 0 p,' , iCID2'1TsTRUCTIOr b
less m gro a enseeds ons, ID C building vial -use agricultural -„ ry building
amps for all other installations, buildings.
Multi-family ❑ Other: CI Fire p ump, ❑ Ins2allahun of 75 KVA or
'; '
r i �
U 1
❑ Enmr
I mo
1B 'S`"+li ) *O Master builder * LO�CA"I N :,, I 1 . , '. g system larger epy dc-rvcd system.
P
�Q
• ❑Addition of enes new m otor load o f ❑ ••p•• .• •• I •Zaratel • •, q •.
Job no.: 4 y Job site address: "7 cSw lb, _ `1 3 _ 100Hr' more. occupancy
lJ•J r � ❑Six or more residential units, ❑ Recreational vehicle perks,
City /State /ZIP:" ' • .0 9 3 ❑ Health -care facilities. ❑ Suppl voltage for more than
❑Hazardouslocations, 600 volts naminnl.
Suite /bldg. /apt. no.: Project name;
3 ❑ Service or feeder 600 amps or more
Cross street/directions to job site;
TAE, ;C>EtDp:UI,1r , '; !
Urxcri rtmn Qty Fr .. T otal "
Ncw residential single- or multi- family dwelling unit.
Includes attached garage,
Subdivision: 1.01. no.: 1,000 sq. 11. or ICES 145.15 4
Tax map /parcel no.: Ea. add'I 500 sq. It or portion 33.40 t
w Limited energy, residential
sq. ,
I 1�CRII'I01"�!. F 1tit,OTi)rC sid ential
{ ' ,': I,. Q �„ ;,, !: i r . ; (with above R,) 75,00 2
C Fry- energy, multi- family '
J t lit CO residential (with sbovc sq. it) 7500 2
Services or feeders installation, alteration, and /or relocation
200 amps or less
f Q: R OI# ,'R TY 01 IV0 � ,�_. r;:: 0, TEN,tN�'' ,! a 01 turps to 400 amps
_ 80.30 2
�� 106.85 ^ 2
Name: A ' 301 amps to 600 amps 160.6() 2
ddress: 601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
its /State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or Tess 66,85 1
Owner installation: This installation is being madc on property that 1 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
Bus t,.. A. Fee for branch c with
. 4 A1P.CAl�'T:i , '!', : : :' I S ; ❑ CONTACT PE RSON t i.: above service or feeder fee,
Business name, — each branch circuit
6.65 2
B. Fee for branch circuits
Contact name: wirhout service or feeder fcc, 86.85 1 „ 2
first branch circuit lL
Address:
Each add'I branch circuit 6.65 Ile..
City /State /21P; Miscellaneous (service or feeder not included)
Each manufactured or modular
9040 2
dwelling, Phone: ( ) tax:: ( ) g, service and /or feeder
Reconnect only 66.85 2
E -mail: ump or irrigation circle 53.40 in
R
COLT IQ, " "^ ' Sign or outline lighting 53,40
c• )0Q �{ I� t Signal circuits? or limited -
Business name; 1 ( Q energy panel, alteration, or
Address: C . D • '.9x>x I a — extension, Describe: Page 2
III
Cit /State /ZI N LM . f 740 — Each additional ins .(coon over allowable in an of the above
Phone: ai.2 [� 9 r 3) , 3 . f , I. U
Per inspection -
�"-t ) 1 T iq F ax: ( c.0 lUT r 62.50 �-
_ Investigation per hour tl hr min) I= 62. 11.11.-
CCB [.ic.: �0 r Electrical Lic.: at _ 1( Suprv. Lit,: i ; 77 Industrial plant per hour IME 73.75
Suprv, Electrician signature, required: ;r ELE " "'P,EIlt14ILT, ;FEES "r'.
-r �- Subtotal; sr
ininamc: � . ): ;p • (O r
State surcharge (12% of permit fee): �j
Authorized signature: Ilk
�f TOTAL PERMIT FEE: rr yri:�
Print name: / 0 + This permit application expires if a permit in rue obtained . ' in 180
Onyx after it has been accepted as cumpl ,
ciauiid nary em rern,hnpr.ene 05/23/06 ' Number of inspcctianr allowed per permit, �y
440.4615T(7 t/0SfCOMM'E0 41 I ? (a '
CITY OF TIGARD _ ._
BUILDING DIVISION PERMIT #: ELC200B•00639 •
13125 SW Hall Blvd., Tigard, OR 97223 A DATE ISSUED: 1i! 17/2008
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ._' .II
INSPECTION WORKSHEET FOR DATE: 11/1812008 TIME: 7:01AM PAGE: 19
SITE ADDRESS: ()7601 SW DARTMOUTH ST CLASS OF WORK:
SUBDIVISION: TP1995 -01 i LOT #: TYPE OF USE:
PROJECT NAME: WNco
DESCRIPTION: �ycr.uritV offices, (6) branch circuits. Job No. 43988
OWNER: wwNCo FOODS LLC, PHONE #: 208. 377 -0110
CONTRACTOR: NORTH SIDE ELECTRIC PHONE #: 5()3_!it35.4079
Inspection Request Scheduled For: Date: 11/10f2008 Pour Time:
Code # Inspection Description (Confirm # Contact # Message
126 Wall rover 0781813 -01 603 - 686.4879 N
v
Corrections /Comments/ Instructions:
►`PASS l ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n ■ IL ____ CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
I nspector:. G Nbe Date: It. 1 Phone #: (503) 718- 9—
�....r.
° ����~�� ������O�������� ~~ �'�
CITY ��m— wmn�y���m��
BUILDING ��U��U��K���&
A. PERMIT u���xx~��xo��� DIVISION #: ELC2008'.^ ��
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/1708 08
Phone: (503) 639-4171
|nopeu�un Hrs.): �
�}3)83Q'4175 o��N�,���, / /~` ~ —
INSPECTION WORKSHEET FOR DATE: 11/2E/20O8 TIME: 7:01/04 PAmE: 12
SITE ADDRESS: 07501 S*VDARTK80t]THST • CLASS OF WORK:
SUBDIVISION: pp1995_013 LOT #: TYPE OF USE:
PROJECT NAME: wilco
DESCRIPTION: Secuhiv offices, (6) branch circuits. Job No. 43880
OWNER: INiWCO F0OQSLLC. PHONE #: 2083770110
CONTRACTOR: NORTHSIDE ELECTRIC PHONE #: 5D3f-05.4879
Inspection Request Scheduled For: Date: 11/25/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 L]ed final 078497 .t Y
Corrections/Comments/Instructions:
ASS .
El PARTIAL APPROVAL ri CANCEL r7 NO ACCESS
/ | FAIL | | CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
� � ��
Inspector: ( /_'2.__ Datm: //- � ~ p Phone #: (5U3) 718' '