Permit 5 /1 is a / /id-4-
�' V ELECTRICAL PERMIT
t . , o�, , CITY OF TIGARD
t` Y a 'r. COMMUNITY DEVELOPMENT Permit #: ELC2010 -00141
.w 4 , ' Date Issued: 04/01/2010
'TIG 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
su^
', ' ,;; Parcel: 2S110DB00500
Jurisdiction: Tigard
Site address: 15336 SW PACIFIC HWY
Subdivision: Lot: 0
Project: Sonic Drive -In Restaurant: Service rating: 27,250 AIC.
Project Description: Electrical work for new drive -in restaurant. 5/21/10, adding low voltage for POS wiring.
Owner: FEES
MWF TIGARD LLC Quantity Description Date Amount
2123 NW ALOCLEK DR #1203 •
HILLSBORO, OR 97124 1 ea Services or Feeders - 601 to 04/01/2010 $301.04
1000 amps
PHONE: 503- 617 -0175 153 crt Branch Circuits w /Purchase 04/01/2010 $1,135.26
Service or Feeder
1 ea Plan Review Electricial 04/01/2010 $459.25
Contractor: 1 ea 12% State Surcharge - 04/01/2010 $220.44
MARK ADAMS ELECTRIC INC Electrical
PO BOX 2748 3 ea Services or Feeders - 201 to 04/01/2010 $400.68
CLACKAMAS, OR 97015 400 amps
PHONE: 503 - 557 -8543 1 ea Limited Energy 05/21/2010 $67.84
FAX: 503 - 557 -8508 0 ea Plan Review Electricial 05/21/2010 $16.96
0 ea 12% State Surcharge - 05/21/2010 $8.14
Electrical
Type of Use: COM
Class of Work: NEW Type of Const:
Occupancy Grp:
Total $2,609.61
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. A ION: Or-. •n law - quires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001 010 through OAR 9 2 -: 01-0100 •u may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
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'
Issue 8 — , t _ - .- / / /.: I Perm S
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:
CO 6 TRACTOR INSTALLATION ONLY
i
SIGNATURE OF SUPR. ELEC' - ✓ // /� �� 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.
`` CITY OF TIGARD ELECTRICAL PERMIT
` • , COMMUNITY DEVELOPMENT Permit #: ELC2010 -00141
"', Date Issued: 04/01/2010
7 tGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S110DB00500
Jurisdiction: Tigard
Site address: 15336 SW PACIFIC HWY
Subdivision: Lot: 0
Project: Sonic Drive -In Restaurant: Service rating: 27,250 AIC.
Project Description: Electrical work for new drive -in restaurant.
Owner: FEES
MWF TIGARD LLC Quantity Description Date • Amount
2123 NW ALOCLEK DR #1203
HILLSBORO, OR 97124 1 ea Services or Feeders - 601 to 04/01/2010 $301.04
1000 amps
PHONE: 503- 617 -0175 153 crt Branch Circuits w/Purchase 04/01/2010 S1,135.26
Service or Feeder
1 ea Plan Review Electricial 04/01/2010 $459.25
Contractor: 1 ea 12% State Surcharge - 04/01/2010 $220.44
MARK ADAMS ELECTRIC INC Electrical
PO BOX 2748 3 ea Services or Feeders - 201 to 04/01/2010 $400.68
CLACKAMAS, OR 97015 400 amps
PHONE: 503 - 557 -8543
FAX: 503- 557 -8508
Type of Use: COM
Class of Work: NEW Type of Const:
Occupancy Grp:
Total $2,516.67
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. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 thro h 0 R 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: xiAv1 l Y ,g 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 IN LLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO. z ' AQ ,S
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.
�HJ�1L0� tl Uf � 47 N Est ' , ,sits -:f �5` r " v\ �rL ..- , t ' � f A 'k? {7 .•
Electrical Permit Application 1 y , r l c)l l « , . 1f ,Y = ' t 5 .-
e
Recived ?J �261O a LLl
ilpg City of Tigard r _ Receive Permit No.
° 13125 SW Hall Blvd., Tigard, OR 97223 MAR 2 E C. J Rim Review
'_ C :_,_ Phone: 503.639.4171 Fax: 503.598.1960 . Date/By: Other Permit:
I I t. '' K I) Inspection Line: 503.639.4175 a t9 Read /B ® See Page 2 for
Internet: www.tigard-or.gov CITY OF T1GA fed Me thod: ( Supplemental Information
TYPE OF WORK UII ➢`r DiVLCIQis(
. PLAN REVIEW
ew construction ❑ Addition /alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
IN-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
❑ 1- and 2- family dwelling g 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 - ", "1 - ",
Job no.: Job site address: 15360 S WI PGL.Ct r #„,j.... IOO or more. occupancy.
�� ❑ Six or more residential units. ❑ Recreational vehicle parks.
Y Gqr Q�_
City/State/ZIP: 1 / ` 2 Z ❑ Health -care facilities. ❑ Supply voltage for more than
0 Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: SO 4 t C D it 1 v e- . JS s or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: �c10• c `..L_� - N e X A eeS Description 1 Qty. I Fee. 1 Total 1 .
I New residential single- or multi - family dwelling unit.
S 1. 14 WA.,0 . Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential 67.84 2
D ESCRIPTION OF WORK . • (w ith above sq. ft.)
Limited energy, multi - family
67.84 2
l � ".1 �r !" I t ew b A . t v Q , _ rte S yt � residential (with above sq. ft.)
tl Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
❑ PROPERTY 'OWNER ❑ TENANT 201 amps to 400 amps 3 133.56 4 Ob• `g 2
401 amps to 600 amps 200.34 2
Name:
601 amps to 1,000 amps 1 301.04 I.Qy 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and /or
City /State /ZIP: relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT above service or feeder fee,
❑ CONTACT PERSON each branch circuit 7.42 ��,26 2
Business name: B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: branch circuit
Each add'I branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67.84 2
Y dwelling, service and/or feeder
Phone: ( ) Fax:: ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail:
Sign or outline lighting 67.84 2
]]
CONTRACTOR - Signal circuit(s) or limited - energy
'— l eG
Business name: /� 0k rr�� G l sT Zt/ c. Panel, alteration, or extension. Page 2 2
ll Each additional inspection over allowable in any of the above
Address: '4 &,, rc /� Z7 go / Additional inspection (1 hr min) 66.25/ hr
Y el(n,�,f�_Gt s c) L 97dr. —
Investigation (1 hr min) 66.25/ hr
City/State/ZIP: IState /ZIP:
Industrial plant (1 hr min) 78.18 / hr
/
Phone: (.S ) _Sic? -- BSY. f2 Fax: (52)3 ) 53 - b"sO Q Inspections for which no fee is 90.00 / hr
specifically listed (Y2 hr min)
CCB Lic.: f71/01it Electrical Lic.: G-L yl3 Suprv. Lic.: 6..S • , ELECTRICAL PERMIT FEES . .
Suprv. Electrician signature, required: /..- Subtotal: 1083(,.9%
G�-� Plan review (25% of permit fee): �sq. 2S /// Print name: , `a Date: �/ 2 �V State surcharge (12 %of permit fee): 220. 94
1111 .) ! r TOTAL PERMIT FEE: %5L o .61
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: • Number of inspections allowed per permit.
I:\ Building \Permits'ELC- PermitApp.doc 10/01/09 440- 4615T(11/05/COM/WEB
Electrical Permit Application { tl M d V, yll' '1 9 N ` ' Y
4 ,,.vi. fk rz ;�, � t, .',1 c � g i i�t : ��'^ �
City of Tigard DateB Received Permit No.: E,Le_ 90 td -00
°a. i ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
11 -"' Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
i I A 1& l) Inspection Line: 503.639.4175 Date Ready/By: Juris: El See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ 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
❑ 1- 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 ", "1 -3 ",
Job no.: ( Xlob site address: < /, / ��� or more more. occu
�. ? �W / ❑ Six Six or more a re residential units. ❑ Recreational vehicle parks.
City/State /ZIP: cr I d i� ❑ Health -care facilities. ❑ Supply voltage for more than
( - ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: SO aj , cc _ ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description 1 Qty. I Fee. I Total 1 •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 67.84 2
/ /� Limited energy, multi - family 67.84 2
, P O „S S /4._ S�e,� - (Lo ' 'v f a vr � yj ei r., .6tv..04Y/` residential (with above sq. ft.)
(J / S ervices or feeders installation, alteration, and/or relocation
DLt v e K Ike l (51-e 200 amps or less 100.70 2
❑ PROPERTY OWNER 1 ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and /or
City /State /ZIP: relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee 7.42 2
each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: branch circuit
Each add'I branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: /State /ZIP: Each manufactured or modular 67.84 2
Y dwelling, service and/or feeder
Phone: ( ) Fax:: ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited - energy
Business name: panel, alteration, or extension. ' Page 2 2
Each additional inspection over allowable in any of the above
Address: Additional inspection (1 hr min) 66.25/ hr
City /State /ZIP: Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: ( ) Fax: ( ) Inspections for which no fee is 90.00 / hr
specifically listed (/2 hr min) _
CCB Lic.: Electrical Lic.: Su rv. Lic.: ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required ��� .."2 o Subtotal:
�f / Plan review (25 /o of permit fee):
Print name: / Gt.�� /` A 6/01_4,0_5 Date: ?' � /') State surcharge (12% of permit fee):
(l TOTAL PERMIT FEE:
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: • Number of inspections allowed per permit.
1:\Building\Permits\ELC- PermitApp.doc 10/01/09 440- 46t5T(1I/05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined ... $67.84
Check Type of Work Involved:
n Audio and Stereo Systems*
n Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $67.84
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
n Boiler Controls
❑ Clock Systems
Er Data Telecommunication Installation — S € t Of-4" e '4--
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
AA A ue 1 -4f-A 0._ e
Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1: \ Building \Permits\ELC- PermitApp.doc 10/01/09
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
!RESIDENTIAL WORKONLY: •
Fee for all residential systems combined ... $67.84
Check Type of Work Involved:
❑ Audio and Stereo Systems*
n B • urglar Alarm
n G • arage Door Opener*
n Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
•
•
COMMERCIAL WORK'ONLY:
Fee for each commercial $67.84
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
n Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
n Fire Alarm Installation
n HVAC
n Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
n Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
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VICINITY MAP .) PHONE: (503) 570-4404 CELL: 849-6548