Permit CITY OF TIGARD ELECTRICAL PERMIT
IN
1 PERMIT #: ELC2007 -00291
COMMUNITY DEVELOPMENT
DATE ISSUED: 4/30/2007
rT[GARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 102AA -02302
SITE ADDRESS: 12202 SW MAIN ST ZONING: CBD
SUBDIVISION: TIGARD HIGHWAY TRACTS LOT : 003 JURISDICTION: TIG
PROJECT: AMERICAN FAMILY
Project Description: (1) branch circuit to reconnect new gas pack. 7/10/07 changed project name from Taqueria Restaurante to
American Family
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/ SVCI 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: 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:
B -B -B PROPERTIES OREGON ELECTRIC GROUP
PO BOX 23952 1010 SE 11TH AVE
TIGARD, OR 97281 PORTLAND, OR 97214
Phone: Contact #: FAX 503 - 535 -2763
PRI 503 - 234 -9900
FEES
Description Date Amount Reg #: ELE 26 -95C
[ELPRMT] ELC Permit 4/30/2007 $46.85 LIP 203
•
[TAX] 8% State Surcharge 4/30/2007 $3.75 SUP 48185
Total $50.60 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: C` Permittee Signature: 4 . 0_, �i .. - '/ _o . (--f 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.
APR -26 -2007 02:39PM FROM -OR ELECTRIC SVC 5035352763 T -445 P.001 /002 F -632
r,rec L___pii It A 11Ca y - ' °ay c I ()k' 11( I� ) � n ` tY r Y .�.,. r i ,
City of Tigard 4.44.
13125 SW Hall Blvd, Tigard, OR 97223 /B ' 4 - ' ti 7 It PerinitNo. :rt ?oa7 _ OCa91
•N
Phone: 503.639.4171 Fax: 503.598.1960 APR 2 6 2 !� ! , r Pl new rr, Other Pandit:
P5.' I �;, D aWBr.
e inspection Line: 503.639.4175 CITY � ` 1 C' �� I "' °ate llea dy/By Jude WI See Page 2 for
Internet: www.ci.tigard.or.us ® Noriticdtmetho& g
UILDING 71 64? Supplemental Information
• TYPE OF WORK. PLAN REVIEW
[J New construction ® Addition /alteration/replacement Please check all that apply;
❑ Demolition 0 Other ['Service ovcr amps. coaun'I ❑Flazardous location
CA • - r OF CONSTRUCTION EScrvice over 320 amps - rating ❑ Buildng over 10,000 sq. it..
of 1- and 2- family dwellings 4 or more new residential
p - and 2- family dwell " : 4 Co, mercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
ulti- family al Master builder El Other: ❑Building over t stories [Weeders, 400 amps or more
❑Occupant load over 99 persons ❑ Manufactured structures or
JOB SITE 10VFORMATION AND LOCATION ❑Egnas/lighting plan RV park
Job no.: 21266 f Job site address 22A2. SW MAIN ST. ❑Health -care facility ['Other:
Submit 2 sets of plans with any attic above.
City /StateJZIP: TIGARD, OR 97223 i - — The above are not applicable to temporary construction service.
Suite/bldg. /apt- no.: Project ram-.. _ FEE' SCHEDULE
- Doc•ipaan Qty. Fm TOM **
Cross street/directions to job site: ^__ ,-•---- �!.. ra i .. - New residential single- or multi - family dwelling unit.
Includes attached garage.
(j 1,000 sq. ft. or less 145.15 4
Subdivision: Lot no Ea. add'l 500 sq. Q or portion 33.40 1
Limited energy, residential 75.00 2
Tax map/parcel no.: Limited energy, non - residential 75.00 2
DESCRI!PI ION OF WORK Each manufactured or modular
RECONNECT NEW GAS PACK dwelling, service and/or feeder 90.90 2
Serviced or feeders Installation. alteration, and/or relocation
200 amps or 1cas 80.30 2
;'PROPERTY OWNER ❑ TENANT — 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: A-r6 •-/ / -07 /ES _ 601 amps to 1,000 amps 240.60 2
Address: ) 4 9.5- Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/StatnfZIP: 77C.4?--/j...6 a 2 9 7a F Temporary services or feeders installation, alteration, and/or
Phone : I Fax: ( ) relocation T
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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
❑ APPLICANT 0 CONTACT PERSON A. Fee for branch circuits with
Business name: service or feeder fee, each 6.65 2
branch circuit
B. Fcc for branch circuits
Contact name: without service or feeder fee. 1 46.85 4/p£ 5 2
Address: ch branch circuit
Eachadd'l branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 12
phone: ( ) I Fax. = ( )
Sign or outline lighting 53.40 2
E -mail: Signal circuits) or limited-
CONTRACTOR energy panel, alteration, or
extension" Describe Paget 2
Business name: Oregon Electric Group
Address: 1010 SE 11th Ave Each additional Inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: Portland, OR 97214 • , Investigation per hour (1 hr min) 62.50
Phone: (503) 234A400 Fax: (503) 535 - 2763 Industrial plant per hour 73.75
CCB Lic -: 203 Electrical Lea y . -• ELECTRICAL PERMIT FEES*
—
Ele
S • . Lic 4460S — Subtotal `"r1' . g
Suprv. Electrician signature, requited: / , — ■ Plan review (25% of permit fee)
�� State surcharge (8% of permit fee) 3- 1 5
Print name: Maya_. V - K / • te: 04/ - � O t O
r 1
TOTAL PERMIT FEE l0
Authorized signature: / -�� `
Thla permit application mpl resItapermitIs oat obtained within 180
MAW D at days after It Ilan been accepted as complete
Print name:
I ' to K d rVWA ` , :� � `r /07 • Fee method elop' set by Tri-County Building Industry Service Board
:
'• Number of inspanions per permit allowed.
i:\a, incline \PCnnile'ELC- PvmitApp.doc 12/03 IV 4r016 1rt(IO/O2,CAM/w®
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007- 00291
'13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4130/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 s "'I -
INSPECTION WORKSHEET FOR DATE: 7/11/2007 TIME: 7:01AM PAGE: 49
SITE ADDRESS: 12202 SW MAIN ST CLASS OF WORK:
SUBDIVISION: TIGARD HIGHWAY TRACTS LOT #: 003 TYPE OF USE:
PROJECT NAME: AMERICAN FAMILY
DESCRIPTION: (1) branch circuit to reconnect new gas pack. 7/10/07 changed project name from Taqueria
Restaurante to American Family
OWNER: B-F3 -B PROPERTIES, PHONE #:
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 503.2349900
Inspection Request Scheduled For: Date: 7/11/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 051784 -01 503. 234 -9900 Y
Corrections /Comments/ Instructions:
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❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
'FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: vv Dater 110 ) r Phone #: (503) 718- k4
1
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007- 002.91
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/3012007
Phone: (503) 639 -4171 e1' r °�I�
Inspection Requests (24 Hrs.): (503) 639 -4175 • '
INSPECTION WORKSHEET FOR DATE: 6/22/2007 TIME: 7:03AM PAGE: 47
SITE ADDRESS: 12202 SW MAIN ST CLASS OF WORK:
SUBDIVISION: TIGARD HIGHWAY TRACTS LOT #: 003 TYPE OF USE:
PROJECT NAME: TAQUERIA RESTAURANTE
DESCRIPTION: (1) branch circuit to reconnect new gas pack.
OWNER: I3-B-B PROPERTIES, PHONE #:
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 503.2349900
Inspection Request Scheduled For: Date: 6/22/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 050766-01 503-357-4013 N
Corrections /Comments /Instructions:
cc, -- PsbVic.S6 214 S ) EYVN 1N) ST
N GCS v
❑ PASS ❑ PARTIAL APPROVAL XCANCEL ❑ NO ACCESS
n FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: r N 6e Le Date: 'Zv Phone #: (503) 718 - 'FAO