Permit CITY OF TIGARD ELECTRICAL PERMIT
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CITY OF V PERMIT #: ELC2009 -00008
COMMUNITY DEVELOPMENT DATE ISSUED: 1/8/2009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S 136C D -02200
SITE ADDRESS: 07850 SW DARTMOUTH ST ZONING: C -G
SUBDIVISION: LOT : JURISDICTION: TlG
PROJECT: COSTCO
Project Description: Electrical for new freezers and cooler. Job No. 439713
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: 39 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:
COSTCO WHOLESALE CORPORATION COCHRAN ELECTRIC
ATTN• EXCISE TAX DEPT 111 BROADWAY ELECTRIC
999 LAKE DR 626 SE MAIN
ISSAQUAH, WA 98027 PORTLAND, OR 97214
Phone: Contact #: PRI 503 - 234 -6564
FAX 503 - 238 -2098
FEES
Description Date Amount Reg #: ELE 37 - 546C
[ELPRMT] ELC Permit 1/8/2009 $306.20 LIC 72942
[TAX] 12% State 1/8/2009 $36.74 SUP 34475
Total $342.94 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
503 246 669 or 1.80 332.2344.
Issued By: a Permittee Signatur c _ 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:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: ` 4 / ' - � �: t ' f y 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.
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Received
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® 13125 SW Hall Blvd., "1'lgard, OR 97223 7 2
Ph one 503 639 4171 Fax 503 598 1960 AN Date By Review Other Permit
Line 503 639 4175 TY OF TIG ARL Dat Re ady /By till
t T I ' 'is' ^ �j El See Page 2 for
.
.is i ' i Internet www ttgard -or gov [ �4lio,�� ®' " amain ' ? otifie d/Method v rC. Supplemental Information
— - E OF Wes° ®�� v - PLAN REVIEW._ '" 7'
❑ 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, oi exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building amps for all other nstallations buildings
❑ Multi - family ❑ Master builder ❑ Other. ❑ Fiie pump ❑ installation of75 KVA or
JOB SITE INFORMATION AND LOCATION
0 Emergency system larger separately derived system
❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "l -3 ",
Job no.:43 1 / 3 Job site address: i g55 ) -ExorI f r o t 10011P of more occupancy
❑ Six oi mole residential units ❑ Recreational vehicle parks
City/State/ZIP' �t 1 a ❑ Health -case facilities ❑ Supply voltage foi more than
❑ Hazardous locations 600 volts nominal
Suite /bldg. /apt. no.: Project name: CD She= p ❑ Service or feeder 600 amps or more
FEE SCHEDULE .
Cross street /directions to job site: Description I Qty I Fee. 1 Total
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: [Lot no.: 1,000 sq ft or less 145 15 4
Tax map /parcel no.: Ea add'! 500 sq ft or portion 33 40 1
Limited energy, residential 75 00 2
. DESCRIPTION OF WORK. .. , . , (with above sq ft )
Limited energy, multi - family 75 00 2 •
\{( '
), D G-(..,i,zz, t coo of e1' residential (with above sq ft )
Services or feeders installation, alteration, and/or relocation
200 amps or less 80 30 2
" ❑ PROPERTY OWNER ❑ TENANT ' 201 amps to 400 amps 106 85 2
Name: CO c, \ ID 401 amps to 600 amps 160 60 2
601 amps to 1,000 amps 240 60 2
Address: Over 1.000 amps or volts 454 65 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
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
Branch circuits — new, alteration, or extension, per r anel
Owner signature: Date: A Fee for branch circuits with
. " ❑ APPLICANT` • - ❑ CONTACT PERSON . ' ' above service or feeder fee,
each branch circuit 6 65 2
Business name. •Ce-- - Ou.) B Fee for branch circuits
Contact name: '- C . rllhoul service or feeder fee, 46 85 r„ 8, 2
,o Q 1� e� first branch circuit r
Address: Each add'I branch circuit 34, 6 65 r j 3, 2
Miscellaneous (service or feeder not included) i
City/State /ZIP: Each manufactured or modular 90 90 2
dwellmt, service and /or feeder
Phone: (0) 5 ..'1 5 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:
Signal circuits) or lmuted-
�o vv —_(' IrY ,A .� C r.�ce- d C �,a_1 C (6/ Cr ergy panel, alteration, or
Address: c '\c. -•f-- extension Describe Page 2 2
' C Each additional inspection over allowable in any of the above
City/State/ZIP: �l ` r.G Cif 7 �( _ Per inspection 62 50
Phone: (S 7) L, 3.4 •- (y y ( Fax: (' - L;j) ) 3 -- - 2-0c; Investigation per hour (1 hr min) 62 50
CCB Lie.: 7 5t-J. Electrical Lie.: 3'1- L j � Ls� Suprv. Lic.:� qua_ hdustrial plant per hour 73 75 •
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: \C \ - Subtotal
Print name: ___ \<___ Date.
Plan review (25% of permit fee) �7
� State surcharge (12% of permit fee) 3(Q 7 y
•
Authorized signature: TOTAL PERMIT FEE a Gr /
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
I \Budding'Permiis\ELC- PermiApp doc 05/23/06 440- 4615T(11/05/COM /WEB
CoTY OF TIGARD •
BUILDING DIVISION PERMIT #:51X1001,Qows
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
0 11410
Inspection Requests (24 Hrs.): (503) 639 -4175 L
INSPECTION WORKSHEET FOR DATE: ‘q, . (. TIME: PAGE:
SITE ADDRESS: 0144f , CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME-- C.106 CO —
DESCRIPTION: F. S e46
OWNER: PHONE #:
CONTRACTOR: ' BREAND vVAIJy PHONE #:
Inspection Request Scheduled For: Date:1 -(0i - b0( Pour Time:
Code # Inspection Description Confirm # Contact # Message
VYA
Corrections /Comments /Instructions:
•
PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: NO8 L Date: Z1111 n 9 Phone #: (503) 718- 1.111
t ITY OF TIGARD
BUILDING DIVISION PERMIT #: 141._x.'2009.0 000
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11t +m9
Phone: (503) 639 -4171 Via' „ t]I � I � t� .
Inspection Requests (24 Hrs.): (503) 639 -4175 ,
INSPECTION WORKSHEET FOR DATE: 1/27/3009 TIME: 7 : 00Am PAGE: 20
SITE ADDRESS: 07050 SW DARTMOUTH ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: COs co
DESCRIPTION: Eleol.rical for new freezers and cooler. Job No. 439713
OWNER: COST CO1 i, OLESALE CO �•'``�'' ATlO'l PHONE #:
CONTRACTOR: (OCI IRAN ELECTRIC I �' PHONE #: 603-234 6564
Inspection Request Scheduled For: Date: if2 /J2009 Pour Time: . •
Code # Inspection Description Confirm # Contact # fteen (Message
195 Misc. inspection 080030.01 5O3-
5 36 cf
Corrections/Comments/Instructions: M _ \
'141.a' I p o4 e 0 o /9-r I' We, R 0 t
n PASS 321RTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ; Date: 1 - 1 i 1 Phone #: (503) 718- l i'b
CITY OF TIGARD
BUILDING DIVISION PERMIT #: I~t.C2O0- O()G(j8
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11 2009
Phone: (503) 639 -4171 yiJl
Inspection Requests (24 Hrs.): (503) 639 -4175 ...... `__..
INSPECTION WORKSHEET FOR DATE: -1/m0009 TIME: 7:00AM PAGE: 1•i
SITE ADDRESS: Cat75ij sw DARTMOUTH ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: cos rco
DESCRIPTION: Electrical ter new freezers and cooler. Job No. (1397'13
OWNER: CO;:TCO MOLESALE CORPORATION. PHONE #:
CONTRACTOR: COCHRAN ELECTRIC - PHONE #: r 231- 656*1
Inspection Request Scheduled For: Date: •Il2&2o()9 Pour Time:
Code # Inspection Description Confirm # Contact # Message
195 Misc. inspection 080010-01 603.5217364 N
. Corrections /Comments /Instructions:
P o-fovu2-ci---- .11 (..- cl C(9--t-e dYle-e c-11
LO II Mr0(i/
{
❑ PASS PARTIAL APPROVAL ❑ CANCEL f NO ACCESS
AIL ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date:. l Z 6 7 a i Phone #: (503) 718-
—.5 . .