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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2011 00014 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/05/2011 Parcel: 2S102CB01802 Jurisdiction: Tigard Site address: 13407 SW PACIFIC HWY Project: AutoZone Subdivision: Lot: 0 Project Description: (1) 200 amp temporary service. Contractor: ADVANCED ELECTRIC INC Owner: BAR -AM, LLC 21811 NE 58TH ST BY GODFATHER'S PIZZA VANCOUVER, WA 98682 1416 THIRD AVE SEATTLE WA, 98 PHONE: 360- 254 -6864 PHONE: FAX: 360 - 254 -2854 FEES Quantity Description Date Amount 1 ea Temp Services or Feeders - 01/05/2011 $59.36 Specifics: 200 amps or less 1 ea 12% State Surcharge - 01/05/2011 $7.12 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $66.48 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 s tet forth in OAR 952- 001 -0010 through OA • •52- 001 -0090. You ay obtain a co. direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. / / Issued B / _. - • 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 INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for the next available inspection date. 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. JAN- 04- 2011(TUE) 13:48 Advanced Electric (FAX)360 2542854 P.001 /002 Electrical Permit Application p C ED FOR OFFICE USE ONLY City of Tigard 1 tt 0.103 ( f ly PcntdtNo.: ic ,, _ l ■ 13125 SW 2 (dull BIvd., Tigard. OR 97223 �II 4 ' Plan RC{ icw si R Phone: 503.71[1,24 Fax: 503.598.196 0 f iate/Date/13 : ( :hlmrhemt T IGARD Inspection Line: 503.639.4175 DateRcadyniy: fa SocPage2for I nternet: www.tigurd- or.guv CITY OF TIGARD Nolifiicd/Mcnmd: / // Supplemental Iuformadou u +rt' n % ,rrtu , r 7�(r arJrty r �I�}!!�� �e rri lwgr:'N Ny, w.il : w,) I xt gl ,r;�p,' Il l ,[+ ;• rl e /. . ,(� t „ II ±� ( I „1PNf1 1 7474� � r 7 iii P r � rlM; i�'1'" !'"; It 9 � �' 714' °y _ - � : r(1 P1 r 6 r 1 7 "7 ;. f'; � IP ■n{' m j IR„:F'f, , �'r 1, ' 'ilia. ; / ..�Z "�a' r �1gitiNggt 0 New construction ❑ Additionfslllerution /rrplteemenl Please Cheek alt that apply (submit z sets of plans wlile,us checker! holow); 0 Service or feeder 4U0 mlp% or more ❑ Building over three stones. ❑ Demolition ❑ Other: where the nvnilnble fault current ❑ Marinas and boatyards. O exceeds 1 } h 7i l? r, I i ; � { , i , , p' r I'! n ; f p!'z iri 1 is ' . i 4 ;(ti np f9 ,` L' 7� Liti19 L1i41 n r cr `i1,; 1 :1 t 1 r h l�f � ' ° r r rrJ'Iirp1 r i;rii nhr "t 0.000 amps at 150 volts or 0] Floating buildin . All411 l .1 , allnC71'�rtlai"r OIll {a 1r All;i N 71,4417Mir.41✓ tloIiir P.d XIN P�1 t ?Jul valh"t110 i,h ww 'i,. err i 1l4Illd.1ao I :iI S6 xl . less to ground, at exceeds IA, ❑ 1- and 2- family dwelling El Commercial /industrial 0 Accessory building amps rot a 000 ©Commrrc J., ex agncuhural an Other instnllat hailrlings, ❑ Multi family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of75 KVA or l) P(�a r1 "',; f +iYrl }I�"11r;f I�I )i� �l t 1 �r a l ■ 5 , rA. e r r M I if l i is 1 ' r7 ❑ t mergcncy system. larger separately derived system. • rrJalloak.s ldtd olad.4 I, {aw I l i - y w l � . , . v h )I yd r 1l o. 1 . , �z,l z, :', C ; d l, 00x. ❑ Addition of new motor load of ❑ "A ", •'E'•, "1.2 • 1 -3 », Job no.: Job site address: 13407 SW PACH IC HIGHWAY IOOHP ur more. occupancy. D Si n ur mare rwciderdial evils, 0 Reerertiunal vebiele perks. City /Statc/ZIP: TIGARD /OR/97223 ❑ I leatth• care facilities. ❑ Supply volt Ibr more than - ['Hazardous locations. 600 volts nominal. Suite/bldg./apt no.: Project name: AUTOZONE STORE 03756 ❑ Service or feeder 600 amps or more. �f g r' G`k� ry :i17r iifi �ii il��u ll�' i 17ri Cross street/directions to job sitc: WEST OF SW PACIFIC HIGHWAY rt„ l� • vi i s ., N r }1jt l! (111' "1�� l � rl Total - New PARK STREET EAST AND NORTH OF SW WATKINS AVE. Intl dm attached singlo- ormulti family dwelling unit. SOUTH OF SW lncludts attached garage. Subdivision: I Lot no.: 01802 1.000 sq. R. or less 168.54 4 Ea add'l 500 sq. ft, or portion 33.92 1 Tax map /parcel no.; R99407 r p Limited energy, r idential - -- � r{p l l r r� re r w�l� � ,',',7ry lr r r r l e ll r C r r i rev y u;,t1 .. � q � ., V a 2 r1 � l , ,Ir l ( Y� 11r . j I r i ) rl �l r r t � l l ` rm ` rr 111 . , ■7:'0 Wldl above . 11:. 75.00 2 « ��r rh l illly 0' %.::1 ;ijeliL� bikSill . "rqth 6 VI. !rl!'ll,11 L":113� :4rt.;,u..1 � �� il . '',,!,,i'4/4/ ( > ) _ — Limited energy, multi-family 75,00 2 ELECTRICAL, TEMPORAY SERVICE residential (with above sq. ft.) — Services or feeders ioatallation and/or relocation 200 amps or less 100.70 2 1 1,1' "1" 1 r '� 1 r ) I " ,; p L •r ' 9 / o'( tR'{ 7 p , 1 It" r r "'""'w,, 7f ,,p jl�r 7 . � a , , ( G l� � t r n der 11 4 "}. .". . g r r d Tr.r i 1, r't ttd.. rrrrem d H r c. h !' 1 ' 1 ,1, 14 201 amps to 400 amps 111.56 2 ry „11 „L; r .it. r.,.� 6 9NA'fQ �g9typ .,�ntr,.l.'rrr ,r.J> ). ,, ,tl. rU 1.7,1 r piers: Llti7 v t�.l. ,.e...Arrt }, ,.rJ.,..rm�y ukra.r Y. irSW�44lr Wi Name: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 i 12 City /StatdZII': Temporary services or feeders Installation, alteration, and/or relocation Phone: ( ) Fax: ( ) 200 amps or less 1 59.36 59.36 • Owner installation: This installation is being made on property that I own which is not 201 amps to 400 snips 125.08 2 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, er panel Owner signature: { r Date: A. Fee fur brunch circuits with r y {� p 7 rjyiml) li� '1 S ri rl , ylwVu ' i 111 17� 1� :7 {i 1 1 , {l 1 1 t F: 1(1lr lfll(it� l l' i Y r t l r l 1, l ` 41a C � , t * rr t7 , r` 11�� i d 1 above service or feeder fee. 6.tii, ,l.,J,.r. ii if :taM.i�:i!iii (.'.11, "lilt MtI111ll .1�dd!1il.84,`a.,ij,...5a1., :11:1 6,11141},,aW ,:ui:1 ''L tuh �l: {.;I each branch circuit 742 2 Business Hume: B. Fce for branch circuits without service or feeder fee, first 56.111 2 Contact name: brunch circuit Each add'] brim h circuit 7.42 2 Address: miscellaneous (service or feeder not Included) dlaclt manufactured or modular City/StateP7,1P: dwelling, service and/or feeder 67.34 2 Phone: ( ) I Fax: : ( ) Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 1r mtltl p Sign or nutlinc lighting 67.84 2 1 r ,,,, �rr 1 1 hr( tit tp�nt �,t l ,7rli ap llirf�il,, 1 t X 9'1 - ,Ii�r la/ l '}r i tri :1 y� i rr lr �,i , irrl,r�l' 17,1 rt r ti ,'il15 : 1.a...i�dL�..eU�;a u1.4Y I Tiii r., aia1.1w,.lr,., llri ••, •, - I, redllAr.1(1.11: n,1Olii1i lIlliliit,lar J,,,i1,.1., ;� �.l:ri Signal circuit(s) or limited -energy Business name: ADVANCED ELECTRIC, INC. panel., ulteration, or extension. Page 2 2 _ �_ Each additional inspection over allowable in any of the above Address: 21811 NE 58"' STREET Additional inspection (I hr min) 66.25/11r .. Investigation (1 hr min) 66.25/ hr City/State/ZIP: VANCOUVER/WA/98682 Industrial plant (I hr min) 78.18/ hr — Phone: (360) 254.6864 Fax: (360) 254.2854 Inspections for which no fcc is 90.00 / Itr s• cifit all listed (S5 hr min CCB Lie.: 117052 u rv, . 45 ,t"i l I'Wr' 11 s rt i eI Jl i4 r r�� "r !• ' .^ ti ia' `i r�( ) p{ 1' i / p � Lie: 373 .r I rip ,,,.,,�. A � 9�C;(�((A � r V � .d .h 7 rr, l,.,,r � ,1 'ni 1 , /„n.il. i� ....1...r.... 1..f ..1.. ll LA. ir? Suprv. Electrician signature, required: r (� �� Subtotal: fee) 59.36 4, r_ � �- �� . J,�... . �... —� �� Plan review (25% of permit fee): Print name: K13NNI3T1-1 H. MUNCIE' Date: 1/4/10 f' State surcharge (12% of permit fee): 7.12 TOTAL PERMIT Ff13: 66.48 Authorized signature: This permit application expires if a permit is not obtained within 180 Print days afkr it hull ban accepted is complete. 1 rint name: Date: • Number of iuspacLwns allowed tier penult. I:\ Duitd iag1PmnitsltLC.PermitApp.duc 07/01/10 140.46157(11 /O5/CCM/WED