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Permit C IT `S O TIGARD A K D Vi ELECTRICAL PERMIT ��" V PERMIT #: ELC2004 -00722 DEVELOPMENT SERVICES DATE ISSUED: 11/10/2004 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2 S 110AC -01101 SITE ADDRESS: 11290 SW BULL MOUNTAIN RD SUBDIVISION: ZONING: C - BLOCK: LOT : JURISDICTION: TIG Project Description: Job No 120512 Work being done is located in the car wash 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: 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: TEXACO REFINING + MARKETING INC SME CORPORATION BY TAX DEPT 6550 N INTERSTATE AVE PO BOX 7813 PORTLAND, OR 97217 UNIVERSAL CITY, CA 91608 Phone: Phone: 503 - 286 - 3728 Reg #: LIC 40659 ELE 26 -556C • FEES SUP 4214S Description Date Amount Required Inspections [ELPRMT] ELC Permit 11/10/200 $46.85 [TAX] 8% State Surcharge 11/10/200 $3.75 Elect'I Final Total $50.60 • 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: � Permit 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'N: DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day • Electrical al Frmat U O . - FOROFFICE -USE ONLY. e . II City 0 Z Tigard . Received perm o. it N • ' Date/By: /�) 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 `I 1 2U04 G �ntndl,iI, I \ DateB : Other Permit: Inspection Line: 503.639.4175 NOV V ` ! =`/ i. Date Ready/By: 7uris: 0 See Page 2 for Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: Supplemental Information Wall 7 e : -. = s . = ❑ New construction ,rEt Addition/alteration/replacement Please check all that apply: ❑ Demolition ❑Other: ['Service over 225 amps, comm'I ['Hazardous location e , � � ,. c ., ,_, = -y,,, '. ,,, _ ['Service over 320 amps - rating EBuildng over 10,000 sq. ft., a ; �" ' '` , E O p . , W �y Z-Ms x: 4 T _.• of 1 -and 2- family dwellings 4 or more new residential >.� x:..� , fig �, e_:v � = ;�. r�.=aw. '... u �..w r: �,.:es: .y r ..: i as«c�r ,.�;s ± - 2,��. - ❑ 1- and 2- family dwelling 'Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure Multi-family Building over three stories EFeeders, 400 amps or more ❑ y . ❑ Master builder ❑ Other: y , a . �. M« ., Occupant load over 99 persons ['Manufactured structures or Kt ' ' --� Q` .' p . x , 0 d ti 4 ❑ Egress/lighting plan RV. park Job no.: l aos- l 7_1 Job site address: 1129 0 Ac � Athy,eyt ❑Health -care facility ['Other: Submit 2 sets of plans with any of the above. City /State /ZIP: 7L e t - The above are not applicable to temporary construction service. Suite/bldg./apt. no.: Project name: 9 S �+ 1 LAS " . s'`• , SAC I, itit L ; `' `, .... , ; Des Qty. Fee. Total Cross street/directions to job site: ckq yv i_ A � I by /.2j New residential single- or multi - family dwelling unit. ,�//�� Includes attached garage. 5k c-/i S Y-90 / 1,000 sq. ft. or less 145.15 4 Subdivision: Wo lg_g r S Lot no.: Ea. add'1500 sq. ft. or portion 33.40 1 ��1J 2 w�9 Tax map /par cel no. Limited energy, residential 75.00 2 Limited energy, non - residential 75.00 2 1a,&:- `��„�':�,"; �,§�C " r t�� �, =�E � sy;��ara Q. i 4 .' 'u s �.� nd m, - = „x mt.. .;i ce. �., :v ;.,,., Fill t ":. " . ' Each manufactured or modular dwelling, service and /or feeder 90.90 2 ALIN `LO 4Ylp 3 ,All,' ✓ 14 e424.7.:71. « i' 2 - Services or feeders installation, alteration, and/or relocation 1/1145 'GR._ N D /,,, /2 Ai AO 200 amps or less 80.30 2 ��, .;;y.� • ...w - c,�,A�+� mss > / �.� ��. = �t ��,�u-= ,t,,: ,s ~�� � "�, �:, -�, 201 amps to 400 x a „ i rig:: -. ; mP amps 106.85 2 a .t- . '...: P,R WN E -- ; g ' >? „ 7.a Tl ," x. 10 . , ����' "��`: ��� ���"� " 401 amps to 600 amps 160.60 2 Name: 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts . 454.65 2 Reconnect only • 66.85 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 600 amps 133.75 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel n _ - "�� ' ,�,� r, A. Fee for branch circuits with a � 4 � ,rs;.cr.; . ,,uc s _ �",`, ,,,A � -• -a x51.- .. service or feeder fee, each 6.65 2 Business name: SM � o - 0A / branch circuit " ��l B. Fee for branch circuits Contact name: /94/0 t e_.- without service or feeder fee, 46.85 i 2 Address: each branch circuit Each add'1 branch circuit 6.65 2 City /State /ZIP: 'Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone/ (,900 S - J /S Fax: : ( ) Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited- 44j ;` Vaga; l ` to 'I SW* v l energy panel, alteration, or extension. Describe: Page 2 2 Business name: S /l4 t,,_ e.ti(21 ".. -4 49yl/ Address: , S T 5 Jj/ i T21 /rlzs ' /7' 9 �j off Each additional inspection over allowable in any of the above / 7 Per inspection 62.50 City /State /ZIP: )00/2„7/1 c ,/ / c9/7e 1 9'7 2 `7 Investigation per hour (1 hr min) 62.50 Phone:( ) S - /,c7S Fax: ( ) Industrial plant per hour 73.75 CCB Lic.: /4 - 9' Electrical Lie.: Suprv. Lic.: ti 21(1.5 Subtotal 4 6, 0 6_ • Suprv. Electrician signature, required: Plan review (25% of permit fee) State surcharge (8% of permit fee) 3 i Print name: Date: / r TOTAL PERMIT FEE 50 , D Authorized signature: ^ _ 4 , t% ;oz This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: ,piyiweL E )55. Date: 1 1 -1© * Fee methodology set by Tri- County Building Industry Service Board ** Number of inspections per permit allowed. i Bui lding,Pemuts PennitApp.doc 12103 440- 4615T(10/02/COM/WEB t Electrical Permit Application - City of Tigard 'f 6. Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: 12F TIDE .AN...0WO I Tea Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* n Vacuum Systems* ❑ Other: Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems E Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation n Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i.\ Building \Pernvts\ELC.PemdtApp.doc 04/03 SME CORPORATION 6550 N. INTERSTATE AVE. PORTLAND, OR. 97217 503- 286 -3728 503- 286 -5395 FAX * * * * ** ` *' ** * * * * *'* * * * * * * ** * * *huo &www smecomeom on the web * * * ** * * * * * * * * * * * * * * * * * * * * * ** To: All Concerned From: Ron Davis Subject: Electrical Permitting I Ron Davis, as Oregon Electrical Supervisor, for SME Corporation, licensed in the State of Oregon, License # Expiring on /,Q /p,;i/l,i request that the following persons be granted permission to pay for and sign for Electrical permits in my absence. Mark Vigil Sr., Oregon Journeyman Electrician License # 16162J Dan Boissel e Oregon Journeyman Electrician License # R12281J Arnie Tryner, Oregon General Manager, SME Corporation Raymond F. McCall, Oregon Senior Service Tech. Portland Wanda Peltz, Oregon Office Manager, Portland I would request this letter be in effect for a period of not less that one year from this date. Ron Davis Signed: )j_o Date: / //jp /42 CITY TIGARD 13125 S.W. HALL BLVD." • TIGARD, OR 97223 IMPORTANT PERMIT NOTICE SME CORPORATION 6550 N INTERSTATE AVE PORTLAND, OR 97217 Electrical Signature Form Permit #: ELC2004 -00722 Date Issued: 11/10/2004 Parcel: 2 S 110AC -01101 Site Address: 11290 SW BULL MOUNTAIN RD Subdivision: Block: Lot: Jurisdiction: TIG Zoning: C -G Remarks: Job No 120512 Work being done is located in the car wash Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the . start of the work to the address above, ATTN: Building Division. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: TEXACO REFINING + MARKETING INC SME CORPORATION BY TAX DEPT 6550 N INTERSTATE AVE PO BOX 7813 PORTLAND, OR 97217 UNIVERSAL CITY, CA 91608 Phone #: Phone #: 503 - 286 -3728 Reg #: L1C 40659 ELE 26 -556C SUP 4214S AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Supervising Electrician If you have any questions, please call 503.718.2433. /h CITY OF TIGARD 24 -Hour BUILDING 4.-- Inspection Line: (503) 639 -4175 MST INSPECTION DIVISION Business Line: (503) 639 -4171 , BUP Received Date Requested " � / AM PM BUP Location le ( be ' Suite MEC Contact Person �l /\ / ylA pi Ph ( ) .' 6 -- 0 `"/ 57S PLM Contractor `J ` `I'�`` Ph ( ��) I SWR BUILDING Tenant/Owner ELC 00 7 Footing ELC 7 37 Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT - Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Insulation 5 �Q� \N I iV\iV Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling - / Roof - Other: Final PASS PART FAIL PLUMBING: - Post & Beam Under Slab Rough -In Water Service Sanitary Sewer - Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL - Post& Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL. Service Rough -In UG /Slab Low Voltage Fire Alarm Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL SITE Please call for reinspection RE: ❑ Unable to inspect - no access Fire Supply Line j ADA 1 AN' \"1 � � c �� L r7 Ext Approach/Sidewalk D Insp ec tor J ri �p Other: Final V DO NOT REMOVE this inspection record fro the job site. PASS PART FAIL LA