Permit CITY OF TIGARD ELECTRICAL PERMIT
r PERMIT #: ELC2005 - 00891
P DEVELOPMENT SERVICES DATE ISSUED: 11/10/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 1S136CD-02200
SITE ADDRESS: 07850 SW DARTMOUTH ST ZONING: C -G
SUBDIVISION: LOT : JURISDICTION: TIG
Project Description: (2) branch circuits for flower cooler.
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: 1 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 BROADWAY ELECTRIC - COCHRAN INC
ATTN: EXCISE TAX DEPT 111 626 SE MAIN
999 LAKE DR PORTLAND, OR 97214
ISSAQUAH, WA 98027
Phone: Phone: 503 - 234 -6564
FEES Reg #: L1C 72942
Description Date ,Amount SUP 3447S
ELE 37 -546C
[ELPRMT] ELC Permit 11/10/200' $53.50
[TAX] 8% State Surcharge 11/10/200` $4.28 REQUIRED ITEMS AND REPORTS
Total $57,78
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:,a rr o 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'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.
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Electrical Permit Application '. ,- *''E011 . 10EFICEIUSE ONEVv.".',.. ',•-:- . ,,.- , , ! , ,,,,, ,, ...:i ,- , , .. ;,;,
City of Tigard NOV 1 0
— TIG
OR 9122 2005 //
Phon. 503.6
13125 SW Hall Blvtf.., Ti2ard, 3 CITY Ot ?la:: Review
e:39 4171 Fax. 503 595 '81.91L,N,,,,,r A 1,
I.
-nL•ei 4 ,?...• qh Da.teBv. 1 O!i•er P,Trn,c
Insrecrion Line' 503.639.4175 4 :-/rIMG Diin .,ii- 1 D4(C Ready/By' -i:y.) Z See Page 2 for
Interr.et: ,, or us 1 ' 'of ON ---- , :co:ificztiNfethod:
) 1 Supplement Informzbor,
-':‘ -:..:-.'::. ii ... ,i; . -,.- : ,;: , . - : :....: -' '... .....:, ::... stRvimw
., .,.
1 1 1 New construction n Addizon/aiteratiowylacerntlat I 'Please check all that apply;
j t_j,Ser/ice over 225 amps, corn:m :2 : location
1 E Demo:inon Other.
' 0 5 C'vCr 320 amps- ratios Li over 10,000 so f:
or mor new resid
iiigirSt r-r q'" 1,- ' , ..' ,, ■; A '. :' 1 of I and 2-f
- m-aly awcilin 4 e e-m:2i
i"...e.....;; a',7":•2•.:,":,,i:-., s_ ... _...2- , :,.......,.,........- ---,...,.... , ■ , '....r. , ' ,. ....:, ',
111 1- and 2-famil) d‘velling Cornmerciallindus.trial H .= build-LIZ ' : l___ISystern over 600 volts nominal ....o:5 in one structure
! LIBut/thng over three stones OF Zeder .5 , 400 amps or 771C7::
Malt-family ri Master builder 1:j Other Ec zou p 9 .. ii: i,,,, over 99 p Lj ma:turas:cured , SCTUC:UT!!S
ta.4:64tr:TTd:q;:'g",(4-ig. gigMigf:- 2 i 7 Egr g ?I's' RV eark
Li 6000 i ' 7_11-1.ealen-care:7Sactlity
Job no . • - .i. 1 Job sitc address: -7 &..„,._ • y o t _ rnou p.-_,_ i
St.lbrrit 2 SC:E oi with 2117? 0: the altove
City/State/ZIP. --T \ Tile above are nnt apl: tc, ternoorar.: col- st.-_:-.:.,,ii.--; szi-, Ise.
,::: ., L. , ..:,:::;.._, -, 0z - -..-soihilLti-E . ' - . ,
Suitcroldv..lapt. no :
i Proje n
ct ame Cod
' Description I "'
Cross i to Job site i New residential single- or multl-family ,aweiliciz unit
; Includes attached garage.
I : 000 sCi, :::. or less
Subdivision: ! Lot no . a. add": 500 so ft, or portacc - .:- . 3,--:0 I
--' — ! Lirr.ited energy, residential 75_00
: Tax map/parcel no 1
; i...reited ener nam-residenual ; 7:: 30
' ±iW(4 . 12. 1. 4glaialttlit - 1&',1 1 .4, 8 e-itUktfii - ION : i : : ` ..`, :ij , Peach manufac7.teed cr modular
r , ! dwt.11int..7, ser .i
vtoe ndfor feea:r
i t CWatC_IDD121._=LOICAC r Services or feeders installation. alteration. and/or rclocatIon -
! _
t070 -
0
' amcs ,' ', n , -,
l i - ,r; ; :',' ,5 $, 1 4 7 iii:grE4,07i ; i 6 1?, ; i7i':;bAiitA;ViNlo.'"4:1;g;;;;'-''':::" *. - q .'Eieic,*'' , _fi■;:fi‘ - .T; -,_:. 7 :,.; ; ,.: s , 1 ,_ :, - - - - - - . 1D
- .... _ . _ .._ _ ___....._ .._ ..._ __ ___........ . . . . ..
COSI
-
;_...
1
! Temporary services or feeders installation. al reration, and:or
,
1 relocation
Phone: c , ) i F i
i '- ,
I
220 amps Cr less 66 35 I
i Owner installation: This installation i, ceing made on property that I own whic. is not I 201 amps to 400 amps .20
intended for sale, lease, rent. or eunan.ge, according CO ORS - -149, 670, and 701. —
I 4'Cil al73125 to 600 arr:os • - --.1 -,.., ' -;
I
; Owner sigr.arure. - II> sue, . ; Branch circuits - new, alteration, or extension, per panel
1 ,
l- ,,.....-„ 4 1 : 1 ,-,.... Fee for br-,. circuits with
- " M.- •
1 service cr reedier fee, cacn
'
Business namc: , ,,
4. joyi. & I / ,Ao lit - ' 6 I brancl: eireuit
.;;:...... --......r
1: for branch :tircults
name: I W. ' or reader fee, i
; ; eacn :wane:: eireuit
[ .ddrass: • " c6 Kial),*) ----
1 il-aer. add'I branc'n circult i
1 esp ii ti, 0 NO 9r7 (--. 1 Ntiscellaneous (ser or feeder not included)
hone: 1 IP ) a 0(- Fa &' ' Oi& i Purao or itrt=ticn circle. - ; -0 F --------- 1 2
1 ''- ( : C 3 ) DF-- ' - - - - , ' .;. .
; Sign or outline ilentin a 1 5 ...i) I -
E-mail: Signal cireult(s) or limited- I
V-ilt 1 energy panel, z , I z e -,--a : , i --- ; 0,- i 1
' eXte.rl3tOrt Desc75' I Face 2 l
! T .:31:51.1:5SACO___
1 Each additin v
uai inspection over allowable in any of the aboe
I Addrtss.
I ?ter inspeer.on I ' :::::: 50 1 ;
i__
1 ciry,..State./ZE°•
Investigabon per nour I a: mac) , EIi.5:0 1 ■
1 Fax ( ,
I I Indust-al ;jai oer itcur 1 1 '25 j I
S. "‘"_' -' ; --..;.;:. • , 7
1 -
i Cc.Iii Lic : 7 zoi 4-2._- ! Elect L.i, 57 5_16 cl Suttr-, r.... 3y...(7_ . — „
suo,,,,-,1
Supry Electrician s:gnature, required: ..... I
Plan re".-tew (25% of perrn!:ee)
—
Sate
surcharsre (5% of pernht (cc) 1
L rardei el ...<_Cuct I Date
:-
I AuthorItte, Slplart.:T':-• Thia pErrn,t application expires 'Ca pert is not obtained within 150
rint ndm,e -
Date: days aft, In bas been accepted .o complete
L P
• Fee : to: by Td Building lace, try Ser,,ic Board
‘• 51',Ir Of irsDeettons per eertret ailowe .
....e.e■kn-,,,, .1t.1 4 4 0- 4 6 - gr{ I 00:'i/C01,STArEEI
CITY},OF TIGARD
BUILDING DIVISION PERMIT #: ELC200&00891 •
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/10/2005
Phone: (503) 639-4171 /a �r�mopq 'I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/22/2005 TIME: 7:02AM PAGE: 9
SITE ADDRESS: 07850 S• MARTMOUTH ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: jCOSTCO )
DESCRIPTION: (2) branch circuits' or flower cooler.
OWNER: COSTCO WHOLES s E CORPORATION, PHONE #:
CONTRACTOR: BROADWAY ELECTR COCHRAN INC PHONE #: 503 - 234 -6564
Inspection Request Scheduled For: Date: 11/22/2005 Pour Time:
Code # _ " io —:•,� • n Confirm # Contact # Message
199 Electrical final 022264-01 503 -260 -7912 N
Corrections /Comments /Instructions:
PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: 2 A/ Date: H 2. Phone #: (503) 718- 21111j.