Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00651
IIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/18/2011
Parcel: 1 S 136DC04500
Jurisdiction: Tigard
Site address: 7501 SW DARTMOUTH ST 100
Project: Winco Subdivision: 1995 -013 PARTITION PLAT Lot: 2
Project Description: (2) branch circuits for refrigerated truck outlets
Contractor: NEW WAY ELECTRIC, INC. Owner: SUN LIFE ASSURANCE CO OF CANADA
PO BOX 21503 BY NORRIS BEGGS & SIMPSON
EUGENE, OR 97402 121 SW MORRISON ST #200
PORTLAND, OR 97204
PHONE: 541 - 686 -2365 PHONE:
FAX: 541 - 686 -2715
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 11/18/2011 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 11/18/2011 $7.63
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 set forth in OAR
952- 001 -0010 through 0 R 952- 00 0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: /p/✓- '8
P/
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.
11/18/2011 08:43 541 -585 -2715 PAGE 01/03
•`
te �aJ Permit Application -
City o Tigard ��� Reo
Date /R : / l ( >�t f)FI'I< l t!51, ONLY w 1317.5 SW Hall Blvd„ Tigard, OR 972 /� //� 9 , Pcrmil No 14,20„/ ��(J�s
II
P.9 Fax; 503.5 "t ; 3i C , Plan Review J
I ! i.; A I 0 htspcction lilac: 503.63!1.4175 1� �� l
Dole/13y;
Phone; 503.718.243 (Aber Permit;
Internet www tlgard or gov
�\1 Os"' ►ac Randy /By;
1 , j km (6l Sec
7St J „ itimclirG amgi; 1,r ++ >r ( 'citified /Method: / t'a(c2
ltdlk,lJ$1 bi�i ;M1 :! Y ,,}lf,i ItirGk+t/laai ,t, r! ,kYl:r"' 3r irp c,. rrp,r Supplementallnformotion
, 1•�, r ^.A,�}nrtl,l, I�i�iG.li{f$,. flY,ti +�mitiC4.S�l1l hiin �h$ +SYi�r� t�', +1� 5 °A�lr �,, {iti {�TtJ ry u ^'lrlim�rr: ,�la }'{4 , �j'hd) i C k {' 1 y' :4r.!g±: r mux:.n o., �-
��--77 rig 1u . 'Fg �,Y,;r>SYI1V , I:i'� [ rd 11v l;'1',']V'! ,t }Yrc�,R'Vid tr- ;s�("'" in .
0 CI New construction / t .• heck l t h at npply hs of ii lannsL s shocked o w )
0 addition /alteration /�' 1 . a� � t Please o ID Servico or feeder 400 amps check All th n 1 � f,J. ��t.,�,,
l,i Demolition CmplitlDemolition t - t PP Y (sabmit,� Bois of prone w /items checked bel ow
r Li Other: . t )
10� J � ,J i 4; !' 1 i ! lrfy,(t iSi y'r {Y, i ti , 7 o Y r T,'Y J f r y i ac , , ! . q i ,.. n where the nvnilable fault c u rre nt ❑ Mi ii tling over three stories.
,IS�F.tIitJ,' YVti� b+ ! r, +i , /f 1 a` �t is s Y1 ❑ m o nag :mdbon
t, a r , a , ..,. h Y, i elM M1�1 . at , ,Y i r�Y ?,!t vM,�Al2t' , .'r i a.:lll , d ' IA,',} +;fir + „t 1i i .� .�l�� i ",¢,`r��r'� Ir "�h'r +,. exceeds 1 0.00D amps n! 180 volts 01 Nerds.
mity dwelling a¢9 to b mowin buildings,
g Commercial/industrial ❑ Accessory building grei+nd, or exceeds 14.000 ❑ Commercial -use a,picahnrn]
0 1- and 2_
❑ Mufti -family a mps for 011 other installat
}f� 1 ,, 0 Master builder q Otltcr Installation
fryi���it'�1� ^ +�1� r�,yit' "�'•:n"7tvR,a�bva +cur, r+s>, re•ayJ.,r, arat, +imr, m• xu ,rm },n r ❑ 1` p Instal
�++ 1 ii,,',L'h l � 171 lotion of 75
stn uai.0 , (.r,,,1�:l�dviatl„ tiJr ?''�,"�:�.,uii,Il. si�tauFw ,?�tn++otsft4PJ,tic,�i',,l Y��r i,(,2�1`1r1' roar+ iii?:. i }hi +t °by'� 1 9 ; ,f°k1"6+ I iP 4 ❑ Krj
U.•�.., : riittata rllnli e +!,� , tn�i,I +l o AdcHtion of new motor lnnd of larftar scpar 2 dc,iv syst
.lob no,: 4275 .lob site address: 7S01 SW Dartmouth '� "F ""I- 2' °t -3
Rd. IOOHPOrmore, occupancy.
❑ Six or more rcsidantial units. ❑ Recreational vehicle parks.
City/State/71P: Tigard, OR 97223
[) Flcaltlt -ante filcilit; ❑ Supply voltngc far meta than
Suite /bldg. /Apt., no.: 1n O Project name: Wince #23 El Harnrdor feeder GOO voile nominal.
—�� ID Service or a r 600 amps or more
Cross street/directions t0 job site: , °, y i (9!1 ) rIY', M } ,1 w t,* T+ n r �f�u
sC �1 B ann � ential vin ih,,i%•li Ai•7,h,�Jl IJ liW7`at �sF, t ion �v�v�a�ft; l/ n�ti d4sJ�1t[ e�i'. i�EltonrlV1 }iit$i1Y, lFiN`lti�i,1'i' ti
New reside le- Qty' ell. Tiani
single- or multi - family dwelling nitit.
Subdivision: Includes t+ttnehed mirage.
[ Lot no.: 1,000 sq. ft, or icss 10(3.54
Tax map/parcel no.: 'l 500 3 I. m a 1
Ea. add
pia I n n rl,T c l ,lrb( q. a tjai n
(� }, , {1 }r yY lift, J "',t l�4 h,l /fr { fl, ll ,li�lj � { f �lr� a ^� u t Aiv�h � IPU �: 11r �) tv � ° r}r'/814 igz)ivl r }y l�}ll�llr S7S } P it n y ;, ,i l' Amited energy, resid ential I
+,:! 4 al,, • a . ,6011 kl.,l, d ti., } , r r , r, r
�S,,,ntb,Y,.c,.�,ti/ia, r .c:,,alAe , bh lr.fb,,:i�Nl'Irlt„., ° l��' r '/, /Iato��r,l�u.,,� ,Yii:,1 „t;l,��!1 with Above sq, It
2
Two 60amp hr Limited energy,
p Itch Circuits to refrigerated truck plugs gy, multi-family —
residentiaawith above sq. ft.)
75 2
N ! `� f/ Services or feeders installation, Alteration and /or
,C+ �t;iIJt L t � J { '� r4 Y ,R. 1i° I } t �n�2llinJl..4 AI .Vi +r in'IVj u741r ,1, � -0 1iiir, P'd� 200 amps or lean 1�.''--1 relocation f1"..,,, U� /YY rotu�i! s� &I 1�, u�4Tu { nr • l� , i, 100,7 2
ri , u„ u: nlua. dnatil'; uF;; N'^ n�tusitldW,++; isY 'rs1'y,l ?,,,It�F„}mkhd.tip,�7d„ u:li ii���iena , a�'stilltr2` t er, iY `5:�Eat� r��r�kRitYdtldr�� z0t- pait ap�to400;lmps
133.56 2
Name;
401 amp to 600 amps 2
Address: amp 552.26 2
601 amps to 1,000 amps 301,04 2
Over 1,000 ma or volts
City /SCai:e / '
Temporary services or feeders Installation, alteration, and/or —
o ^ n p : )
Ch --- rel 1�ax : ( ) 200 amps or less
—owner This installation is being made on property that I own which is not 59.36 j
201 amps to 400 amps ME 125,08 2
wner in
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. �
Owner a 401 amps to 599 amps
lgniiture ! 68.51 2
'irH+ r iQ J!' r ' S•} '.tt,m,^� r n 1 acre A . F eed rirc ci n ti i s with ntinn�, or extension, per panel
!kf41 N ^' �+' + i r ''!li � y rr la,c fi t k t,r ,•, N ,., A. cforhr � � - �•- -�
�k�r r 6 il7Sr'' ir;�sE! ",11� irti { itlt"anl,ii J tR,.tlj�:. 4'J ?.6�nati It!� { � �1���t y �� /Y'rilrIft'r3Xhil" Sri r , S „ x Ir ir r n7 } ^ >7 � i7 � ', ' above service or feeder fee
a n a)tai,r 1 ih 1 r 9Wf�r + J +ll,ltaiiiiy
Business name: New Way Electric, Inc. ea branch circuit 7.4z 2
�--� S. Fee for branch circuits ivirhont �' �—
Contact name: Jonette Boll branch or feeder fcc, first
_� branch circuit 56. I R 56.18 2
Address: IS Box 21503 Each add'I branch circuit Z 7.42
Miscellaneous service or feeder not included) 7,42 2
City /Sl:fltc /7_,lP: Eugene, OR 97402
Each manuthcutrcd or modular — 2
Phone: (541) 686 - 236$ - - dwr Ilit, service and /or fcc<Icr
67.84 2
_ I .Fax:: (541 -) 686 -2715 Reconnect only 67,84
E-mail: j @newwayclectrie.eom �” Pump or irrigation circle
/ fC y q : +il r,. .r, jonette@newwayelectric.com
A i a , + rrl ! , n p pp 67.84 2
i'i .I111e11,U,}.,: lis1�1Y,�Ai?U�u ".411ES(t �t�yh�l .I i�vli, 1 ,}� E nN �IYCLlnclPi[/ i' t�mrV .,r..l,f9'rF6'6ti"1„f�hS1�'p Jl �l + {j'dd 1i �}Ir T1 nr1 4 1 ' ,Y y ih ` l olrtlito)o !Milted-energy ,
tl Q r.,m4",v t,;,\ t1 „,, ^(S.duL(�tpt,.,lc�it�9,'r+ S, ! rxYr ( 11 ( „r MI 67,84 !�
uu6,,,u�:a t i,.,,ahc; to si clrcuit or �7
y i3usiness name: New Way Electric, Inc.
W
panel, alteration, or extension, Page 2
Address: P.O. pax 21503 -____ Each additional ins action over allowable in an of the above
City/State/ZIP: Eugene, OR 97402 Additional inspection (I hr min) 66, hr
Investigation (I hr min) 06,25/ 251 hr
one: (54 1) ti - 2365 Industrial plant ( h r min) hr MEM
MEI
Fa: :41) 6: 6 - 715 inspel leas for which no fcc is
.6 i,
t:C13 Lic.; 51088 Electrical Lie.: 20 -14 x S t s ccaflcall listed 1 /, hr min 9000 / hr
pt't' L1 52523 i' JT ;' it �s �i� ' a � S��” '"�"'� + �V }
! '"d' lJ,, 4 elr�ull.7l'l Wren,
Suprv. Ficctricinn signature. rcgttircd: t
- , da / )0' Subtotal, 63,60
Print name:
.lustin Parlay Plan nevicw (25v / oafper mi -
Date: State surcharge (12 "/" of permit fcc); 7.64
Authorized signtiturc: This _ TOTAL PERMIT PEE: ..24 ✓
permit application expires if n permit is not obtained within TAO
Print name: Justin Paslay Date: days after it ens been accepted nv complete.. 2,,„. " Number of inspections allowed par permit, #2 I .
ViniIdinp1Pormi +eltiLC•PermllApp,dnc 07/01/10 440 -46I5T I lN9/
( COM/wea
11/18/2011 08:43 541 - 685 -2715 PAGE 02/03
Electrical Permit Application - City of Tigard
Page 2 - Supplemental information
LIMITED ENERGY PERMIT FEES:
U�`�m�.1�`tl �. #I it t >.�l(� r +�, ti ty.�} / /n,1 f ry ,�x}, 4 dl /4 t� t r i iUlr,�f 1
e ...rlyeertln,r,�,r,�„i ,. ;- 1 / d 1 !, t4 r W
r,e� a A�,�.���.vµ �i� ��'.vN�r,!�!Kf+ +Itha �r1 +.wit':1° I��` r {f�f�t'�'�t�1�t1j ��r��7
Pee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar, Alarm
❑ Garage Door Opener*
❑ Pleating, Ventilation. and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
j� i�„ { } "^1 ;�} n +v 4 ¢ � � t � x 3r! 1 � 4� t i r, 4 r
4ArkMat�{ un,u,N.')3 r'; at�i1iiGlnrtlti l4d nntiuiLtRlltn �/ i�„, ilrcy�tall�x ,.,+6M��'11�SIv�yf�,�Nfl1n�t��11'
Fee for each commercial "`n'�" 5 00
system .,
$75.00
(SEE OAR 9i8 -3o9 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ CI Systems
❑ Data 'Telecommunication Installation
❑ I/irc Alarm Installation
❑ T -IVAC
❑ .Instrumentation
❑ Intercom and Paging Systems
❑ l .andscapc irrigation Control*
❑ Medical
❑ Nurse Calls
❑ O utdoor Landscape Lighting*
❑ P rotective Signaling
0 Other
Total number of comtnercial systems:
*No licenses are required. Licenses are required
for all other installations
t 1PUIIQing\ParmIt ^U?t t'orrnitApp 09/01/10