Permit - '''4 CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: 0
DATE ISSUED: 4/26/2 007 00273
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S 126CA -01100
SITE ADDRESS: 09009 SW HALL BLVD 100 ZONING: C -G
SUBDIVISION: WASHINGTON CIRCLE PLAZA LOT : JURISDICTION: TIG
PROJECT: TARGET
Project Description: Fire damage; 3 circuits
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 NM/ 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: 2 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:
DAYTON HUDSON CORPORATION CROWN VOLTAGE
BY TARGET #345 TAX DPT 14 -1 DANIEL TUCKER
PROPERTY MGMT ACCTG CC -470 12607 NE 199TH ST
MINNEAPOLIS, MN 55440 BATTLE GROUND, WA 98604
Phone: Contact #: PRI 360- 666 -0995
FAX 360- 666 -4673
FEES
Description Date Amount Reg #: ELE 37 -984C
[ELPRMT] ELC Permit 4/26/2007 $60.15 LIC 153934
[TAX] 8% State Surcharge 4/26/2007 $4.81 SUP 41165
Total $64.96 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 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: 1 /� ✓ ...
i
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.
Apr, 2 -4 07 04:53p CROWN VOLTAGE, INC. 1 360 666 4673 p.2
` leeirlcal Permit ,A, bca"ti : ,.r FOR Orr ICE 1. F OILY
City of Ti and o Dare /B . Mid "Jt Permit .,a `7- o a
13125 SW Flall 131vd_, Tigard, OR 9722_3 1 plan Rents.
:, � d� , Other Parma_
e;
Phone 503.639.4171 f"sue 501598.1960 AP R L , YLl- i;' : t}alerls
Inspection l.in 503.639.4175 ,-.2!,,4• I ; Date RextylOy Jens: ta See Page fur
Internet: www.ei_tiranl.or.us f ,_ }ci .,4 t� 6 ®� it `. . S` N"ufudiM` ,&L Supplemental rr
lnformatio
TYPE oF' S'1 $ 11 ` 1 "+ ickl�` i t
PLAN REVIEW
- ❑ New construction % Additictt /altetilttoti/replaacmcnl Please thecae all that apply.
OSr viccover 225 amps, comin 1 ❑Haeardous location
❑ Demolition ❑ Other: _ []Service over 320 amps - rating ❑liuildng over 10,000 sq. R,
CATEGORY OF CONSTRUCTION of l- and 2- family dwellings 4 or more new residential
❑ i - and 2- family dwclling� Commer ciallindustrial ❑ Accessory building — ❑Stan over 600 volts nominal unirs hi one Structure
❑Building avea stories ❑1•eeders, 400 amps or more
❑ Multi family ❑Master built« ❑ Other. DOccupant load over99 persons ❑ dmanfoamed structures or
—
JOB suit !INFORMATION AND LOCATION (� ❑ l lthcare facility
[] Egress/lighting plan kV park
/ -� (, t ` 4.l m Other.
Job >x, Job site addns: C1 l
Submit 2 sets of plans with Any of the above.
ti. The above are tot applicable to temporary cortslntction service.
City /StaleiZII - mac . t � ZZ ` D
Suite/bldgjapt. no.: I Project name
FEE' �Y'IiLDt'T E .F
Deverimlae I o!Y J _ re a I Twat J
Cross street/directions to job site: New residential si.F3e -or rwwtlYrar ally dwelling unit.
Iadlades attached garage.
13000 al. R. or less 145.15 4
Subdivision: Lot no.: pa, add't 500 so. fl_ or portion 33.40 1
- w- Limited energy, residential 75,00 2
Tax map /parcel no.: Limited energy, nrnrteSyidenlial 7500 2
DESCRIPTION Olt WORK Bch tnanufa dared or modular
"M `^ ` tlwdling, service and/or feeder 90.90 2
-
\\A 6 r. C. � t, c services or feeders i.Mt4llatlon, altrratiow, sndtnr relocation
-<„ \ 200 amps ok less _ _ 80,30 2
PER TV OWNER 1::1 TENANT amps to 400 amps 106.85 - 2
_ .. 401 amps to 600 amps 160.60 2
Name: -""- (` M^ 601 ampsto 1,000 amps 240.60 2
Address_ 1 "� Over 1,000 on ampsorvolts 454.65 r 2
Reconnect only 66.85 2 f
City /State/ZIP: 3`emparwry toerviees or feeders ua tritatinn, alteratius, rtodktr
relocation
Phone_ ( ) _�. Fax: ( ) ., 200 ramps or ices 66 .85 .. 1
Owner ittstalis,tino, 'Otis installation is being made on pnopcdy that I own which is not 201 amps to 400 as 10030 2
intended for sale.1ease, rent, or ccchani ;, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature; ... , u•,v - Date: Brandt dreams- mew, olteratioa, C:tcm3i05, per goad
Q APPLICANT ❑ C'oNT',wr rEILSON A Fox for branch circuits with
service or feeder tee, each
6_65 2
Busine s none: • branch circuit _ _ _.
I3.1'ee for branch circuits
Contact name: without service or feeder foe . 4&.85 / , • 2
each ranch Clrctit
Address: ss: liner add'1 branch circuit ej _ 6.65 12 „ I 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Penrp or irrigation circle 53 d0 2
Phones( ) fax::( ) _ Sign orartlincliphting 63.40 2_
E-mail; 'V Signal circuit(s) or liniited-
cONTRACTOR cony panel, alteration. or
__ extension_ Descrihc Page 2 2
Businc s name: ( C , 0_,,c(;) t..9... V 0 1 e 1�C. b additional terpcCt105 over allowable . '
Address; '\ 1 f ` e P) ,� 0 i I9 S C • allowable is k/1 ofthe above
y C� I Io
Cit f/State /Z,IP: 1 Imo, (4 & i Investigation per hour (1 lir min) 6230
Phone F a c t : ( 1 6 3 0 td �! Lo3 Industrial plant p er tour .
-- 73,75
(� ) �{p�A tJ Q�.7 ELECTRICAL PFRl III PF.E.S•
Cal Lae.: 16" , t( 3H 1 1:;Icctritarl lie.: r3 y-4$c{ — 1 suprv. l it.: - l l / /(,5 Subtotal 1 , j
uprv. Electrician signature, required- Plan review (25% ofpermit fee)
_... _., (('' _- 1�� / Sate surcharge (8% of permit fee) I
Print name: �{\ L Gk T �+( _ TOTAL PERMIT FEE (.0 (p—
Authorized signature; I oak peewit ■ppGed:rr eJtpirer if a permit 6 ■■t aLtaiocd within Ito
dqa .dater it ins fret,. ateeptsd ,x complete
Data • Fen metlpdnlury act by Tri -Cowry Daddies Wintry Service Uvard
Print name_ `f t1� �y f•°�S D �lI�
� ��' � - f --- 1 • •• Number of insocatnos ter 1►:rmit allowed.