Permit 61°1 JVV I
41�.� t—C4 ELECTRICAL
E
ITY elia •,
PERMIT #: ELC2006 -00740
'' °' COMMUNITY DEVELOPMENT DATE ISSUED: 12/28/2006
T I GA RD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S136CD- _00100 _
SITE ADDRESS: 11705 SW PACIFIC HWY X ZONING: C - G
SUBDIVISION: PACIFIC CROSSROADS LOT : JURISDICTION: TIG
PROJECT: LITTLE CAESARS PIZZA
Project Description: 14 branch circuits. TI 2/20/2007 Add 1- 200amp service and 5 branch cir.
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: 1 W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 0 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 19 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:
PACIFIC CROSSROADS PROPERTIES, I FIVE STAR ELECTRIC, INC.
BY WYSE INVESTMENT SERVICES CO PO BOX 555
200 SW MARKET ST STE 345 BANKS, OR 97106
PORTLAND, OR 97201
Phone: Contact #: PRI 503 - 324 -0948
FAX 503- 324 -0973
FEES
Description Date Amount Reg #: ELE 34 -665C
[ELPRMT] ELC Permit 12/28/200( $133.30 LIC 158231
[TAX] 8% State Surcharge 12/28/200( $10.66 SUP 4622S
[ELPRMT] ELC Permit 2/20/2007 $73.35
(additional fees not listed here) REQUIRED ITEMS AND REPORTS
Total $223.18
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:
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.
riea:fe'rmit ' is t ;.. D ,_ 1ki f) FOR (JFFi (F USE ON►.V
City of Tigard 11 Received , 00 : , ii�YWIV• /� _ . i , r .. 00/' D
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
2 2 2006 ; « ., es Other Permit:
Phone: 503.639.4171 Fax: 503.598.190 }; I • { Dat
Inspection Line: 503.639.4175 '' Date Ready.By: IMI 63 Sec Page 2 for
Internet: www.ci.tigard.or.us ` �/ r �,�,, - .. •ARr Notitied:Aletltod: Supplemental Information
i1/4-1.1 a 1./� , PLAN REVIEW
��f 4�t
a_ r� •
❑ New construction ►T'' • t ition/ ter atton/replacement Please check all that apply:
❑Service over 225 amps. comm ['Hazardous location
❑ Demolition • Other:
QScrvice over 320 amps - rating ❑Bulldog over 1 0,000 sq. ft..
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
El 1- and 2- family dwelling pt/C mmercial /indust r ial ❑ Accessory building ❑System over 600 volts nominal units in one structure
['Building over three stories ❑Feeders, 400 amps or more
❑ Multi- family 0 Master builder ❑Other: []Occupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND LOCATION 0Egress/lighting plan RV park
�j, ❑Health -care facility ❑Other: —
�j� �J
I Job no.: � Job site address: �I1 W �aGC> l !Wl! Submit 2 sets of plans with any of the above.
City /State/LII': Ti ya 2 %� J The above are not applicable to temporary construction service.
1 ✓ �. j� FEE* SCHEDULE
Suite/bldg. /apt. no.: _G Project name: S `12 . ption
Qty. Fee. Total j I •.
Dexr
Cross street/directions to j te: New residential single- or multi-family dwelling unit.
X Includes attached garage.
1.000 sq. Cl. or less 145.15 4
• Subdivision: I Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy- non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
4 ,n.^ �,�,, ,,, y dwelling, service and /or feeder , 90.9() 2
e) 1 vn �ie, 1' �1C/1 rt Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I ❑ TENANT , 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: 601 amps to 1.000 amps 240.60 2
Address: Over 1.0(10 amps or volts 454.65 2
Reconnect oniy 66.85 2
City /State/ZIP: Temporary services or feeders installation. alteration, and/or
relocation
Phone: ( 1 I 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
❑ APPLICANT 1 ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee. each
6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee. 46 �1t7 / CyL
each branch circuit - 6 2
Address: Each add'I branch circuit j•3 6.65 cgc,LIs 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) i Fax: : ( ) Sign or outline lighting 53.40 2
E -mail: Signal cireuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 I 2
Business name: Five Star Electric, Inc.
Address: PO Box 555 Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State /ZIP: Banks, OR 97106 Investigation per h our t.l hr min) 62.50
Phone: (503) 324 -0948 I Fa. :_ _ : ) 324 - 0973 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lie.: 158231 Electrical Lic . 34 - 665C Suprv. Lic.: 4622C Subtotal ' S.
Suprv. Electrician signature, required: � fi , Plan review (25% of permit fee)
r State surcharge (8% of permit feel ! U bb
Print name: g Ajai G , s+eaas Date: 1 2122 M(.1
U^ TOTAL PERMIT FEE ' i! 3 .q b
Authorized signature: This permit application expires if a permit is not obtained within 180
` da ffy after it ha been accepted as complete
Print name: / \ Date: - Fee utethodology set byTO-Comity Building Industry Service Board
•• Number of inspection per permit allowed.
;ttutM ;,,,O.m f` Duren ;lxnntinr r1IM 1,11 I CT: 1 WWI ITLnlR:o
10'd O I2i,LDS'IS SUS SA I.3 83:01 9003- 33 -0SG
•
CITY OF TIGARD - -
BUILDING DIVISION PERMIT #: El,G2o0b'00`J4/Zs
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 1'
Inspection Requests (24 Hrs.): (503) 639 -4175 °
INSPECTION WORKSHEET FOR DATE: 1- -Q\ TIME: PAGE:
SITE ADDRESS:, 1•1OS' S t'`) Pa 4.1c- H 5 U la" 5 C CLASS OF WORK:
SUBDIVISION: v LOT #: TYPE OF USE:
PROJECT NAME: u' L , CIE 61 5
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: s�'1� PHONE #:
Inspection Request Scheduled For: Date: 3''t ' v Pour Time:
Code # Inspection Description Confirm # Contact # Message
\ X01 b0 % -01
Corrections/Comments/Instructions:
e' PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Cam W Date: 4 69 Phone #: (503) 718- 24113•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006-00740
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/2812005
Phone: (503) 639 -4171 'N �Illrh
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2/21 /2007 TIME: 7:00AM PAGE: 43
SITE ADDRESS: 11705 SW PACIFIC HWY X CLASS OF WORK:
SUBDIVISION: PACIFIC CROSSROADS LOT #: TYPE OF USE:
PROJECT NAME: LITTLE CAESARS PIZZA
DESCRIPTION: 14 branch circuits. TI 2/20/2007 Add 1- 200amp service and 5 branch cir.
OWNER: PACIFIC CROSSROADS PROPERTIES, I,
PHONE #:
CONTRACTOR: FIVE STAR ELECTRIC, INC. PHONE #: 503 -374 -0948
Inspection Request Scheduled For: Date: 2./?1/2007 Pour Time:
Code # Inspection Description -- Contact # Message
125 Wall cover 043637 -01 503 324 -0948 Y
Corrections /Comments /Instructions:
ANN
• I A ( 3 S08 ( ) N o L.
0 I�
,PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ' ( W s Date: 9 -0 1 107 Phone #: (503) 718- O7' •
CITY OF TIGARD ; - r -
BUILDING DIVISION i PERMIT #: El._C 200E 00740
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/28/2006
Phone: (503) 639-4171 '
Inspection Requests (24 Hrs.): (503) 639 -4175 P._..
INSPECTION WORKSHEET FOR DATE: 2/20/2007 : 09AM PAGE: 92
SITE ADDRESS: 11705 SW PACIFIC HWY X CLASS OF WORK:
SUBDIVISION: PACIFIC CROSSROADS LOT #: TYPE OF USE:
PROJECT NAME: LITTLE CAESARS PIZZA
DESCRIPTION: 14 branch circuits. TI
OWNER: PACIFIC CROSSROADS PROPERTIES, I, PHONE #:
CONTRACTOR: FIVE STAR ELECTRIC, INC. PHONE #: 503.324-094B
Inspection Request Scheduled For: Date: 2/20/2007 Pour Time:
Code # Inspection Description Co Contact # Message
125 Wall cover 04354B -01 971 - 246-1582 N
Corrections /Comments /Instructions:
II
Q 14 O g M CAS■1. CRkletik)() S W ILL L E6 1 N ctvi
vJ AN u f o a l t & . vjllik o i l ' t 1'k(L 1,
gfr lq - 6%
V
El PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: cr t Date: 2 131 Phone #: (503) 718 -m .
CITY OF TIGARD •. ��
BUILDING DIVISION • PERMIT #: ELC2006 00740
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/28/2006
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2/16/2007 TIME: 7:00AM PAGE: 20
SITE ADDRESS: 11705 SW PACIFIC HWY X CLASS OF WORK:
SUBDIVISION: PACIFIC CROSSROADS LOT #: TYPE OF USE:
PROJECT NAME: LITTLE CAESARS PIZZA
DESCRIPTION: 14 branch circuits. TI
OWNER: PACIFIC CROSSROADS PROPERTIES, I, PHONE #:
CONTRACTOR: FIVE STAR ELECTRIC, INC. PHONE #: 503 -324 -0948
Inspection Request Scheduled For: Date: 2/16/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
125 Wall cover 043509 -01 971 - 246-1582 Y
Corrections/Comments/Instructions:
❑ PASS ❑ PARTIAL APPROVAL ACANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 14 0 2 L Date: 2 -1 6' 1 3 "1 Phone #: (503) 718 - VAo