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Permit CITY OF T I G A R D ELECTRICAL PERMIT PERMIT #: ELC2002 -00382 ul1 DEVELOPMENT pr SERVICES RV2 C ES ) 639 -4171 DATE ISSUED: 8/8/02 PARCEL: 1S135DD-03301 SITE ADDRESS: 11945 SW PACIFIC HWY 242 SUBDIVISION: HOFFARBER TRACTS NO.1 ZONING: C -G BLOCK: LOT : 002 JURISDICTION: TIG Project Description: Install 2 branch circuits to steam tables. Job #7189 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: TIGARD PROPERTIES INC TEAM ELECTRIC CO 2106 SE OCHOCO ST 9400 SE CLACKAMAS RD MILWAUKIE, OR 97222 CLACKAMAS, OR 97015 Phone: Phone: 557 -7180 Reg #: LIC 47336 SUP 4416S ELE 3 -225C FEES Required Inspections Type By Date Amount Receipt Rough -in PRMT CTR 8/8/02 $53.50 2720020000( Elect'I Final 5PCT CTR 8/8/02 $4.28 2720020000( Total $57.78 EXPIRED 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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or 1 -800- 332 -2344. . Permit Signature: Issued By: ` � / 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: (r) CL-19. • DATE: LICENSE NO: 4 1 1 // . 5 Call 639 -4175 by 7:00pm for an inspection the next business day , AUG. 2.2002 3 : 4 72 M TEAM ELECTRIC NO.815 P.1 /1 - - ' Electrical Permit Application • Date received: , g p 9/ Permit no. , _.603 + � 'j 1 '; it' �! City of Tigard , A Project/appl. no.: Expire date: Chyofrgard Address: 13125 SW Hall Blvd, Tigard, OR 9723•1 • Date isauod: : % Receipt no.: Phone: (503) 639 -41711, ', ,, ' Fax: (503) 598 -1960 N 24� • • Case ale no.: • • Payment type: - Land use app •" . ' • - -- . . TYPE. 01 i'1 ?It111T O I & 2 family dwelling or accessory '0 • mmercial/industdal CI Multi- family CI Tenant improvement O New construction ■ Addition/alteration/replacement © Other, 0 Partial .10R SITE INFORMATION Job address: LtIUM Bldg. no.: Suite no.: Tax map/tax lot/accountno.: Lot: Block Subdivision: project name; 0 , 7 _ ea3gr• Description and location of work on premises: T 2, _STE C, Estimated date of completion/inspection: r. I ► j l^ P eil� ,A, V 00 ' ('ON I't('TOlt API'LI('A "htON F :l: SCIIEDI ILL ' Job no: i3; Ka mien Business name: -T 4 J '#2J 7"„'e.,, di4 ' - ,. don S. . (ea. 'rotor no. to , - New te sldald4.edtgleornwlti- fatoib'per Address: 9600 S 9 'l - de.4m4S Jed dtrelOngnnlG Includes Member' garage. City: - • State: O ' ZIP: • D /. senloelnctadod Phone: , - r ; • Fax: E-mail: -.i2 o • 1000 s • . ft. or less 4 Each additional 500 • . ti. or • onion thereof CCB no.: Elec, bus. lie. no: y- - C Limited anew reaidontiat 2 City/metro lie. no.: Limited matey. non- residenuat 2 Each renaufactured home or modular dwelling Signature of supervising I a an ( ircd) Date Serviceand/orfeeder ^ � 2 U Sup. elect. name (print); ,U , , License no: yy /drS Sourcesorleeders— Inadtllution, alteration or relocation: 1'I1,OPLR'1'1 OWNER 200 amps or less 2 Name (print): AJ A 201 amps to 400 amps 2 2 Mailing address: to amps to 100 saps . 2 '601 amps 1000 amps City: State: ZIP: Over 1000 amps or volts 2 Phalle: �J Fax: I Email: Reconnect only , , 1 Owner installation: The installation is being.made on property Iowa Temporary marries or raders - _, which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrvlocsNoa: 200 amps to or less - 2 ORS 447, 455. 479, 670, 701. 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600. . 2 LNGlNI r:R preach circuits- new, alteration, orextegsion parpatra Name: 1 -. A. Fee for bnotch Circuits with purchase of • Address: service or feeder fee, each branch circuit 2 City; I Ste I ZIP: a, Fee for branch circuits without purchaso B5 of service or fvoderfee, tint branch circuit: 1 � � 2 Phone: Fix: g - mail: Each additional branch atomic C.- l'1•AN RL'i ILIV (Please check all that apply) Misc. (service or feeder not Included): O Service over 225 aenpafammercial • t1 Health-carefhcilitiy Each pump or irrigation circle 2 U Service over 32oantips- ratingof]&2 0 Hazardous location Each sign or outline lighting 2 wily dwellings Cl Building over 10,000 square feet four or Signal eiradt(s) ore limited energy panel. T U System over 600 volts nominal more residential units In ono structure alteration. or extension• + 2 O Building over three swries UFeedera,A00 amps ormore •Description: • O Occupant load over 99 persons O Manufactured structures ot park Each additional inspection over the allowable In any [Me abovam O Egress/lightingplan O Other - Per inspection I I I ,- Submit sets of plans with any 011ie above. , Inca dgotion the The above are not applicable to temporary construction service. • other, Net all ladamctima accept credit ands. please Dell ludrdleden Aar information. Notice: This permit application Permit fee ()visa U MasterCard expires if a permit is not obtained Plan review (at — `A°) $ Caditcmd aamber� 1erZ.192A ! � 101 within 180 days after it has been State surcharge (8 %) .... $ , Z-B M 7 � r / N aO > skr m i o nyy�� lroar� as accepted as complete. TOTAL $ ��- 7.1•R . D � id ,Lt� • S s Z i nanw re Amount EXPIRED 4404615 (6i00/COM)