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Permit ' CITY OF T I G A R D ELECTRICAL PERMIT PERMIT #: ELC2001 -00408 --- , �y DEVELOPMENT SERVICES DATE ISSUED: 08/08/2001 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S102CC -00500 SITE ADDRESS: 13560 SW PACIFIC HIGHWAY STARBUCKS SUBDIVISION: ZONING: C -G BLOCK: LOT : JURISDICTION: TIG Project Description: Installation of (2) service /feeders. 65 branch 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 HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: 2 W /SERVICE OR FEEDER: 65 PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 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: STARBUCKS COFFEE COMPANY ST JOHNS ELECTRIC INC 2401 UTAH AVE S 4415 NE MINNEHAHA SEATTLE, WA 98134 VANCOUVER, WA 98661 Phone: 206 - 318 -1575 Phone: 360 - 693 -5100 Reg #: LIC 43135 SUP 3024S ELE 37 -350C FEES Required Inspections Type By Date Amount Receipt Ceiling Cover PRMT CTR 08/08/2001 $592.25 2720010000( Wall Cover Elect'I Service 5PCT CTR 08/08/2001 $47.38 2720010000( Elect'I Final Total $639.63 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: a J Issued By: 411 / 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: 6) I a - DATE: LICENSE NO: 3 Call 639 -4175 by 7:00pm for an inspection the next business day 1 • • • E l trical Permit Applicat iE CEIVEJ PE ', Date received 7/D I Permit no.:EL - :.•� City of Tigard Project/appl. no.: Expire date: City of Tigard Address: 134 6Vtliall Ny Tigard, OR 97223 Date issued: By: ge I Receipt no.: Phone: (503) 639 -4171 UU Fax: (�J�8y1• _,; r, Case file no.: Payment type: r • !'.: 4 ; Land use approval: ' ' TYPE OF PERMIT ❑ I & 2 family dwelling or accessory ACommercial/industrial ❑ Multi- family ❑ Tenant improvement ❑ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial JOB SITE INFORMATION Job address:13500 SW Pacif is HWY Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: I Block: Subdivision: Bldg. Permit # BUP 2001 -00258 Project name: I Description and location of work on premises: Estimated date of completion/inspection: CONTRACTOR APPLICATION FEE SCIIE1)111.E Job no: Fee Max Business name: St. Johns Electric, Inc. Description Qty. (ea) Total no.insp New residential - single or multi- family per Address: 4415 NE Minnehaha St. dwelling 'mil Includes attached garage. City: Vancouver I State: WA I ZIP: 98661 Serviceincludesh Phone:3606935100 I Fax699 -1345 I E -mail: 1000 sq. ft. or less 4 CCB no.: 43135 I Elec. bus. lie. no: 37-350C . Each additional 500 sq. ft. or portion thereof Limited energy, residential 2 City /metro no.: IV _ Limited energy, non-residential 2 ../-..e1.-4' g/0/ Each manufactured home or modular dwelling Signature of supervismT: trician (required) Dat Service and/or feeder 2 Services or feeders — installation, Sup. elect. name (print): lean R. B ' ur Licenseno:30245 alteration or relocation: PROPERTY' OWNER 200 amps or less 2 Name (print): 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: 601 amps to 1000 amps 2 City: I State: I ZIP: Over 1000 amps or volts 2 Phone: I Fax: 1E-mail: Reconnect only 1 Owner installation: The installation is being made on property I own Temporary services or feeders- . . which is not intended for sale, lease, rent, or exchange according to ltatlon, alteration, orrelocation: 200 amps or less 2 20 ORS 447, 455, 479, 670, 701. 201 1 amps to 400 amps 2 Owner's signature: Date: 401 to 600 am s 2 Branch circuits - new, alteration, Name: or extension per panel: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 City: I State: • I ZIP: B. Fee for branch circuits without purchase Phone: Fax: E -mail' of service or feeder fee, first branch circuit: 2 Each additional branch circuit: PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included): ❑ Service over 225 amps - commercial ❑ Health -care facility Each pump or irrigation circle 2 ❑ Service over 320 amps- rating of 1&2 ❑ Hazardous location Each sign or outline lighting 2 family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, ❑ System over 600 volts nominal more residential units in one structure alteration, or extension' 2 ❑ Building over three stories ❑ Feeders, 400 amps or more *Description: ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above: ❑ Egress/lightingplan ❑ Other er inspection Submit sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ ❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $ ' Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ Expires accepted as complete. TOTAL $ . Name of cardholder as shown on credit card $ Cardholder signature Amount 440 -4615 (6r00/COM) i Electrical Permit Fees: Limited Energy Fees: Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY p Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) , Service included: Items Cost Total `1' Check Type of Work Involved: Residential - per unit 1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems Each additional 500 sq. ft. or portion thereof $33.40 1 ❑ Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular ❑ Garage Door Opener Dwelling Service or Feeder $90.90 2 Services or Feeders El heating Ventilation and Air Conditioning System* Installation, alteration, or relocation I 200 amps or less 2. $80.30 /40.4(3. I=1 Vacuum Systems' 201 amps to 400 amps $106.85 2 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 2 ❑ Other Over 1000 amps or volts $454.65 • 2 Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY Installation, alteration, or relocation Fee for each system $75.00 200 amps or less $66.85 2 (SEE OAR 918-260 -260) . 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved: / Over 600 amps to 1000 volts, see "b" above. 1Z1 Audio and Stereo Systems Branch Circuits Boiler Controls New, alteration or extension per panel a) The fee for branch circuits with purchase of service or n Clock Systems \ feeder fee. Each branch circuit toy $6.65 y�'1a. q c 2 VI Data Telecommunication Installa Ion b) The fee for branch circuits without purchase of service ❑ Fire Alarm Installat n or feeder fee. First branch circuit $46.85 Each additional branch circuit $6.65 n HVAC Miscellaneous ❑ Instrumentation (Service or feeder not included) Each pump or irrigation circle $53.40 ❑ Intercom and Paging Sy ems Each sign or outline lighting $53.40 Signal circuit(s) or a limited energy panel, alteration or extension Z $75.00 /52,2_011 Dn ❑ Landscape Irrigation 4 ntr I Minor Labels (10) $120.00 ❑ Medical Each additional inspection over the allowable in any of the above ❑ Nurse Calls Per inspection $62.50 Per hour $62.50 In Plant $73.75 ❑ Outdoor Lands - •e Lighting Fees: �❑-I I Protective Sig .t ling S' Enter total of above fees c2 , a5 $ 2 i ' I Other 8% State Surcharge / ' ' 3 ? $ —lSlA Number of Systems 25% Plan Review Fee See "Plan Review" section on $ No licenses are re. fired. Licenses are required for all of er installations front of application. Fees: Total Balance Due 4, 56/. 0 $ Enter total of - • ove fees $ s v ❑ Trust Account # 8% State S charge • $ - T) Total Ba ance Due $ e . , ' " " i:\dststfonns\elc- fees.doc 10/09/00 • bITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 / BUP Date Requested l b AM PM ✓ BLD Location / 35 (g 21-1--- Suite MEC Contact Person Ph PLM Contractor - j-. c T L/ 4 /.� i C Ph SWR d BUILDING Tenant/Owner � ELC 4U/ e / 3 Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: S SX Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear / ,n Framing SC 0 Insulation Drywall Nailing C � F //z C 7v ��� p Firewall Fire. Sprinkler 0-0 7 es! t ff Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING .1---e1,42() ppc 64, Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains , Final y PASS PART FAIL MECHANICAL ^ Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm PART FAIL Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk / /R / / r'i 6 t t Ext Other Date h 6 t Inspector Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.