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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2006 -00384 DEVELOPMENT SERVICES DATE ISSUED: 7/12/2006 4J1. 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2 S 103 D D -0 0800 SITE ADDRESS: 13815 SW PACIFIC HWY 100 ZONING: C -G SUBDIVISION: LOT : JURISDICTION: TIG Project Description: (1) 200 amp service, (10) branch circuits. Job # 14780. 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: 10 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: D.W. SIVERS COMPANY ATLAS ELECTRICAL CONTRACTORS 4730 SW MACADAM AVE 4403 SE ROETHE RD #101 MILWAUKIE, OR 97267 PORTLAND„ OR 97201 Phone: Contact #: FAX 659 - 4944 PRI 659 -2212 FEES Description Date Amount Reg #: ELE 3 - [ELPRMT] ELC Permit 7/12/2006 $146.80 LIC 1532 [TAX] 8% State Surcharge 7/12/2006 $11.74 SUP 25815 Total $158.54 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: : 11 . 4 - Permittee Signature: sp \()\ 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. ATLAS ELECTRICAL Fax:5036594944 Jul 12 2006 9:58 P.02 ` FOR OFFICE USE ONLY E�ectJricai Permit Auplicatiou G City of Tigard G`v G 0 Received D )14 Permit T.o.: ( k O iy g E / 13125 SW Hall Blvd., Tigard, OR 97 .. Pia» MAW Other Pertni i . Phone: 503.639.4171 Fax: 503.598. ' ��Q 'elf ; I ii �' Date/By; Inspection Line: 503.639.4175 Jv � 1 ,11. L. ' Date ReadyBY: kris) fj i ri Hi Bee Page 2 for Internet: w.ci.tigard.or.us P A • Nod6ed/ fethod: � supplemental 6dormatioo wtv . -. . ,..:•.. — v .Ili `,�, r , � . . • h*` , ;fir . ��:. , i.:,.r.•, ,:u r °ne ,; ? :: • •:•.L. $.. •At,41,: ;:;•_ ',: ri:i.. , �...;•: =,i;�: _ .. y" :.riff' 4' . .. .. ' " .., �..,.. ., , .. ... ..� . �� ,'j.'.. .a .. . .•.,.,,.. , a� ��,: .. �'li- t' ._ '•r�TC . t:ir i., . ,. 1 c �� � o .. ' •- ! � �l'.,� -. �.. i ....... .... ...... . ... . - �' ;� i i i _`� ::• . ... •: .. - El ew construction J [j A• • ` t r. ; teration/replacennent I y Please check all that apply: :: N ❑Service over 225 amps, comm'l I❑liazardous location ❑ Demolition ❑ Other: ❑Service over 320 s — rating 1 ❑Buildng ova 10,000 sq. ft, . > •.<•:.: r 1;1;: :•' " 1 : , : -'• `. `;•••°;: •°• " ''' and 2-family w e in - t1 `.t.f {� F. • • •. . . : " .. = .� : ro!� •, Y:F,E�e� �'ti G • - ci' ..,�..:a J � i �i .... .... .. .. oft- dwellings 4 or more new residential {.. . v: , • , ° a units in one Unice= ❑System over 600 volts nominal In 1- arid 2 - family dwelling ® Commercial /industrial ❑ Accessory building D13uilding over three stories E ❑Feeders, 400 amps or more ❑ Multi- family ❑ M ild ❑Occupant load over 99 persons t ❑M ;,::.. ;. builder El r:;lr.: ". ;••,•... R vnpf�ct u red structures or ' „ �� plan t : „ e �uia:r` ❑ th tgho ❑ ea -care cility ! ❑Other 14780 Job site r Submit 2 sets of plans with any of The above. City/State/ZIP! Tigard Or -. The above are not applicable to temporary construction service. I1'I. 4 li jibl•1• • 2 Y!!i !14 4�c�:�tt"', J • .. • • • - . - • - Description ( Qty. I Fes ... Tosal I .. Cross street/directions to job site: • New residential single- or multi -f mity dwelling unit. Includes attached garage. 1,000 sq. ft. dr less S 145.15 . 4 Ea. add'! 500 sq. R. or portion i 33.40 - 1 Subdivision: Limited energy, residential ! 75.00 2 Tax map/parcel no.: a u ; Nt ;z, Limited energy, non-residential f 75.00 2 , ^ n ' d-.' ' a . r, , t ; ,c Each manufactured or modular °'�au�«,1,� .. ". • , ! f � �, `: Jtrt .: .'r. i . )sal . -i•'��ii dwellinfl, service and/or feeder t 90.90 2 ElectriCal for Services or feeders installation, alteration, and/or relocation 200 amps or less ; 1 80.30 SO. 30 2 _ 201 amps to 400 amps 106.85 2 e at: ' e ` 401 amps woo corps 160.60 2 • Name: 601 amps to 1,000 amps 240.60 2 caarfie Par•i fi r• DPI& Address: • 13815 Pacific Hwy Over 1,000 amps or volts i 454.65 _ 2 Reconnect only I 66.85 _ 2 City /State/ZIP: Tigard, Oregon 97223 Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) 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 ` 2 Owner signature: Date: Branch circuits — new, alteration', or estenslon, per panel ..... -• :, • • • • .,,> ::.::..:: . y; .1,'::, ft' ::< A. Fee for branch circuits with • ., " ', • :.:.. . : ; " ; z ;'r .. � = S . o..,.., service Or feeder fee. each 6.65 2 • Business name: Atlas Electrical Contractors, Inc. O 66.50 branch circuit B. Fee for branch circuits Contact name: Ty Sheperaky without service or feeder fee, 46.85 2 • each branch circuit Address: 4403 • SE Roethe Road Each add'I branch circuit l' • • 6.65 2 /5 �� Miscellaneous (service or feeder' ntit Included) Mi lwaukie, Qreaon • 7267 • + Pump or irrigation circle 53.40 2 Phone; ( 503 )659 -2212 Fax: : ( 503) 659 -4944 Sign or outline lighting 53.40 2 _ - E - mail: Signal circuit(s) or li mited - # ��,. "_�;,: ; _ r u r; 1;^ "; Pi::a p Y 2 ■ ener panel, alteration, or ,....} ,.. a Y�.,'1e1 'i�1 gTi Pia { r -1 ;1 • ; V ':5•�:, =! r e ._" 1 "r�." '�A '' Fe�il`: _'.I[Fl!1..:el:•':1+1 �': VA' � :Y:.:i ` Page 2 2 • ,. . +R:, rn i , � li5 < � exten DeSCrlbe• Business name: M El pot -i ran rnnt tart nrG , Tnr• Each additional inspection over allowable in any of the above - Address: 4403 SE 'Roethe Road Per inspection i ' 62,50 ' City /State/ZIP: Milwaukie, Oregon 97267 investigation per hour (1 hr min) I 62.50 Industrial plant per hour f 73.75 Phone: 503) 659 -2212 1 Fax: ( 503 )659 -4944 :,.r:510t' • -r;?; P,• t. *b,. �',.. CCB Lic.; 1532 Electrical Lic.: 3 -2C Suprv. Lic.: 50O9S i Subtotal _ 146 130 Suprv. Electrician signature, required: likelle.44,4 Plan review (25°/o'Af permit fee) • State surcharge (8% - .)f permit fee) 1 1 - 74 Print name: Ty Shepersky Date: 7/12/06 TOTAL PPRM11' FEE 158.54 i Authorized signature: . joti Ti to pe rmit ap plication eiplres if a permit is not obtained within 130 days after it has been Accepted as complete Print name: Ty Shepersky 'Date: 7/12/06 - Fee methodology set by'lfi•County!.Buildiag Industry Service Board — s. Number of inspections per permit allowed. iABu0dinePernwsl6c .GPennitAppdoe 12101 . 44046151110/O2/GOM/WEB _. .... • 1 CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2006 00304 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/12/2006 Phone: (503) 639 -4171 Ham Inspection Requests (24 Hrs.): (503) 639 -4175 . -_ —_ I INSPECTION WORKSHEET FOR DATE: 10/9/2006 TIME: 7:01AM PAGE: 66 SITE ADDRESS: 13815 SW PACIFIC HWY 100 CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: PETRONE DELI /LOTTERY DESCRIPTION: (1) 200 amp service, (10) branch circuits. Job # 14780. OWNER: SIVERS COMPANY, D.W. PHONE #: CONTRACTOR: ATLAS ELECTRICAL CONTRACTORS PHONE #: 659.22.12 Inspection Request Scheduled For: Date: 10/9/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 037778 -01 503-901-6923 N Corrections /Comments /Instructions: t 1 0 , IA C , )1 A I b r 7 \,) ..- - 1APASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: \3 4 Date: ■ / b Phone #: (503) 718 1 CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC200 &00384 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/17/2006 Phone: (503) 639 -4171 o- t I � I Inspection Requests (24 Hrs.): (503) 639 -4175 F. INSPECTION WORKSHEET FOR DATE: 6/23/2006 TIME: 7:03AM PAGE: 64 SITE ADDRESS: 13815 SW PACIFIC HWY 100 CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: PETRONE DELI /LOTTERY DESCRIPTION: (1) 200 amp service, (10) branch circuits. Job # 14780. OWNER: SIVERS COMPANY, D.W. PHONE #: CONTRACTOR: ATLAS ELECTRICAL CONTRACTORS PHONE #: 65L.2212 Inspection Request Scheduled For: Date: 8/23/2006 Pour Time: e # Inspec cription Confirm # Contact # Message 130 Ceiling cover 035414 -01 503- 901 -6923 Y Corrections /Comments /Instructions: 1z--k L Ilk 2 t� 1 J :PkAtni tom P ►i \j L o • s o a . Pc<N L. \ ‘ S ‘-e i c...< kw RANI PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ' N 6b Date: )" 23 ' 0 Phone #: (503) 718- 2s440 CITY OF TIGARD ._ • - • BUILDING DIVISION PERMIT #: ELC2006 -00384 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/12/2006 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 8/17/20()6 TIME: 7:01AM PAGE: 44 SITE ADDRESS: 13815 SW PACIFIC HWY 100 CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: PETRONE DELIILOTTERY DESCRIPTION: (1) 200 amp service, (10) branch circuits. Job # 14780. OWNER: SIVERS COMPANY, D.W. PHONE #: CONTRACTOR: ATLAS ELECTRICAL CONTRACTORS PHONE #: 659-2212 Inspection Request Scheduled For: Date: 8/17/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 115 Electrical service 035158 -01 503-901 -6923 N Corrections/Comments/Instructions: 1 r 0E G-rtz of.)b t-01.11t J `Pt wg#N 6Revzor vra, 7..co eco irk • 16 • I L% .:'i:,( V e% N M� 1 ,L p ► iN 5 ) CUYA1 PER A fair V ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS X FAIL CALL FOR INSPECTION XADDITIONAL FEES ASSESSED Inspector: &A R., N 66 Lite. Date: D 4 1 • C Phone #: (503) 718- 1-446 CITY OF TIGARD _ . - -. BUILDING DIVISION #: ELC2006 -00384 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 7/12/2006 Phone: (503) 639 -4171 (1 Inspection Requests (24 Hrs.): (503) 639 -4175 I �.. INSPECTION WORKSHEET FOR DATE: 8/16/2006 TIME: 7:05AM PAGE: 83 SITE ADDRESS: 13815 SW PACIFIC HWY 100 CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: PETRONE DELI /LOTTERY DESCRIPTION: (1) 200 amp service, (10) branch circuits. Job # 14780. OWNER: SIVERS COMPANY, D.W. PHONE #: CONTRACTOR: ATLAS ELECTRICAL CONTRACTORS PHONE #: 659-2212 L r-1 c 5o3 9 •i -69 Z 3 Inspection Request Scheduled For: Date: 8/16/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 035016-01 503- 659.2212 N Corrections /Comments /Instructions: A IL. re Q 44 Of N 0 No sw; ,i_ r p6) y s i ti cio/ /e cl 0 On Q. I /e_ 9lo / } k ct Sec e c • t/ ` �_, ' S J i 1 0 yr cam. 4 d et u i ;&.$11--; `C< q 6 / G� 0 /VD elec,-1- -"cc l p 0_,,L -14,-, j -f (4r 4?-01 Q- / i//C ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS . AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED 7 Inspector: l Date: Q 4 ` 0 6 Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION . #: ELC2006 -00384 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 7/17J2006 Phone: (503) 639 -4171 1,. rrah' Inspection Requests (24 Hrs.): (503) 639 -4175 _'!'i "II.. INSPECTION WORKSHEET FOR DATE: 8/3/20138 TIME: 7:05AM PAGE: 61 SITE ADDRESS: 13815 SW PACIFIC HWY 100 CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: PETRONE DELI /LOTTERY DESCRIPTION: (1) 200 amp service, (10) branch circuits. Job # 14780. OWNER: SIVERS COMPANY, D.W. PHONE #: CONTRACTOR: ATLAS ELECTRICAL CONTRACTORS PHONE #: 659.2212 Inspection Request Scheduled For: Date: 8/3/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 115 Electrical service 034286-01 503 - 659-2212 N Corrections /Comments /Instructions: CO Pc ovrCs MAIN S yi ©I5 citAiTaZ17 Z. r 1it ' METER, 1...,6--t.„4 I csm , N I F - V64 SE9N i c.. c- c . ( w , 5 N ` NZ P Lbw ) t By 1 1-.04 . NZ.1 2 3q , I o (A) 0) ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS X FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G^ l V B Date: O - i j O O Phone #: (503) 718- 21 110 • O. CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2006 -00384 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/12/2006 Phone: (503) 639 -4171 :a�my i+l Inspection Requests (24 Hrs.): (503) 639 -4175 ^'f " INSPECTION WORKSHEET FOR DATE: 7/28/2006 TIME: 7:01AM PAGE: 34 SITE ADDRESS: 13815 SW PACIFIC HWY 100 CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: PETRONE DELI /LOTTERY DESCRIPTION: (1) 200 amp service, (10) branch circuits. Job # 14780. OWNER: SIVERS COMPANY, D.W. PHONE #: CONTRACTOR: ATLAS ELECTRICAL CONTRACTORS PHONE #: 659-2212 Inspection Request Scheduled For: Date: 7/28/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 115 Electrical service . 033975 -02 503-901-6923 N Corrections /Comments /Instructions: ❑ PASS ❑ PARTIAL APPROVAL ■ CANCEL JO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ' 3 DITIONAL FEES ASSESSED // `` Inspector: 1V % Date: 1 Z-- lib Phone #: (503) 718- __ I,.. , ,. CITY OF TIGARD BUILDING DIVISION , _ PERMIT #: ELC200G -00384 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/12p006 Phone: (503) 639 -4171 � "NINAi/It, Inspection Requests (24 Hrs.): (503) 639 -4175 W __.. INSPECTION WORKSHEET FOR DATE: 7/25/2006 TIME: 7:04AM PAGE: 30 SITE ADDRESS: 13815 SW PACIFIC HWY 100 CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: PETRONE DELI /LOTTERY DESCRIPTION: (1) 200 amp service, (10) branch circuits. Job # 14780. OWNER: SIVERS COMPANY, D.W. PHONE #: CONTRACTOR: ATLAS ELECTRICAL CONTRACTORS PHONE #: 659-2212 Inspection Request Scheduled For: Date: 7/255/7006 Pour Time: • - : Inspec • - Description Confirm # Contact # Message 125 Wall co er 033671 -01 503 -901 -6923 N Corre . • • • omments /Instructi • .:. PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED f Inspector: $ Date: 4 o4 Phone #: (503) 718- Milt-