Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00280
DEVELOPMENT SERVICES DATE ISSUED: 5/18/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 2 S 112A D - 00900
SITE ADDRESS: 14800 SW SEQUOIA PKWY ZONING: I - P
SUBDIVISION: LOT : JURISDICTION: TIG
Project Description: 1 branch circuit to coffee kiosk.
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: 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:
HOME DEPOT USA INC ALL THINGS ELECTRICAL INC
BY MARSHALL + STEVENS INC 10004 NE 7TH ST
ATTN: MELISSA SHAPIRO • VANCOUVER, WA 98664
PHILADELPHIA, PA 19103
Phone: Contact #: PRI 360 - 604 - 0241
FAX 360 - 604 -3025
FEES
Description Date Amount Reg #: ELE 37 -81 IC
[ELPRMT] ELC Permit 5/18/2006 $46.85 LIC 132095
[ELPLCK] ELC Pln Rev 5/18/2006 $3.74 SUP 4665S
Total $50.59 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: r� Permittee Signature: '7-y✓_
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.
.
W 05/17106 09s93P P.002
.
Electrical Permit Application FOR 01.1:I( 1.: t til: U
City of Tigard E IV ED Received /
13125 SW Hall Blvd., Tigard, OR 97223 Dan „e /� /DLO 6' Permit N. _ gp6,�"pay0
�..,,
Other Permit:
Phone; 503.639,4171 Fax; 503.598.1960 � ' I Daidfiy:
1
Inspection Line: 503.639.4175 MM 1. 8 2 J N L Dale Ready/By. t al See Paget for
Internet: www.ci.tigard.or.us Notified/Method. -rib. Supplemental Information
'n'r1�13>sa' Ai�1a, A 9 Rf PLAN• REVI EW ' . .
• ❑ New 'construction AddIgiKlitga owreplacement Please check all that apply: ,
❑ Demolition Other: ['Service over 225 amps. comm'l ❑Wazardous location
❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.
CATEGORY OF CONSTRUCTION • • of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2 family dwelling pil Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
['Building over three stories ❑Fccders, 400 amps or more
❑ Multi family ❑ Master builder ❑Other;
❑Occupant loud over 99 persons ['Manufactured structures or
• • " • 3013 SITE INFORMATION AND LOCATION • ❑Egess/lightingplan • RV park
Job no.: I Job sift address_11�, S ) vo P K wi( ❑1•1eallh -care facility ❑der:
}-- S ubmit 2 sets of plans with any of the above.
City/State/ZIP: Tyt rti • O R The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: 1 Project name: Fl --b,,,F,,„A- T.
Pe.:Alo a 1 Ory. 1 Fee. 1 Tad
Cross street/directions to job site: New residential tingle- or multifamily dwelling unit.
- - Includes attached garage.
1,000 sq. It or less • • 145.15 ' 4
Subdivision: I Lot n0.: Ea. add'I 500 sq. f, 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
• . 15 u.k1 1 c CUL ‘4 "C� Go ce-c 1 G l i O s k . . dwelling, service and/or feeder 90.90 2
T f l Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
• ❑ PROPERTY OWNER .. • • • I 17 TENANT 201 amps to 400 am 106.85 2
401 amps to 600 amps 160.60 2
Name: " . 601 amps to 1,000 amps 240.60 2
Address: • :Over 1.000 amps or volts 454.65 2
- Reconnect only 66,85 2
City /State/ZIP: Temporary services or feeders installation, alteration, and/or
Phone: ( ) • l Fax: ( ) _ relocation
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 salt,• 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...JRSON A Pee for branch circuits with
service or feeder fee, each
6.65 2
Business namc: - • branch circuit
B. Foci for branch circuits
Contact namc: without service or feeder fee. 1 46,8s 4i±o x5 2
each branch circuit
Address: ��� " Each add'I branch circuit 6.65 2
City /StatcfZlP: Miscellaneous (service or feeder not Included)
Phone: ( ) 1 F - ( ) Pump or irrigation circle 53.40 2
1 -- Sign or outline lighting 53.40 2
E - mail: Signal circuits) or limited.
CONTRACTOR' energy panel, alteration, or
(�` —1-\(-\\, I extension. Describe: Page 2 2
Business name: P 1\ le (L.' t C t -T) c ,_
Address: i 6 + •
Each additional inspection over allowable in any of the above _
—fl r Per inspection 62.50
City /State, ZIP: \,( () 1 ,\j (Ai qg j 4 Investigation per hour (1 hr min) 62.50
Phone: (A) (C)),.1 o - 4i I Fax: ( ad) coati 3 6a3-- Industrial plant per hour • 73.75
1 ELECTRICAL PERMIT F E E S. . . . . .
CCB Lie.: 1' Electrical Lie.: 3 _g 11 G Suprv. I.ic.: ` t 1065 S Subtotal t g 5
SLIM. Electrician signature, req ., ��. Plan review (7.5% of permit fec) CA
Print name: w; L' W W.
{ l. ;.e I s , Nate' I (1 I () State surcharge (11% of permit fee) 3. 7 df
n t TOTAL PERMIT FEE 60, 51
Authorized signature: ` (.,,_". t ,e2 This permit application expires Ifs permit Is not obtained within ISO
N days after It has been accepted as complete
Print naMe' "" `� y, 1 e-1 t S Date_ r) 5) wn
� - Jo t . r Fee methooet by Tty Building Industry Service Board
Number's! of inspecion, per permit allowed.
i :Mines egPem ,itaVILC- PemtiIAppatuc 12/03 440.4015T(iAl02/COM,WID
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006 -00280
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 5/18/2006
Phone: (503) 639 -4171 dow t i I
Inspection Requests (24 Hrs.): (503) 639 -4175 .. +L F'-.
INSPECTION WORKSHEET FOR DATE: 8/7/2006 TIME: 7:02AM PAGE: 60
SITE ADDRESS: 14800 SW SEQUOIA PKWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: HOME DEPOT
DESCRIPTION: 1 branch circuit to coffee kiosk.
OWNER: HOME DEPOT USA INC, PHONE #:
CONTRACTOR: ALL THINGS ELECTRICAL INC PHONE #: 360 - 604 -0741
Inspection Request Scheduled For: Date: 8/7/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
198 Electrical final 034457 -01 503-572-6017 N
Corrections /Comments/ Instructions:
toQie WZNA) la cz.D.AD s ‘o 101 1\41... $
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[ PASS TIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
. Inspector: G� 1V Date: 10 - 1 - 1 56 Phone #: (503) 718- 2446
CITY OF TIGARD
BUILDING DIVISION PERMIT #: aC2Q 02 O
13125 SW,Hall Blvd., Tigard, OR 97223 DATE ISSUED: .iat 0G
Phone: (503) 639-4171 heitp
Inspection Requests (24 Hrs.): (503) 639 -4175 A.141%. ;1
INSPECTION WORKSHEET FOR DATE: (:1112006 TIME: 7:0 AM PAGE:
ADDRESS: - 1.1f1()() SW <:;1 :-O•U.)Oi: 1: :=K' y CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE: •
PROJECT NAME: HOME DEPOT
DESCRIPTION: "l L • ^ =oth c:9 coft'nri
OWNER: I - INC, PHONE #:
CONTRACTOR: AI_I.ililN'VS E:! EC:t'°?lCA[.INC PHONE #:
Inspection Request Scheduled For: Date: €R 12.000, Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections/Comments/Instructions:
•
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•
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
; v
)FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
n, �
Inspector: 1 ) Date: 6 -1 ~e Phone #: (503) 718- 2441
•