Permit v CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit# ELC2012 -00542
Date Issued 09/18/2012
T
WARD. 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Parcel 1 S 136DC04500
Jurisdiction Tigard
, . Site address 7501 SW DARTMOUTH ST 100
Project Winco Subdivision 1995 -013 PARTITION PLAT Lot 2
Project Description (6) branch circuits for recycle machine
Contractor PRAIRIE ELECTRIC INC Owner WINCO FOOD LLC
6000 NE 88TH ST ATTN TAX DEPARTMENT
VANCOUVER, WA 98665 PO BOX 5756
BOISE, ID 83705
PHONE 800 - 573 -2750 PHONE
FAX 360 - 573 -9866
FEES
Quantity Description Date Amount
6 crt Branch Circuits wo /Purchase 09/18/2012 $93 28
Specifics: Service or Feeder
1 ea 12% State Surcharge - 09/18/2012 $11 19
Type of Use COM Electrical
Class of Work ALT
Type of Const
Occupancy Grp
Total $104 47
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes-and all other applicable law 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 the 180
days ATTENTION Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
952- 001 -0010 through OA' 95 - 001 -0090 You may obtain a copy of the rules or direct questions to OUNC by calling 503 232 1987 or 1 800 332 2344
Issued By , u Permittee Signature O& 19 PPu CA77 old,
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' Date
LICENSE NO
Call 503 639 4175 by 7 00 a m for the next available inspection date
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
09/18/2012 12:12 FAX 360 573 9866 Prairie Electric Inc. Fj 001/002 - s-L, 4 V '
Electrical Permit Appli 6
xl r
D FOR OFFICE USE ONLY
�
1 _ . a u.' Receved
City of Tigard 8 Re e iv 4b cr l�,°1 Permit No LG LCao /a- AbS
II n 13125 SW Hall Blvd , Tigard, OR�-7 131 8 2012 Plan Review Other Permit
a • Phone 503 718 2439 Fax 503 398 1960 Date/B
T 1 G A RD Inspection Line 503 639 4175 C, •' T, c ' Data Ready/13y EMI 0 See Page 2 for
Internet www ttgard -or gov 11 d I k-31 I i - -' " '- 10 Notified/Method Supplemental Information
X " r;.s1 -
, t4 , •y:I 5s. 1lirr ... � •..+ ,,,. 1 .45 �!r •• i . .i : t w) 9 . 7 . ,I T. „r: w r. t r't ti
_ C4,.,.,.E�r� ,..� i...,y� � yn•1 - �iE �>"L'�- y L._:_:�r..._ h.��rr� ;�'I yii'.. r�7 !'�;. ,.. �� ��. ° � �1',.':��i- i��3ec.1" a;L:, :
..��- a. Fd°- -, I�, ...y .• , , i i �1 • ' r �'�i�ce! 41Fr�."_� -. ,. .:w • _ Please check all that apply (submit 2 sets o plans whiems checked below)
❑ New construction P,! Addition/alteration/replacement
❑ Service or feeder 400 amps or more ❑ Building over three stories
El Demolition ❑ Other where the available fault current ❑ Marinas and boatyards
- A.:1 ;1. v -A.: 'C,G�- ,= r, = W ' ' � 7 -� @ Otix'g T-7~ :4411.04-gal 7 exceeds 10,000 amps at 150 volts or ❑ Floating buildings
`n ti.... - Ck f u! RFd14E ' : i O r - :::• —a i. _+c7= .4 i L'L ..1.1 Fr'•=yr. - , .1111' ,, E=. = .q..a.•a' less to ground or exceeds 14,000
• •�• - 0 Commercial-use agricultural
❑ 1- and 2- family dwelling 17. Commercial /industrial El Accessory building amps for all other installations buildings
❑ Multi- family • Master builder (yl 1 1 Other ❑Fire pump ❑ Installation of 75 KVA or
r t _ _ , r � , L3 , ❑ Emergency system larger separately derived system
r, 61 -�r; _ S. -,-. '.N V,.. = -r, -. --, 4,, l - �: c r s ;= ,,, •> t, ❑ Addition of new motor load of ❑ ,. .. 2 .... 1 _ x ..
Job no i/`' � � �� u I ix oP or more ar ion
k
��7 ? I Job site address
❑ Six or more residential units Recreational vehicle parks
City /State/ZIP -1 O li q-7-7,..z3 ❑ Health-care facilities ❑ Supply voltage for more than
/ _ ❑ Hazardous locations 600 volts nominal
Suite/bldg /apt no / dQ Project name N� ,jD,s 0 Z3 ❑ Service or feeder 600 amps or inure
_ t
Cross street/directions to job site _ oeseiiption -"
Or). Pea I To[al I
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision I Lot no 1,000 sq ft or less 168 54 4
Ea add'I 500 sq ft or portion 33 92 1
Tax map /parcel no Limited energy, residential 7500 2
•;a,7 ,�.: , , , n_ ,,l �, g . it ;i,, 1IM =ii5 ' ; af -- :c'Afc• (with ft
7. r - l _,''_ iS- 1= 3T,� o _ 7 � '- W v J, , -- IL 1 '.--r-',4-1 �r or_,l� 1
( sq )
s ` -` {`c it "f Limited energy, multi- family
, C / U / 1 Wok g/L , V( - residential (with above sq fl ) 75 00 2
1r V . Services or feeders installation, alteration, and/or relocation
200 amps or less 100 70
i t , ,i ' - 1
• -1 - ,t :. " ,° " _ -_"-_- -� „= P r"`” t 9i tt-= • ^�;•` to 400 am s 201 amps p 133 56 2
�T d _ e 'i M E i 5•'� ,5
..y4 -_ = - r ' vr� '�_IP n___ '.ar}_ 4 - ^� 21, ' A 200 34 2
�� ' , _ : d me n s ' ._ ,,,��,. -, 401 amps to 600 amps 2
Name W M1 ' F O As 601 amps to 1,000 amps 301 04 2
Address Over 1,000 amps or volts 552 26 2
Temporary services or feeders installation, alteration, and /or
City/State/ZIP relocation
Phone ( ) I Fax ( ) 200 amps or less 59 36 1
201 amps to 400 amps 125 08 2
Owner installation: This installation is being made on property that I own which is not —
401 amps to 599 amps 168 54 2
intended for sale, lease, rent, or exchange, according to ORS 447. 449, 670, and 701
Branch circuits — new, alteration, or extension, per panel
Owner signature Date A Fee for branch circuits with
;, �,F ; ; "li p 7,: -'- _ _ e:.-^2.1 _ - 3_' , above service or feeder fee, 7 42 2
��w 71 z. It :- n ' n ?'L "tr -.. -- _ ° z- 4-N .!. 1� M° - i ` " + 1 each branch circuit
i •,..s r71«� Fb-G= - .7A i r_ 13 __ •_ ,�`+! !S!+ Q.... ^."-
Business name PRAIRIE ELECTRIC, INC. B Fee for branch circuits without
service or feeder fee first 56 18 0 118 2
Contact name ANITA PASO branch circuit
Each add'I branch circuit 7 42 '3 /0 2
Address 6000 NE 88 STREET M1Lscellaneous (service or feeder not included)
City/State/ZIP VANCOUVER, WA 98665 Each manufactured or modular
Ct 67 84 2
ty dwelling, service and/or feeder
Phone ( ) 503286.9209 I Fax (360) 573.9866 Reconnect only 67 84 2
Pump or imgation circle 67 84 2
E - mail. anitap@. prairielectric.com Sign or outline lighting 67 84 2
l.s�r'. ! e t i '-a5- „,,,im- Q � fi •n i . ,,.. ,9;;�. , ' r 5 ..1 .. ."=' S ignalctrcmt(s)orlimited-energy
Business name PRAIRIE ELECTRIC, INC. panel, alteration, or extension _ Page 2 2
Each additional inspection over allowable in any of the above
Address 6000 NE 88 STREET Additional inspection (1 hr min) 66 25/ hr
City/State/ZIP Investigation (1 hr mm) 66 25/ hr
ity/State/ZIP VANCOUVER, WA 98665
Industnal plant (1 hr mm) 78 18/ hr
Phone ( ) 503.286.9209 Fax (360) 573.9866 Inspections for which no fee is 90 00/ hr
specifically listed ('h hr nun) _
CCB Lic 60178 Electrical Lic 3 491 C Su c 2 '= ��;)t,'If 'f10../O:.;�TE&N ,'r; rF =r =1 = ' 1i
Subtotal
Supry Electrician signature, required
Plan review (25% of permit fee)
Print name. BILL HALBERG Date 1 /8, /Z^ State surcharge (12% of permit fee) 1 ft
TOTAL PERMIT FEE a r
Authorized signature --
g This permit application expires if a permit is not obtained ithr 180 •
Print item I Date days after it has been accepted as complete • OMANI I Num alto 40. 03udd,ngP L v01 as /CO 40 4 ! I �� l • ,