Permit CITY OF TIGAR® � ELECTRICAL PERMIT
.---- ' PERMIT #: ELC2004 -00520
- — D EVELOPMENT SERVICES DATE ISSUED: 8/18/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S126C0 -01403
SITE ADDRESS: 09300 SW WASHINGTON SQUARE RD
SUBDIVISION: ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: Install outlets in Dockers area.
Job # 81458.
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:
MAY DEPT STORES COMPANY, THE OREGON ELECTRIC CONST /GROUP
ATTN: PROPERTY TAX DEPT 1010 SE 11TH AVE
611 OLIVE STREET PORTLAND, OR 97214
ST LOUIS, MO 63101
Phone: 314 - 342 -6227 Phone: 503 - 234 -9900
Reg #: L1C 203
SUP 4460S
FEES ELE 26 -95C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit • 8/18/2004 $53.50
[TAX] 8% State Surcharge 8/18/2004 $4.28 Rough -
Elect'l Final
Total $57.78
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: - 2 ,l 11 7 Permit Signature: SX,I.., p/ T T
OWNER INSTALLATION ONLY 11
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 639 -4175 by 7:00pm for an inspection the next business day
AU6717 -04 12 :47PM FROM - Oregon Electri tine
` 5032313587 T -127 P.001 /002 F -113
' c -- .)
Electrical-permit A i x FOR OFFICE
Received q ,r-✓ pertnitNor✓ _
City of Tigard �± 1 'L0 - -
13125 SW Hall Blvd., Tigard, OR. 97223 p u(j Plan Review OtherPemdt
11‘.1^, ' �. i
A ,,,,,:s Date/8v:
Phone: 503,639.417 Fax: 503.598.1960 Date Ready /By, irk 0 sec Paze 2 for
inspection Line: 503.6394175 I 1 ' D\V -- Notified/Method: C L sappleme Information -
Internet: www.ci.Ggard.or.us - PLAN RE VIEW
TYPE or WORK .� _ • • .
Please check all that apply:
0 New construction ®AdditiONalteration /replacement ❑Service over 225 amps, comm'I DHazardous location
Other: ❑Service over 320 amps - rating ❑Buildng over 10,000 sq. ft.,
Demolition ❑ . - of 1 and 2-family dwellings 4 OT more new residential
CA Y OF CONSTRU�CIIUN ❑System over 600 volts normnal units in one structure
❑ 1- and 2- family dwelling E Commercial /industrial ❑ Accessory bu ❑Building over three stories ❑Feeders, 400 amps or more
❑ Multi - family ❑ Master builder ❑ Other: ❑Occupant load over 99 persons ❑Manufactured structures or
E
• • JOB..$1tE!IN ' AP1DI LOCATION • • . ❑ slli n f ng plan RV park • • ['Other.
facility
Job no.: 81458 Job site address: 9300 SW Washington Square Rd Submit 2 sets of plans with any of the above.
The above are not applicable to temporary construction service.
City/Stale/ZIP: Tigard, OR 97223 ' • FEE* SCHEDULE
Suite/bldg./apt. no.: Proj name: Meier and Frank peacrtpnoa I Qry _� Rem. I Total l ••
-
New residential single or multi- family dwelling unit.
Cross street/directions to job site: _ Includes attached garage-
' 1,000 sq. ft. or less 145.15 4
Subdivision: l Lot no.: Ea. add'1500 s9 ft. or portion 33 40 1 _ Limited energy, residential 75.00 2
_
Tax map /parcel no.: Limited energy, non - residential 75.00 — 2 -
. ' i ; DE SCRIPTION OP W,¢1tK Each manufactured or modular 2
- dwellir, service and/or feeder 90.90
Install outlets in Dockers area. Services or feeders installation, alteration, and/or relocation _
200 amps or less 8 0.30 2
201 amps to 400 amps 106 85 2
❑ PROPERTY OWNER T EN 401 amps to 600 amps - 160.60 , 2 _
4/,5b•--4? / s 601 amps to 1 amps 2 40.60 2
Name: r 454.65 2
- Over 1 , 0 00 amps orvohs
- Address: - Reconnect only 66.85 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
t�3) f j i oZb - •-• i ( I Fax: ( ) . 200 amps or less 66.85 1
Owner installation: This installation is being made on property amps to 400 a mps 100.30 2
that 1 own which is not 133.75 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
I ❑ 'CONTACT• PERSON A. Fee for branch circuits with
❑ APPLICANT I ; service or feeder fee, each 6.65 2
branch circuit _ _ -
Business name: B. Fee for branch circuits / �!
Contact name: withoru service or feeder fee, ) 46.85 I %& g �1
each branch circuit
Address: Each add'l branch circuit 6.65 (p -G
Miscellaneous (service or feeder not included)
City/State/ZIP: pump or irrigation circle 53.40 2
Phone: ( ) I Fax: : ( ) Sign or outline lighting , 53.40 2 -
E -matt Signal circuits) or limited -
OR • ' energy panel, alteration, or
_ CONTRAC'[' extension. Describe: Page 2 2
Business name: Oregon Electric Group
Each additional inspection over allowable in any of the above
Address: 1010 SE 11th Ave _Per inspection 62
Ts* City /State/ZIP: Portland, OR 97214 Investigation per hour (1 nr ruin) 622.90
s , _ Industrial plant per hour 73.75
9,- Phone: (503) 535 -2652 Fax: (503) 231 -3587 ELECTRICAL PER11Ia.. FEES*
CCB Lic_: 203 I Electrical _ r • " -9 upfv. Lic_: 44605 Subtotal , SCj
Plan review (25% of permit fee)
Suprv. Electrician signature, required _ L /
/ Stoic aurchor ( 8% of permit fcc) ! `� •�
Print name: — /f�JG I Date ��� TOTAL PERMIT FEE `7
Tide pern>:t application expires If a permit is not obtained win tau
Authorized signature: ��
/ _ days after it has beta accepted as complete
• Print name: d .�iV f7-. `-!/ L /� ` Date: I/ 7 ' Fee methodology act by Tri- ty Building Induany Service Board
c--- .• Number of inspections per permit allowed.
i• �aullding\PcmlimBLC- PcrmuAppdoc 12/03 440-46151110i0 440-46151110i0 COtww coun
5a
CITY OF TIGARD 24 -Hour
BUILDING Inspection..Lirt (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
c BUP
Received Date Requested 0 ' Z� AM PM BUP
. Location C V)0 1 -0 I' • S a Suite MEC
ontactrl?erson Ph ( ) ( A 9 - S R PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner Q P j' ELC 00� - 005 D-
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain /_
Slab Inspection Notes: �..- SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing 1
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
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 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SI Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line 4;'z ADA Approach/Sidewalk Other: Date f r 22 ' O Inspector 44 Ext
y - �
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL