Permit CITY OF TIGARD
ELECTRICAL PERMIT
4 114 , �i DEVELOPMENT SERVI PERMIIS*: ELC9B-0072B
PARCEL: 1S126C0 -01109
SITE ADDRESS...:O95O0 SW WASHINGTON SQUARE RD
SUBDIVISION ZONING:C —G
BLOCK LOT JURISDICTION: TIG
Project Description : Add a first branch circuit for the optical department at
J. C. Penny's.
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS - 0 0 — 200 amp ° 0 PUMP /IRRIGATION ° 0
EACH ADD'L 500SF...: 0 201 — 400 amp - 0 SIGN /OUT LINE LTG..: 0
LIMITED ENERGY - 0 401 — 600 amp ° 0 SIGNAL /PANEL - 0
MANF. HM/ SVC /FDR..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (10)...: 0
- - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- -
0 — 200 amp ° 0 W /SERVICE OR FEEDER: 0 PER INSPECTION ° 0
201 — 400 amp : 0 1st W/O SRVC OR FDR.: 1 PER HOUR : 0
401 — 600 amp : 0 EA ADD'L BRNCH CIRC: 0 IN PLANT ° 0
601 — 1000 amp ° 0 PLAN REVIEW SECTION
1000+ amp /volt - 0 ) =4 RES UNITS > 600 VOLT NOMINAL..:
Reconnect only : 0 SVC /FDR )= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: FEES
J. C. PENNY' S type amount by date recpt
9500 SW WASHINGTON SQUARE ROAD PRMT $ 35.00 GEO 02/13/98 98- 303285
TIGARD OR 97223 5PCT $ 1.75 GEO 02/13/98 98- 303285
Phone #:
Contractor:
OREGON ELECT CONSTRCTN /GRP INC $ 36.75 TOTAL
1010 SE 11TH
REQUI RED INSPECTIONS
PORTLAND OR 97214 Ceiling Cover Underground Cove
Phone #: 234 -9900 Wall Cover Elect'1 Service
Reg #.. : 0026 -9
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001-0010 through OAR 952-001-1987. You may obtain a copy
of these rules or direct questions to OUNC by calling ( -1987. ///
V
Permittee Signature: Issued By° /r �,%
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: -13-1,3
LICENSE NO: / 'd S
G F�/
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next hi,siness Hay
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
i
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # 6 z-c - �l 7., a0, IA
Date Issued
,TII Phone (503) 639 -4171
FAX (503) 684 -7297 / -a)
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development , J - � • e- ♦1y )S Number of Inspections per permit allowed
i.
Address g500 5IAJ A5 k I n3--(-11%_)
W . ICG► • Service included. Items Cost(ea) Sum
City /State /Zip'�0 I - ha. 0 q1 12 4a. Residential - per unit
1000 sq. ft. or less $110 00 4
Name (or name of business) Each additional 500 sq ft or
-,/ portion thereof $25 00 1
Commercial I �I Residential El Limited Energy $25 00
Each Maned Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
•
• Electrical Contractor r • I ' lc. 0 0 Installation, alteration, or relocation $60.00 2
Addres I , 3 . le � •' ri 20 amps or less p $80 00 2
201 amps to 400 amps
4 01 amps to 600 amps
$120 00 2
City Ilia_ a S ate a, Zip 7PICir $180 00 2
Phone No. ( 4 S •-0 ( 7 34 601 amps to 1000 amps
Over 1000 amps or volts $340 00 2
Job NO. 9 4' I S _ Reconnect only $50 00 2
contractor's license NO. at —4c-C. 4c. Temporary Services or Feeders
Contractor's Board Reg. No, . .1 Installation, alteration, or relocation 2
Signature of Sur. Elec'n " / /, PI 200 amps or less 2
Li' 201 amps to 400 amps $50 00
License No. / Phone NO. L � -d 201
amps to 600 amps $75 00 2
Over 600 amps to 1000 volts $100.00
2b. For owner installations: see „b„ above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane
Address a) The fee for branch circuits with
purchase of service or feeder fee. 2
City State Zip Each branch circuit $5.00
Phone No. b) The fee for branch circuits withou
The installation is being made on property I own which is purchase of service or feeder fee. 2 2
not intended for sale, lease or rent. Eddch C - $$5 00 �5 . t�
Eaacc h a additional b l branch urcuit $5 00
Owner's Signature 4e. Miscellaneous
(Service or feeder not Included) 2
•
3. Plan Review section (if required Each pump or imgation circle $a0 00 2
Each sign or outline lighting $40 00
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40.00
4 or more residential units in one structure Minor Labels (10) $100.00
Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.C. Chapter 5 Per inspection $35 00
Per hour $55 00
In Plant $55 00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
5a. Enter total of above fees
--`-
NOTICE $
5% Surcharge (.05 X total fees) $ 4 )
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. wordlcomdeWeiec- ❑ Trust Account #
prm app $ ___—
Balance Due $ 3(0.75
�,• . ,. ,., j . '+ r , r=: , r,� : xX:y =ter rr: �, /.
!,
•
•
RECEIVED,
FEB 091998
COP1MUP■11TY DEVELOPMEfv7
0927 00//C
3 -.M
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested:
ji,.. 3 A.M. P.M._______ MST:
Location: ( "75DO 'L( ) 60asilk 4 / 4 ( .R BUP:
Tenant: V C 1. i f J Suite: Bldg: MEC:
i
Contractor: _ / 1■1_� _ " Phone: 6 �hi- �73 PLM:
Owner: Phone: r ELC: g6 0--
_IMr4g 1 . rl _ v ' t / i OK. ELR:
I / SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL omwrraTgo SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Ahn Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved Not A 0 'roved Not Approved
FINAL FINAL FINAL IN -1 FINAL
�- J. T LIU : 6t" 0 a I ..
W115 - 01?-3
6 - .1 k , s ID - ' , �! s
n44 Q _ GAS
P ,' /Pe - . .. ii
SO-
O Call for reinspection O Reinspection fee of $ required before ne inspection O Unable to inspect
Inspector: Date: Page of