Permit CITY OF TIGARD ELECTRICAL PERMIT
3 111 Permit #: ELC2013 -00424
2 COMMUNITY DEVELOPMENT Date Issued: 07/24/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: SEG860
Jurisdiction:
Site address: SW NO ADDRESS
Project: Walmart Subdivision: Lot:
Project Description: (1) 200 amp service and (3) branch circuits for new service at NW comer of Dartmouth St and 68 Ave.
Contractor: E C COMPANY Owner:
PO BOX 10286
PORTLAND, OR 97296
PHONE:
PHONE: 503 - 224 -3511
FAX: 503 - 295 -3012
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 07/24/2013 $100.70
Specifics: amps or less
3 crt Branch Circuits w /Purchase 07/24/2013 $22.26
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 07/24/2013 $14.76
Electrical
Type of Const:
Occupancy Grp:
Total $137.72
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 952- 0090. ou 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: GAJ /5'7°,4./6o
___ "` LLL
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 503.639.4176 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.
Jul. 19. 2013 2 : 47 PM No. 0941 P. 1
Electrical Permit ApplicatiRECEl VED roi, ()Fill F t. tit ONO
City of Tigard Received ; PermitNo.71? ,,3 . %
u 13125 SW Hall Blvd., Tigard, OR 9722g11.1 2 2 2013 _ 4- .
Plum R
' _ ' Phone: 503.718.2439 Fax: 503.598 DereB . °thcr lit �f=�� /,2 -' • I i A
T i c. r, rl Inspection Line: 503.639.4175 pp��C I OF TII Ready/By: GARD DalReady/By: B y: kris: Sae Page 2 for
Internet: www.tigard-or.gov BtJIQntNG 1 H,vISroN Notified/Method: 7- Supplemental Information
TYPE OF WORK c PL/►N REWEW :.
® New construction 0 Addition /alteration/replacement Please deed all that apply (submit a sea of plans w /items checked below):
❑ Demolition ❑ Other: ❑ Service or feeder 400 amps or more ❑ Bolding over three stories. •
what the available fault cwremt ❑ Marinas and boatyards. •
CATEGORY OF CONSTRUCTION . . exceeds 1 0,000 amps at I so volts or D Routing buildings.
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building less to r a l l o f or exceeds 14,000 ns ❑ Commercial-use agricultural
amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 150 KVA or i
JOB 'WIT I FOR M ATION . AND LOCATION n o f n y w em largo E",' separately derived system
❑ motor load of ❑ 'A", � _2n,., _3 ", i
Job no.: 65469 Job site address: Dartmouth St. @ 68' Ave ❑ R residential' units. ❑ cal vehicle parks. . •
City/State/ZIP: Tigard, OR ❑ Health -:me facilities. D Supply voltage for more than
- - - G7 Hazardous locations. 600 volts nominal. •
Suite/bldg./apt no.: Project name: 0 Service or feeder 600 amps or more. 1
Cross street/directions to job site n �:,�'. ,
I Qty. I F r. I Total 1
New residential single- or multi-family dwelling unit. ,
_ Includes attached garage.
Subdivision: Lot no.: 1.000 sq. ft or less 168.54 4
Tax map /parcel no.: _S P4 0 Fla X1 energy, sq, ft, or portion 33.92 1
. DESCRIPTION OF WORK :. . . . . (with above sq. 2.) � 75.00 2
Limited energy. multi -family 75.00 2
Install service for new traffic signal /97.. N lit. e.6 residential (with above sq. ft.) .
• Renewable Energy ❑ See Page 2
Services or feeders installation, alteration, and/or relocation
❑ PROPERTY. OWNER { . Et TENANT.
200 amps or less 1 100.70 100.70 2
201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 _ 2
Address: 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/Statc/Z1P _ : Temporary services or feeders installation. alteration, and/or
Phone: ( ) Fax ( ) relocation
1 200 amps or less 59.36 1
Owner installation: This installation is being made on property that 1 own which is not
or exchange, according 670, 201 amps w 400
rent, tlrig accord to ORS 447 449 670 and 701. a� 12.5.08 2
intended for sale, lease, ren
Owner signature: Date: 401 amps to 599 amps 168.54 2
Branch circuits - new, alteration, or extension, r panel
I R APPLICANT : . ; D. CONTACT FERSC N A. Foe for branch circuits with
above service or feeder fee, 3 2226
Business name: E C Company each branch circuit 7.42 2
B. Fee for branch circuits without
Contact name: Shanna Fullbright service or feeder fee, first
56.18 2
haunch circuit
Address: P 0 Box 925 Each add'! branch circuit 7,42 2
City /StatcJZIP: Albany, OR 97321 Miscellaneous (service or feeder not included)
Each rommfac urcd or modular 67.84 2
Phone: (541) 926 - 4266 Fax:: (541) 926 - 0165 dweilink_sesvice and/or feeder
Reconnect only 67,84 2
E -mail: shannaf@le
CONTRACTOR Pump or irrigation circle 67.84 2
Sign or oeulme lighting 67.84 2
Business name: E C Company Signal eircuit(s) or limited - energy See
.. panel, alteration. or extension. Page 2 2
Address: P O Box 935 Each additional inspection over allowable in any of the above
Additional inspection (1 hr min) 66.25/ hr
City /State/ZIP: Albany, OR 97321
Investigation (1 hr min) 6625/ hr
Phone: (541) 936 -4266 Fax: (541) 926 -0165 Industrial plant (1 hr min) 78.18/ hr
CCB Lie.: 49731 Inspections for which no fee is 3
Electrical Lie.: 22 -15c Suprv. ic.: 7s specifi ., cal listed 9a019/ M-
ply lis ...
Suprv. Electrician signature, required: .. � rCAE P�MFF FEF19
r a ` Subtotal: 122.96
Print name: William it Coburn Ik 1 , tci . IS Plan review (25% of permit fee):
State surcharge (12% of permit fee): 14.76 /
Authorized signature: TOTAL PERMIT FEE: 137.72 ✓
This permit appieadon expires If a permit is not obtained within ISO
Print name: Date: days after it has been accepted as complete.
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
SW NO ADDRESS, TIGARD, OR
Commercial - Electrical
199 Electrical final
PASS - No C of O
June 4, 2014 at 7:53:55 AM
ELC2013-00424
Jeff Grove
Violation Summary:
Inspector Contractor