Permit CITY OF TIGARD ELECTRICAL PERMIT
'a'# ' COMMUNITY DEVELOPMENT Permit #: ELC2013 -00178
- IQAR O 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/05/2013
Parcel: 2S 101 BA00101
Jurisdiction:
Site address: 7500 SW DARTMOUTH ST
Project: Tigard Retail Center, Retail #2 Subdivision: WEST PORTLAND HEIGHTS Lot:
Project Description: Electrical for new 12,000 square foot retail shell.
Contractor: E C COMPANY Owner: WAL -MART REAL ESTATE BUSINESS TRUST
PO BOX 10286 2001 SE 10TH STREET MAIL STOP 5570
PORTLAND, OR 97296 BENTONVILLE, AR 72716 -5570
PHONE: 503 - 224 -3511 PHONE: 479 - 273 -4000
FAX: 503 - 295 -3012
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 05/28/2013 $100.70
Specifics:, amps or less
1 ea Services or Feeders - Over 05/28/2013 $552.26
Type of Use: COM 1000 amps or volts
Class of Work: NEW 15 crt Branch Circuits w /Purchase 05/28/2013 $111.30
Service or Feeder
Type of Const: 1 ea Plan Review Electricial 05/28/2013 $191.07
Occupancy Grp: 1 ea 12% State Surcharge - 05/28/2013 $91.71
Electrical
Total $1,047.04
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 ' 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. TENTION: Oregon law r • ires you to follow the rules adopted by the Oregon Utility Notifi ' enter. Those rules are set forth in OAR
952 -0 1 -0010 through OAR 952-0. 0090 may obtain a copy of the rules or direct questions to OUNC • ty -eatl 32.1987 or 1.800.332.23 , .
Iss ed By: _� / lL Permittee Signal e: _.e'er / ���hr - rc-L
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' ` � `�- f (« Date:
LICENSE NO. "?.2-
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.
12/05/2013 11:57 5032410807 EC PAGE 02
12/C. 201 3 12: .. .,5 5F,J:35981cli CT' OF 11ARD PAGE
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Phone: 11 'PA '2419 rill.: 503.598 px.e vAR 2p 2013 , f>avtly:
Inttroutlor Line! 3133,63 I 75
In 1011E11 www .tigard.01". go%
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trotiG.,tmethee T f / f -7 t! l'amit etc..Azi5-16o/76'
1.0 717 Permit; ii pA IA _
1 Roe Pap 2 tar
snowman& istermation
: 1 sonsomor: • ■illar • ,
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- - " . ' '. Planta chtt:k eft that apr y (nub,* I Mk A ' p no ttritcros el . oti 15clew I.
10 Ned/ cen5tnictIon 0 AdditIonfeltetationfrep overlent a sew'« gq ibed,. Inc amp% 44 more CI MOON; over three troria.
• DCITIOUti on • °lbw rhos the mantle Mit current 0 htnrinott and boat:met
exceerch I c.,0110 xmv$ r 'O 4t or C F'orrirtr tAtIld'REIR
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le to groune. or mettle I ..:.V1' 1:1 comrcrcinl.lece fittricelholl
• 0 I.. end 1.frvrifly ()%61!Iris p Commercial/industrial E Accessory building hrivg Ibr ell ether insinlattons. buildings.
0 Phe pump. 0 ImtslIstion of 75 KVA nr
Multi. mil Monter bulidor Othtr: OPAILsgene? worm, larger tepareicIy nerivee ottter.
0 .iddition arm racim lod of
I orPHP nr Attire occupancy
Joh no.: Job site) address 7500 5'‘‘' Dartmouth St 17,3ci• or MOTV .75111CISIIII unite. 0 Rovankorkw01.ehiele parks.
-- 7:____I
•••• 13 I kollh-c ova IttellIT14: TO Suppl7 vnlOuta l'r■Y more Ow
City/State/ZIP: Tigard, OR 9/223 00 , N1ts mindful.
CI riernrdooF loon=
ES-71r-k, I 1 0 Santee rie Pmder NV Amen ne atom
5..zitolgritt....art no •
11: Ictt martrrligia
—.- ------- ..
CRItIc ntrnotMitoetirrro to job site: SW Dartmouth & SW 72fid Ave -AE.TALL.- 1
1 I I
New reeldentird sinde- or ninIti-frunib. /welting nnil.
I n
„ ._.._,..........„ ...._________ , . _ tludos sttechnet wow.
I ,00tI gi. it, Or WA I I MI,' 4 4 1
Subdiviwion . :...rt. nr.: ._
_ __....--..------___.--- , Ea eddl 5(10 irl, ft, or 66ttiOn 1 33.92 1 1
----.
- 1trx t1mp3t e .- 0420111, 0.101 01400 lmtc yy. residemial i 75.00
. Limiled rocrgy, moui.r.nno) •
, - 1.5 CIO I .
Construction of an approximate 12.000 SF Outpartel Bu t) ilding IRetail 2) , rasidentielpith abowcs. I J I ,
______ • -------------------••••------ : servient or feeder-I RIO alkileustiteradosatid/or reload°,
. 20l.e or less I 1 10E70 /0606
iimmmilmaniimi
133 SA i
. .. mum to 400 timg*
! 401 amps IC 600 rintrt 200.34 ,
Name: 'Waltnert Stores. Inc (Steve Dyer) .
_ , I trenftrte 1.000 Mir I . 301.0 I ; 1
Addreqs: '2001 St 10th St • 0..cr 1.000 rnps 1 :t 1 ' 1 101 1 9 i 1 I 352.2t1 - 1, . ,2
i----- ----+...-r----------- ; Tpwrporlary scrvetet Ot Feeders Inwtolbtrigri, •Irrret10111. 414d/1)
' CitylStinfl'ZIP: Benmoville. AR 72716 . retro titian
_ ---,..........■.----- .
Clione! 14701273-V167 .
- _I F0X • ( ) , :00 • or less
---,,_ „--7—, . . --i 201 imps to 400 amps
t2.1.0 ..
8 ___
.
Owner initollaktinnt Thit imtollotion is being riode or properly inra I own wh I not , ________ _.
6 to 399 mon
Intended for mole. leas:, rent, or cxchnnge, occordn 401 ernp 169.54 i
* to ORS 447. 449, 610. ond 101.
8 . nett eirrult0 - new, altarat . Or ritinriNlj ter nonet
Owner si store; Date; A. 'ee thr branch Circuits ntrrh r _
n i, < ,,,,, arnioo or On or rcc. .. ) 74 ))I,
tretinch c-Inui: .. . /
BURInee2 name: BCRA, he, El Re ter tyrtneh eintllis withoo: _
•
--- ---- 1.AirviC0 Or fierier tec. runt 56.12
Cortnet name; Lorin Limson Cole Nana einusit
F athil hivnch eltemit r 7.42
Addrual: 2106 Pacific Ave, Sults 300 miseettonees (
oservice or feeder oat .
included) •
. 1
— E3CV. manutriennve or module/ I I
C tr'SltsteiZIP: Totems, WA 98402 dwoIlin : atir•ice andror ftzeci . 67,1)4 2 I
Phone! ..353 ) 6274307 I Fax : c ? Reconnect only I 67.114 --- 2
Pomp or irrigation cin:1c 67.84 --7•I
E.rrail; feln Sle,er mIllne 1 6 I 2 .
Sirol elteutr(g1 or II rnlIod
• ' ill
_ -
8, „ erne , -. E . .... . , I L...p.stelnitton. Or Co1101)11100, Paw 2
— - .A..... lEecn edditlonal inspection ova allowable In ass s of the above
Adciregs' k t ..f jy\ f Additional ingneerion (I hr min) i_ 1 AR.23' h
Cit:State '' , _ l •
I
ylIP: c -0 cri, lc)
(:/'f invesdpoon (1 hr min)
• • oxtustrist pint 0 hr min) .
• n, . R.' hr
Phone {9,3 ') 9,g, kA. - vt.°5 ‘ t Fax: t'a15 %.,) —C imtotetiomi far which no fee iF 11111
90.00 , r
1 . . T .,._ . _ .
cr. t. it. t\1( F i , - - . -c Suri-i, Lir : •-.R.'!"nsi • ......
•
v Sulltntle.; Wril2 . T
Surr: . EIrrtriciln sirraturr, required: -,.. - .
,i
Print noincL2 4 - 0 4)(2 — — '.
-.3 . .
1 ,-) . c _
.,_
t7--- Plan rodow (21 perm L
it fee): I m 4'1
1 . • '
S ha
tate surcrge (12% o m
f perit rec --
TDate: .-----H
TOTAL PERMIT PE ,
E: 11
-f ••
Authorized Ittom a tuTc.:
1------------------------------------- This permit 411014 rx011reldr It OMR *bet obeli', raithlro 1 MI
Clint name: Dote. days neer h Ma bert, weavOrd les oornolete,
• 1•41.bsr nr 1rtpreetInn. Allerwtoi N. walk.
.,........ - --- '
1,4ini'rIng Pri,i..$ n,t*.rpelv14,,typ do, , .1. , ,1!..0 0411.4tt '11114111'014/A14101
r21. "
Electrical Permit Application FOR OFFICE USE ONLY
i
City of Tigard B ECEIVE) Date Rece /By: ved ROII (� PennitNo. ELI S W Hall Blvd., Ti ard, OR 972
II a Phone: 503.718.2439 Fax: 503.598.1960 Plan Review u / t - Other Permit: /� .4. 9, /� /� 0IA _tea ,,/ , /
Q
"CSC 3
TI t: A R D Inspection Line: 503.639.4175 M A R 2 0 20 Date /By: / fi t" f Date Ready /By. 3 Y tJ / ^ �^ Juris: ®See Page 2 for
Internet: www.tigard- or.gov Notified/Method: 7 / 7/ /3 G6 —d0'/ Supplemental Information
aa. :. n I • . —
TYPE OF W a �.4 . g e • �'ll� /
® New construction ❑ Addition/alteration /rep acement Please check all that apply (submit 2 sets of plans wiitems checked below):
El Service or feeder 400 amps or more ❑ Building over three stories.
❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards.
CAT '---------9551411ik exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ I- and 2- fantil■ dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi-family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: 7500 SW Dartmouth St. 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
T��F Ti¢/ [ e E Jr� 2 ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: i >� El Service or feeder 600 amps or more.
� f 7 7 4 - / 1_ 2
Cross street/directions to job site: SW Dartmouth & SW 72nd Ave Description Qty. Fee. Total
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add] 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: 04200, 00101, 01400
Limited energy, residential 7500 '
(with above sq. ft.) -
Limited energy, multi - family 75.00 '_
Construction of an approximate 12,000 SF Outparcel Building (Retail 2) residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less I 1 I 100.70 I / 70 2
201 amps to 400 amps 133.56 , '
401 amps to 600 amps 200.34 '
Name: Walmart Stores, Inc. (Steve Dyer)
601 amps to 1,000 amps 301.04 '
Address: 2001 SE 10th St. Over 1,000 amps or volts 1. 552.26 55 ,.4 2
City/State /ZIP: Bentonville, AR 72716 Temporary services or feeders installation, alteration, and /or
relocation
Phone: (479)273 -4567 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
2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
above service or feeder fee, 7 42 / f j , 3 2
each branch circuit
Business name: BCRA, Inc. B. Fee for branch circuits without
service or feeder fee, first
Contact name: Lode Limson Cole branch circuit 56.18 2
Each add'I branch circuit 7.42 2
Address: 2106 Pacific Ave, Suite 300 Miscellaneous (service or feeder not included)
City/State/ZIP: Tacoma, WA 98402 Each manufactured or modular 67.84 ,
dwelling, service and/or feeder
Phone: (253) 627 - 4367 Fax: : ( ) Reconnect only 67.84
Pump or irrigation circle 67.84 2
E - mail: Icole@bcradesign.com Sign or outline lighting 67.84 '
Signal circuit(s) or limited- energy
Business name: ',
panel, alteration, or extension. Page 2 --
Each additional inspection over allowable in any of the abov
Address: Additional inspection (1 hr min) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
City/ State/ZiP: Industrial plant (1 hr min) 78.18/ hr
Phone: ( ) Fax: ( ) Inspections for which no fee is
90.00/ hr
s.> ificalh listed (' hr min)
CCB Lic.: Electrical Lic.: Suprv. Lic.: 1 1 1 1 1 . 3 3 3 E 2 ' ,}
Suprv. Electrician signature, required: Subtotal. 7 T
Plan review (25% of permit fee): ) l I • 0 7
Print name: Date: State surcharge (12% of permit fee): q `, '7
TOTAL PERMIT FEE: Log
Authorized signature: This permit application expires If a permit is not obtai ed within 180
Print name: Date: • days after it has been accepted as complete.
Number of inspections allowed per permit.
1: sBuilding , Permits\ELC- PermitApp.doc 07/01 /10 440 -461 ST(II/05/COM/WEB
Electrical Permit Application - City of Tigard
i .
Page 2 — Supplemental Information � .•
LIMITED ENERGY PERMIT FEES: •
RESIDENTIAL WORK ONLY: •
Fee for' all residential systems combined .. $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System* . • •
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY: I
Fee for each commercial $75.00
system •
(SEE OAR 918 - 309 - 0000).
Check Type, of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
D . Clock Systems
❑ Data Telecommunication 'Installation
❑ Fire Alarm Installation •
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation. Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
1 f Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations, •
I: \Building \Permits \ELC- PermitApp.doc 07/01 /10
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
7500 SW DARTMOUTH ST, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2013-00178
Jeff Grove
Violation Summary:
Inspector Contractor