Permit CITY OF TIGARD ELECTRICAL PERMIT
• PERMIT #: ELC2006 -00417
' � DEVELOPMENT SERVICES DATE ISSUED: 7/28/2006
° �I I I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 102AC -01704
SITE ADDRESS: 12720 SW PACIFIC HWY ZONING: CBD
SUBDIVISION: LOT : JURISDICTION: TIG
Project Description: Sign on west wall.
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: 1
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: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 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: •
JAKE WHEELER HIGHLIGHT SIGN CORP
12720 SW PACIFIC HWY PO BOX 23667
TIGARD, OR 97223 TIGARD, OR 97281 -3667
Phone: 503 - 684 -9017 Contact #: PRI 503- 620 -8205
FAX 503 - 624 -3725
FEES
Description Date Amount Reg #: ELE 37- 660CLS
[ELPRMT] ELC Permit 7/28/2006 $53.40 LIC 104599
[TAX] 8% State Surcharge 7/28/2006 $4.27 SUP 517SIG
Total $57.67 REQUIRED ITEMS AND REPORTS
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 Ce er. Those rules are set
forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct clues ins to OU It 503- 246 -6699 or
1- 800 - 332 -2344. /
Issued By: �.(j f Permittee Signature: ¶4 Z%� ii��[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'N: DATE:
LICENSE NO:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
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.
•
•
Electrical Permit Application � F012 Or FICl ESE ONLY
City of Tigard 2 � Received 7 , 7 1 6 1 Permit No.6LC, 6 O j t�/) 1
13125 SW Hall Blvd., Tigard, OR912'.—
7
Plan Review
•
Phone: 503.639.4171 Fax: 503.598.1960 1 00% patty. Other Permit:
T 1 c n K u Inspection Line: 503.639.4175 1UL 2 2 Date Ready/By. Ituis: RI See Page 2 for
Internet: www.tigard - or.gov �+ Notifed/Method 1 ir Supplemental Information tiki
TYPE OF WOlt1� or t JiC101° PLAN REVIEW
New construction ❑ Addition/alte AA pg/ l ' Please check all that apply (submit a sets of plans w /items checked below):
�l p ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: 11 were the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ y�Acc`cessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder I vtner: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "l -2 ", "l -3 ",
Job no.: Job site address: I , d co". A I or more. occupancy.
r�«/ /> ❑ Six HP Six or more residential units. ❑Recreation al vehicle parks.
City/State/ZIP: y p q � ag 3 7 ❑ Health-re
d ousl ocalon
❑ H ❑ Supply voltage for more than
azadous locations. 600 volts nominal.
Suite/bldg./apt. no.: j2, I Project name: / 9#f $n p0 fit C__. ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: Description I pry. I Fee. I Total I •
New residential single- or multi -family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family 75.00 2
) N $ Lf4 Al #1.4 0 0204#x, Sf$ oN W05r MAW residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I El'iSlANT 201 amps to 400 amps 106.85 2
Name: pR • Tkit, w ky /1.1Z.1/A 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 1'120 5 L p.41 /AJ. A i g ". S , ', Over 1,000 amps or volts 454.65 2
City/ State/ZIP: � 7 Temporary services or feeders installation, alteration, and/or
�-./ relocation
Phone: (53) t i i. / 7 I Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits — new, alteration or extension, per panel
Owner signature: �Date: A. Fee for branch circuits with
ili APPLICANT I I� �CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: // /bnL fj$ 0/�j j , B. Fee for branch circuits
without Contact name: Svitt/ft. QiO a /E4.O first branch cu t feeder fee, 46.85 2
Address: 17,7 FW, Ale.rjr14 be-a/2 /4/4 Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder n of included)
City /State/ZIP: ,q 442, gItao 3 Each manufactured or modular 90.90 2
I i G dwelling, service and/or feeder
Phone: (44 ) a - I Fax: : ( «z. it v_37„,r Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting N 53.40 2
Signal circuit(s) or limited -
Business name: 1 Iyf t 1404/ fi p /e�/�• energy panel, alteration, or
Address: gA�� 0 ld� K " ' _ Rd a extension. Describe: Paget 2
City/State/ZIP: ? . y r /9 0,3 Each additional inspection over allowable in any of the above
7 Per inspection 62.50
Phone: ( ; 0 ; )419 ed/' Fax: (dad) C 784" Investigation per hour (I hr min) 62.50
CCB Lic.: 1Q q .g'; Electrical Lic.: f/ 4s/ 7 Suprv. Lic.: Industrial plant per hour 73.75
// ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: 37.. (04 a C ` .$ Subtotal: 3" Y V t]
Print name: An 1 ept-A (E t. A e Date: 7 /AR /06 Plan review (25% of permit fee):
r1 State surcharge (8% of permit fee):
*deli Authorized signature: pi TOTAL PERMIT FEE: 57 c 7
This permit application expires if a permit is not obtained within 180
Print name: Date: 7/02/640 days after it has been accepted as complete.
• Number of inspections allowed per permit
t:\ Building \Permits\ELC- PamitApp.doc 0523/06 440.4615T(I1 /05 /COM/W®
Electrical Permit Application - City of Tigard .
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*
El Burglar Alarm
❑ Garage Door Opener*
El Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918 -260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
•
El Clock Systems
•
El Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
El Instrumentation
El Intercom and Paging Systems -
❑ Landscape Irrigation Control*
❑ Medical , •
•
El Nurse Calls
El Outdoor Landscape Lighting*
❑ Protective Signaling ,
❑ Other ' '
Total number of commercial systems:
*No licenses are required. Licenses are required
•
for all other installations
1:\ Building \Pamits\ELC- PamitApp.doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006 -00417
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/2812006
Phone: (503) 639 - 4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 0/2712006 TIME: 7.Q7AM PAGE: 44
SITE ADDRESS: •1200 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: TIGARD DENTAL
DESCRIPTION: si on Wewi wall.
OWNER: WHEELER, JAKE PHONE #: 503,684901 7
CONTRACTOR: HIGHLIGHT SIGN CORP PHONE #: 503- 620- 8205
Inspection Request Scheduled For: Date: 9/27/2006 Pour Time:
Code # . • - tion Description Confirm # Contact # Message
140 Sign in to 037201-01 503-62G-8205 N
a°N q
Corrections/Comments/Instructions
4 PASS n PARTIAL APPROVAL n CANCEL NO ACCESS
n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N 4* Date: C 1121(C)L. Phone #: (503) 718 - AA