Permit r� CITY OF TIGAR® ELECTRICAL PERMIT
, " PERMIT #: ELC2007 -00148
' -` k t A., COMMUNITY DEVELOPMENT DATE ISSUED: 3/12/2007
e GA 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 104 B B -07900
SITE ADDRESS: 14350 SW BARROWS RD 002 ZONING: C -
SUBDIVISION: RUSSELL'S SCHOLLS FERRY SUB LOT : 002 JURISDICTION: TIG
PROJECT: SUNSHINE NAIL & SPA
Project Description: (1) wall sign.
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:
ALBERTSON'S INC #576 GRAPHIC D'SIGN LLC
PO BOX 20 2255 SE 122ND. AVE.
BOISE, ID 83726 PORTLAND, OR 97233
Phone: Contact #: PRI 503 - 256 -2064
FEES
Description Date Amount Reg #: ELE 26- 1235CLS
[ELPRMT] ELC Permit 3/12/2007 $53.40 LIC 154462
[TAX] 8% State Surcharge 3/12/2007 $4.27
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 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 503.246.66 9 or 1.800.332.2344.
i
f
Issued By: ��� A Permittee Signature: ( iti m
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:
Cali 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.
3 d 2,..5o - 1 —c D cj q C,
Electrical Permit Application - . FOR OFFICE USE ONLY
!:; / / ��� Permit No. — —` I 131SW Hall lvdTigard, OR 97223 Review
Phone: 503. 639.4171 Fax: 503.598.1960 /ri+ 1 Date/By: Other Permit:
Inspection Line: 503.639.4175 .4,441., 1,11,„ Date Ready/By: luris: H See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
::: z::: i:`::::;:;:::;;:;:;::::>:: is :::!:::: ;::::::::: ::::::::>:. i«<;;;:>< a::;<;«<:<:<::::<:;!: zz:::::::::: :::::::::::::::: »::::::: >::ii:: ;;::i
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.:::::::..:.:.................................................................................................................. .......................... ...........
❑ New construction ❑ Addition/alteration/replacement Please check all that apply:
❑Service over 225 amps, conun'I ['Hazardous location
❑ Demolition ❑ Other:
❑ Service over 320 amps - rating [I Buildng over 10,000 sq. ft.,
- dwellings 4 or more ne w residential
>,..,:<} > >�:<::: >:::: »:::::: ><::: >`s:i r; > 8 >: of 1 -a nd 2 Tamil d
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑ System over 600 volts nominal units in one structure
❑ Multi - family ❑Master builder ❑ Other: ['Building over three stories ❑ Feeders, 400 amps or more
❑Occupant load over 99 persons Manufactured structures or
RV R park
`' "i�01�t'AiNIJE:Tt�C/t�T i�f . .. Egress/lighting
P
>:�OB:sSITE >3I�2?�MRMA E t htin plan
Job no.: ( Job site address: 1 S() 4W. ' rrovv Qc . ❑Health -care facility .
Submit 2 sets of plans with any of the above above.
City /State/ZIP: r ,y 4 t 1 L � 9 79,7 %
The above are not applicable to temporary construction service.
ET > TJTiFi:::» is >s`'s sss > ` ..... 3
Suite/bldg. /apt. no.: Project name: �` r- c ::::::::.::. ............................................... ...............................
l r 1 �"by- 1 t I �tAf/ Description I Qty. I Fee. I Total I •'
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: 1 Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Litnited energy, residential 75.00 2
Tax map /parcel no.:
Limited energy, non-residential 75.00 2
. .. 5y0
::
E manu or modular
dwelling, service and/or feeder 90.90 _ 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
:::::::::::;:;;:
: : i :. :.;:.;:. 201 amps to 400 amps 106.85 2
<..a> f". �t�4? Plw l��`'> E'.: tQ! #! k? llw �:.;:.;:.; :. :. :. :. :.:::::. . : .:; :. :.;;:;.;:.;:.;❑:.: Tg!?? ��. :.;;: . :< :;.;;:.;:.;
:::::::::::::::::::::::.;::.;.;•.,:•.:.::::::::::::::::::::::::.::::::;:::::::::.:::::::::::::::::::::::::.;:::::: ::::::::.:::.;::::::::::: ;::::: 401 amps to 600 amps 160.60 2
Name: O n7 G (-Q_C 601 amps to 1,000 amps 240.60 2
c + �i 1 Over 1,000 amps or volts 454.65 2
Address: V r ► �R,, 1 # Z V V Reconnect only 66.85 2
City /State/ZIP: , potzr ti ' 6 , c f . 1 1 2,04 Temporary services or feeders installation, alteration, and/or
'- r relocation
Phone: G
2� ` Fax: ( ) 200 amps or less 66.85 1
Owner installation: s Marllation 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 600 amps 133.75 2
Owner signature: cist,uy„ Y.ex. A \' -ctt j,. ih-4,L, Date: Branch circuits - new, alteration, or extension, per panel
: ......:::. ...:.....:;s >:<::::: >: <: »: >:>:a : >:<:i:c:: <.;:;:«; : >:• >s >;:;:: ; A. Fee for branch circuits with
service or feeder fee, each
Business name: Q 1. c, i> " ..‘,_0. VVc L branch circuit 6.65 2
LL J�� 1 B. Fee for branch circuits
Contact name: without service or feeder fee,
each branch circuit 46.85 2
Address: Each add'I branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( , ) _ Fax:: ( )
1 ► Sign or outline lighting yt 53.40 2
E -mail: Signal circuit(s) or limited -
energy alteration, or
ner
n,
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gY panel,
extension. Describe: Page 2 2
:::...........................:. .............
xtension. Desc t e. g
Business name: a l } � - k l (.. 0 S i t i i — C
Each additional inspection over allowable in any of the above
Address: L p Z c S J E, (1 ,c( ikv. Per inspection 62.50
City /State/ZIP: pG EA- A_� , 012_ . 01i 7_3 3 Investigation per hour (1 hr min) 62.50
0 tJ Industrial plant per hour 73.75
3
Phone: (n3 ) 2 0 F ax: ( ) :::::,:• ::: :• :.: .....:.. . ::;• .: ::::
rRJCAL > PJ RMIT:FE1 * : : : : : >: > : :::::: >::::>:: 0:
CCB Lic.: i S4-4(0 2 to Co >:: > ::ELJC Electrical Lic.: 242 .-1 2,3 s US Su rv. P Lic.: Subtotal .. ...............................
D
J Suprv. Electrician signature, required: (,.-1, (,.-1, Plan review (25% of permit fee)
,
State surcharge (8% of permit fee)
Print name:( -��Q %' �t - C {N j G y Date:
TOTAL PERMIT FEE 5 6 7
Authorized signature: c_ .... e ;- 1 , 1 l ( This permit application expires if a permit is not obtained within 180
days alter it has been accepted as complete
Print name: L ( L -1 l J ' ,,�� Date: * Fee methodology set by Tri County Building Industry Service Board
** Number of inspections per permit allowed.
i:\ Building \Pennits\ELC- PeimitApp.doc 12/03 440- 4615T(10 /02/COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00148
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3112/2007
Phone: (503) 639 -4171 :41
Inspection Requests (24 Hrs.): (503) 639-4175
WORKSHEET FOR DATE: 4/2/2007 TIME: 7:02AM PAGE: 39
SITE ADDRESS: 14350 SW BARROWS RD 002 CLASS OF WORK:
SUBDIVISION: RUSSELL'S SCHOLLS FERRY SUB LOT #: 002 TYPE OF USE:
PROJECT NAME: SUNSHINE NAIL & SPA
DESCRIPTION: (1) wall sign.
OWNER: ALBERTSON'S INC #576, PHONE #:
CONTRACTOR: GRAPHIC D'SIGN LLC PHONE #: 503-2! &2064
Inspection Request Scheduled For: Date: 4/2/2007 Pour Time:
Code # Inspection Description Confirm Contact # Message
199 - Electrical final 045828-02 503- 256 -2064 N
Corrections/Comments/Instructions:
\ \\
%Iv \
PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: • I R ( A Date: -2-' Phone #: (503) 718- L
' CITY OF TIGARD .,1�
BUILDING DIVISION PERMIT #: ELC2007- 00148
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3//212007
Phone: (503) 639 -4171 ,, 11� IL
Inspection Requests (24 Hrs.): (503) 639 -4175 ...'!�i R__.,
INSPECTION WORKSHEET FOR DATE: 4/2/2007 TIME: 7:02AM PAGE: 40
SITE ADDRESS: 74350 SW BARROWS RD 002 CLASS OF WORK:
SUBDIVISION: RUSSELL'S SCHOLLS FERRY SUB LOT #: 002 TYPE OF USE:
PROJECT NAME: SUNSHINE NAIL & SPA
DESCRIPTION: (1) wall sign.
OWNER: ALBERT SON'S INC #576, PHONE #:
CONTRACTOR: GRAPHIC D'SIGN LLC PHONE #: 503- 256 -2064
Inspection Request Scheduled For: Date: 4/2/2007 Pour Time:
Code # Inspection Description (Confirm # Contact # Message
140 Sign installation 04 -01 503 -2 -2064 N
Corrections /Comments /Instructions:
-
A, PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL 1 I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-