Permit cimmtiN , A ® ELECTRICAL PERMIT
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CITY OF ���/`''!i�® PERMIT #: ELC2007 -00513
COMMUNITY DEVELOPMENT DATE ISSUED: 7/25/2007
RD 13125 SW HaII Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 102AC -01704
SITE ADDRESS: 12720 SW PACIFIC HWY ZONING: CBD
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: CORNERSTONE PROPERTIES
Project Description: (2) sign lightings.
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:
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL: 2
MANF HMI 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:
RICK BRAEM HIGHLIGHT SIGN CORP
9895 SW KILLARNEY LN PO BOX 23667
TUALATIN, OR 97062 TIGARD, OR 97281 -3667
Phone: 503 - 819 -0443 Contact #: PRI 503 - 620 -8205
FAX 503 - 624 -3725
FEES
Description Date Amount Reg #: ELE 37- 660CLS
[ELPRMT] ELC Permit 7/25/2007 $106.80 LIC 104599
[TAX] 8% State Surcharge 7/25/2007 $8.54 SUP 517SIG
Total $115.34 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
suspende• more - 180 d- . ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those les are set forth in • • R 952 -• I1 -0010 through OAR 952 -001 -0100. You may obtain copies of these rules o irect quest•• s to OUNC at
503. '46.6699 or 1.800.33/2344. 7
C
Iss ed By: ` / Permittee Signature: / /., �`
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.
1.4111.A.,L1.1,11.11.411. 11. •,.a a c1NNaaa.uuvu • • • •
City of Tigard Received 7o �� Permit No.: £'��i��<
Date /B �;
Cr
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date /By: Other Permit:
TIGARD Inspection Line: 503.639.4175 ` 2 Date Ready /By: luri • See Page 2 for
Internet: www.tigard- or.gov 2� 7'D J Notified /Method: /a supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ❑Addition /alteration /replacement
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ® Other: Sign where 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 ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ® Other: Sign ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ". "I -2 ", "I -3 ",
Job no.: Job site address: 12720 SW Pacific Highway IOO or or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard /Oregon /97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: Cornerstone Properties ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: On highway 99 Description 1 Qtv. 1 Fee. 1 Total 1 *
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. 11. 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
Hook - up 2 each single face illuminated wall signs as required. residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or Tess 80.30 2
❑ PROPERTY OWNER ® TENANT 201 amps to 400 amps 106.85 2
Name: Rick Braem 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 9895 SW Killarney Lane Over 1,000 amps or volts 454.65 2
City /State /ZIP: Tualatin /Oregon /97062 Temporary services or feeders installation, alteration, and /or
. relocation
Phone: (503)819 -0443 Fax: ( ) 200 amps or less 66.85 1
Owner installation• his ' 41'.tion is .eing made on property that I own w. ich i,ot 201 amps to 400 amps 100.30 2
intended for sale, ase, ' •nt .: exch. - ge, according to ORS 447, 449, 670, ,nd 71 . 401 amps to 599 amps 133.75 2
Owner signatur.' . 4 ,1... Date. i / Branch circuits - new, alteration, or extension, per panel
A. Fee for branch circuits with
® APPLICANT ❑ CONTACT ' RSON above service or feeder fee, 6.65 2
each branch circuit
Business name: Highlight Sign Corp. B. Fee for branch circuits
Contact name: Greg Baker without service or feeder fee 46.85 2
first branch circuit
Address: P.O. Box 23667 Each add't branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Tigard /Oregon /97223 Each manufactured or modular 90.90 2
Phone: 620 - 8205 Fax: (503) 624 Reconnect service and/or feeder
503
( ) ( ) 624 372 Reconnect only 66.85 2
E - mail: greg @highlightsign.com Pump or irrigation circle 53.40 / gd 2 -
CONTRACTOR Sign or outline lighting A 53.40 2
Business name: Highlight Sign Corp. Signal circuit(s) or limited -
energy panel, alteration, or
Address: P.O. Box 23667 extension. Describe: Page 2 2
City /State /ZIP: Tigard /Oregon /97223 Each additional inspection over allowable in any of the above.
Per inspection 62.50
Phone: (503) 620 -8205 Fax: (503) 624 -3725 Investigation per hour (I hr min) 62.50
CCB Lic.: 104599 Electrical Lic.: 517SIG Suprv. Lic.: 517S1G Industrial plant per hour 73.75
ELECTRICAL PERMIT FE
Suprv. Electrician signature, required: Subtotal: /66 . ho
Print name: Mike Cleary D . 07/25/07 Plan review (25% of permit fee): t
///��^ ^� — State surcharge (8% of permit fee): il• J
Authorized signature: .— y max , ``y'—s TOTAL PERMIT FEE: /1 5. � j [ / �
Print name: Greg Baker D ate: 07/25/07 This permit application expires if a permit is not obtained within I80
g days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\ Building \Permits \ELC- PermitApp.doc 05/23/06 440-46t5T(I I /05 /COM/WEB Sr-: 3
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007- ()02,13
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/2r:�2007
Phone: (503) 639 -4171 'JL
Inspection Requests (24 Hrs.): (503) 639 -4175 �'; "__...
INSPECTION WORKSHEET FOR DATE: 8/301)()07 TIME: 7:OOAM PAGE: 28
• SITE ADDRESS: 12720 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: CORNERSTONE PROPERTIES
DESCRIPTION: ( sign lightings,
OWNER: BRAEM, RICK PHONE #: 503-8113- 0443
CONTRACTOR: HIGHLIGHT SIGN CORP PHONE #: 503 - 620 -8205
Inspection Request Scheduled For: Date: 8/30/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
, - "115" 054886 -01 .'‘, , 503 - 620 -8205 N
Corrections /Comments/ Instructions:
N .
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f I �
J
PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL 1 I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: GY , 1406 � Date:
I Jb r) Phone #: (503) 718-