Permit CITY OF TIGAR® ELECTRICAL PERMIT
° • g �( PERMIT #: ELC2008 -00213 .
° COMMUNITY DEVELOPMENT
DATE ISSUED: 4/14/2008
Tlcnk 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 102C B -01802
SITE ADDRESS: 13405 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: STEEL HORSE BAR & GRILL
Project Description: Installing sign lighting.
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: SIGNAUPANEL:
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:
MIDAS PROPERTIES INC. CARRICK ELECTRIC
1300 ARLINGTON HEIGHTS RD 4875 NW KAHNEETA DR
ITASCA, IL 60143 PORTLAND, OR 97229
Phone: NA Contact #: PRI 503 - 591 -8474
FAX 503 - 645 -8273
FEES
Description Date Amount Reg #: ELE 34 -439C
[ELPRMT] ELC Permit 4/14/2008 $53.40 LIC 120169
[TAX] 12% State Surchar 4/14/2008 $6.41 SUP 2295S
Total $59.81 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 503.246.6699 or 1.800.332.2344.
Issued By: ��L � `�i- - Permittee Signature: 002.4'74 ' OA/
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 � i OFFICE USE O
eceived C
C City of Tigard Date /B ` m (577 Permit No.: C, • —W, 1 1
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Re
1111
.` C ' Phone: 503.639.4171 Fax: 503.598.1960 1 't o � $ Dale : Other Permit:
T I G A K D Inspection Line: 503.639.4175 APR 1 Date Ready /By: Juris: ® See Page 2 for
Internet: www.tigard- or.gov O*Il ^p't'l, i ethod: Supplemental Information
• TYPE OF WORK C I T Y {�� r v� � PL AN REVIEW
❑ New construction ❑ Addition /alteration/101 /0 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 Er Other: 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 el 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.
JOB SITE INFORMATION AND LOCATION
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
•
I OOHP or more. occupancy.
Job no.: Job site address:
13e/os 5.0.). ?At. 4 -C) c.- HwLi .
❑ Six or more residential units. 0 Recreational vehicle parks.
City /State /ZIP:
..----7 1 c tkr t) 0 9 1 Z �3 ❑ Health-care facilities. 0 Supply voltage for more than
t - ❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: S {cc I t' se 6 offo s7) 0 Service or feeder 600 amps or more.
• N FEE SCHEDULE
Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 Total r •
— -- - - - - -- — - -New residential single- or multi - family dwelling unit. - --
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
no.:
Tax map/parcel Ea. add] 500 sq. ft. or portion 33.40 1
Limited energy, residential
DESCRIPTION OF WORK (with above sq. R.) 75.00 2
j � Limited energy, multi - family 75.00 2
t.L'UNcc 51Sr. 1 t 10 e v : is -1∎v etEctri .ji <, •C, residential (with above sq. ft.)
J I Se rvices or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
0 / PROPERTY OWNER ❑ TENANT - 201 amps to 400 amps 106.85 2
% J _, /� ; 4 ,s J 401 amps to 600 amps 160.60 2
Name: �U �/
601 amps to 1,000 amps 240.60 2
Address: J '(f ? ,4ci 71,, -- / , e Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) 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, , er panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
-- Address: — — _ — Each add'I branch circuit — 6.65 - — - -- 2 - --
--
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting / 53.40 5 3, ce 2
Business name: / Signal circuit(s) or limited -
(_ A L? 0....1 c. k Itiic.. energy panel, alteration, or
Address: / extension. Describe: Page 2 2
YFF i 5 N'. t , ✓ . , t , g A)6c DR .
City /State /ZIP: 3 ore. 72 zcj Each additional inspection over allowable in any of the above
i Per inspection 62.50
Phone: (5-03 ) 5 I _ " 1 7 , 1 t Fax: ( ) Investigation per hour (I hr min) 62.50
CCB Lic.: / Zc i 6 c Electrical Lic.: l'y- ej 3 9 (+ Suprv. Lic.:Zze/ 5 ; Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: \ Subtotal c
5 3 (a
Print name: a f � `` Date: Plan review (25% of permit fee):
J re State surcharge (12% of permit fee): (. y /
Authorized signature: // TOTAL PERMIT FEE: $9.
72 - [ This permit application expires if a permit is not obtained within 180
Print name: -3',„./ (� !/Lez Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\ Building \Permits\ELC- PermitApp.doc 05/23/06 440- 4615T( 1 1/05 /COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2003
-
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/i41/20011
Phone: (503) 639 -4171 tea • f l l flk
Inspection Requests (24 Hrs.): (503) 639 -4175 _ L
INSPECTION WORKSHEET FOR DATE: 4117/2008 TIME: 1: 02AM PAGE: 29
SITE ADDRESS: 13405 I a, PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: STC. E.L HORSE F3fk ? 8, GRILL
DESCRIPTION: lnclalling ;sign lighting.
OWNER: MIDAS PROPERTIES. INC., PHONE #: NA
CONTRACTOR: CARRICK ELECTRIC PHONE #: 503 591 1:3474
Inspection Request Scheduled For: Date: 4/17/2008 Pour Time:
Code # Inspection Description Confirm# Contact # Message
199 Elect.iical final i 41E;O517 -01 \` 503- 702 -0035 N
Corrections /Comments /Instructions: ,...
I
III PASS ` PARTIAL APPROVAL ❑ CANCEL NO ACCESS
I CALL FOR INSPECTION I 1 ADDITIONAL FEES ASSESSED
Inspector: CT • log) 1- � Date: L c Phone #: (503) 718- 14i'D