Permit CITY OF TIGARD ELECTRICAL PERMIT
l: PERMIT #: ELC2008 -00261
COMMUNITY DEVELOPMENT DATE ISSUED: 5/8/2008
I GARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 102CC -00500
SITE ADDRESS: 13600 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: TIGARD MARKETPLACE LOT : JURISDICTION: TIG
PROJECT: H MART
Project Description: Installing electrical connection for internally illuminated 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: 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:
13500 PACIFIC CORP TUBEART SIGNS
BY CAP ADVISORS 4243 -A SE INTERNATIONAL WAY
38345 W TEN MILE RD, STE 170 MILWAUKIE, OR 97222
FARMINGTON HILLS, MI 48335
Phone: Contact #: PRI 503 - 653 -1133
FAX 503 - 659 -9191
FEES
Description Date Amount Reg #: ELE 37- 554CLS
[ELPRMT] ELC Permit 5/8/2008 $53.40 LIC 70956
[TAX] 12% State Surchar 5/8/2008 $6.41 SUP 366S1G
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 les are set forth in
OAR 952 - 001 -0010 throu• h OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC a - • :..699 or '.800.332.2344.
Issued By: � l` `= i� 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.
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Electrical Permit Application � , • 5AP n1 I oRiTOF F ICI UsF,ONLY 'Al-W i t > w
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1 "5?E" Received
t ,�� : Ci t y of Tigard �� Date/By: �Vvg` Permit No - � J? -U f (,
-1,`a q Y
13125 SW Hall Blvd., Tigard, OR 97 O Plan Review ES llt I ". C . j : Phone: 503.639.4171 Fax: 503.598.1960 J D O ate /1 : Other Permit: �/ p ^ � �
�' o- yri Inspection Line: 503.639.4175 �` ate Read /B t (,r
�T I G''R'Di
p �Cj��� Ready /By: ® See enta! or
i'3t; :l Internet: www.tigard or.gov
O � `� l ��s Notified/Method: I Supplemental Information
. TYPE 'OF WORK CA � ��� �� PLAN REVIEW
® New construction E] Addition/alteration cement
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: 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
❑ I - and 2- family dwelling [ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of 2" "
Job site address: 2 / (� ' / 100HP or more. occupancy.
Job ❑0.: l I
1 - ' I • 1 J UDO SW ? ,4' (_ YL ❑ S ix o r more residential units. parks.
w 1 0 vehicle
City /State /ZIP: 11
` 0 1 1 v 7-a .)_ ye 3 y
3 0 Health-care facilities. 0 Supply voltage for more than
❑ Hazardous locations. 6(X) volts nominal.
Suite /bldg. /apt. no.: Project name: H _ A 4_ ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: Description 1 Qty. 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. 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
/ .� A' r esidential ( with above sq. rt.) 75.00 2
� Cif r`• L.1,1 c � t.r�7:�1 d n f J� N � / "pct � '� q
Services or feeders installation, alteration, and/or relocation
• �/
i r _ 4.4 (�y 'I ( t.,.v 4 ,�..c1,1 S t q IA 200 amps or less 80.30 2 -
❑ PROPERTY. OWNER ® TENANT . 201 amps to 400 amps 106.85 2
Name: H _ A.-4- - 7vt''R ' . '
t.a.H - B-" t S I r kG-� 401 amps to 600 amps 160 2
l 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City /State /ZIP: Temporary services or feeders installation, alteration, and/or
,s-cut.,-,...t_ relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100 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
' ® APPLICANT , ®; CONTACT PERSON above service or feeder fee,
6.65 2
each branch circuit
Business name:
4_,‘ Q A r* .. `p 10.1 S B. Fee for branch circuits
without service or feeder fee,
Contact name:
y A e t At Ai-, � first branch circuit 46.85 2
Address: L f�(� 3 _J z � �v� Miscellaneous llan branch (s r v i ceit 6.65 2
"1 5 � � Miscellaneous (service or feeder not included)
City /Stale /ZIP: / 1 l W USIA Ic 0 p q 7- Each manufactured or modular 90.90 2
/ '` dwelling, service and/or feeder
Phone: (5 ) ( 53 - (t 33 Fax:: (s ) (o $ " ( ( Reconnect only 66.85 2
E -mail: (s 4i J. X.41 P_ 6j' 4- q ,h,Q r _,.- - cr tn. t Pump or irrigation circle 53.40 2
3 t C r ONTRACTOR . Sign or outline lighting ( 53.40 53 4 2
Signal circuit(s) or limited -
Business name:
,L A- �� p, 1Ji-4 . t o t S energy panel, alteration, or
Address: extension. Describe: Page 2 2
Set -vim. P
City /State /ZIP: 5 "--( Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) S cw+-� Fax: ( ) cu...‘,.....4 Investigation per hour (1 hr min) 62.50
CCB Lic.: G S & Electrical Lic.:37_ 5 L t L c Suprv. Lic.: 3C6._S-�(r. Industrial plant per hour 73.75
t ELECTRICAL - PERMIT FEES '
Suprv. Electrician signature, required: 4 .4.., Subtotal: 5/ AA.)
/ Plan review (25% of permit fee):
Print name: �i Date: 517_14
L e--1--, s� _ State surcharge (12% of permit tee): ('p r
Authorized signature: z / _ -/ - TOTAL PERMIT FEE: ••=5/ d
2 ( ` ^ / n This permit application expires if a permit is not obtained within 180
Print name: '� _ J k /'t 1 A ecAle Date: 0-7-1 q days after it has been accepted as complete.
Q * Number of inspections allowed per permit.
I:\ Building \Permits \ELC- PermitApp.doc 05 /23/06 410- 4615T(I I /05 /COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008.00261
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 578/2008
Phone: (503) 639 -4171 R I�I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/5/2008 TIME: 7:00AM PAGE: 48
SITE ADDRESS: 13600 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: TIGARD MARKETPLACE LOT #: TYPE OF USE:
PROJECT NAME: H MART
DESCRIPTION: Installing electrical connection for internally illuminated sign.
OWNER: 13500 PACIFIC CORP, PHONE #:
CONTRACTOR: TUF3EART SIGNS PHONE #: 503 - 653.1133
Inspection Request Scheduled For: Date: 6/5/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 070900 -01 603-653-1133 N
Corrections /Comments /Instructions:
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL NO ACCESS
n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: G N Date: C` S " Phone #: (503) 718- 2.4%)