Permit CITY OF TIGARD ELECTRICAL PERMIT
, PERMIT #: ELC2007 -00601
COMMUNITY DEVELOPMENT DATE ISSUED: 8/27/2007
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TlGARDd 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S136AD-04000
SITE ADDRESS: 11511 SW PACIFIC HWY ZONING: C - G
SUBDIVISION: PACIFIC TERRACE LOT : 007 JURISDICTION: TIG
PROJECT: GROW AMERICA
Project Description: Install (1) exterior 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 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:
NORRIS & STEVENS TUBEART SIGNS
621 SW MORRISON STE 800 4243 -A SE INTERNATIONAL WAY
PORTLAND, OR 97205 MILWAUKIE, OR 97222
Phone: 503 - 223 -3171 Contact #: PRI 503 - 653 -1133
FAX 503 - 659 -9191
FEES
Description Date Amount Reg #: ELE 37- 554CLS
(ELPRMT] ELC Permit 8/27/2007 $53.40 LIC 70956
[TAX] 8% State Surcharge 8/27/2007 $4.27 SUP 366SIG
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 40 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 otification Center. Those rules - - set forth in
OAR 952 - 001 -0010 through 0 • C • -001 - 0100. You may obtain copies of these rules or direct questions to • UNC at 503.2 1 , 6699 o %10.332.2344.
Issued 4111111111*/ / //� / 1 /// Permittee Signature: LI•' / //.
I
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.
i` i M r. ., ,, lit r f r !, i , ,.
T L 1 S
Electrical Permit Application �`' I . 1 OR O 1 ICI U'I ONI
City Received
Y of Tigard 111 Date /B : / I'ilri • a MI_I . /
.
r' q 13125 SW Hall Blvd., Tigard, OR 97: C EVED Pla n Review Phone 503.639.4171 Fax: 503.598.19. Date /B : Other Permit:
T I G A RID Inspection Line: 503.639.4175 AUG 2 7 2007 Date Ready /By: ® See Page 2 for
• ' • Internet: www.tigard - or.gov Notified /Method: Supplemental Information
TY0 e {GATID
TYP OF .. !.... t f;�9I�� BQ�4 PLAN REVIEW
E New construction El 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:
where the available fault current 0 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 ❑ "A' "F° "I -T' "I -l"
Job no.: 109192/1 I Job site address: 11511 SE Pacific Hwy IOOHP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage I'or more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: I Project name: Grow America ['Service or feeder 600 amps or more.
Cross street/directions to job site: tenant on NW corner of 71 & 99w FEE SCHEDULE
Description 1 Qty. I Fee. I Total I *
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 I
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
Limited energy, multi - family 75 00 2
Install (1) exterior wall sign residential (with above sq. ft)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I ' ❑. TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
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
relocation
Phone: ( ) 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
CI APPLICANT I ❑ CONTACT PERSON ' above service or feeder fee, 6.65 2
each branch circuit
Business name: TubeArt 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 90.90 2
dwelling, service and/or feeder
Phone: ( ) I Fax: : ( ) Reconnect only 66.85 2
E - mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 1 53.40 53.40 2
Business name: TubeArt Signal circuit(s) or limited -
energy panel, alteration, or
Address: 4243 -A Se International Way extension. Describe: Page 2 2
City /State /ZIP: Milwaukie, OR 97222 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 653 -1133 I Fax: (503) 659 -9191 Investigation per hour (1 hr min) 62.50
CCB Lic.: 70956 I Electrical Lic.: 37554CLS I Suprv. Lic.: 70956 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: 53.40
j
Print name: Ken Schult� • Date: 8/27/7 Plan review (25% of permit fee):
Ale I SO State surcharge (8% of permit fee):
41•24
Authorized signature: , x /i"� TOTAL PERMIT FEE: 5 9, /„Z
�I/ This permit application expires if a permit is not obtained within 180
Print name: Dan Oster t Date: 8/27/7
days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\ Building \Perm \L -LC- PerniitApp.doc 05/230)6 140- 4615TI 11 /05 /COM/WER
CITY OF TIGARD
BUILDING DIVISION PERMIT #: El- 02007.00601
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/27/2007 Phone: (503) 639 -4171 °'' ' .,'ll
Inspection Requests (24 Hrs.): (503) 639 -4175 �._�
INSPECTION WORKSHEET FOR DATE: 10/19/2007 TIME: 7 :01AM PAGE: 44
SITE ADDRESS: 11511 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: PACIFIC 1ERRACE LOT #: 007 TYPE OF USE:
PROJECT NAME: (;ROW AMERICA
DESCRIPTION: Install (1) exterior wall sign. Contractor just connecting cign.
OWNER: NORRI S & STEVENS, PHONE #: 503-223-3171
CONTRACTOR: TUL3EART SIGNS PHONE #: 603-653-1133
Inspection Request Scheduled For: Date: 10/19/2007 Pour Time:
Code # Inspection Description / ' %Confirm IV Contact # Message
199 Electrical finial 0:57920.01 \ 503.653-1133 N
Corrections /Comments /Instructions:
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. a PASS n PARTIAL APPROVAL n CANCEL 1 I NO ACCESS
• • n CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: 6 ► N LE Date: 101 I'°( J ctl Phone #: (503) 718- *DO