Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00403
DEVELOPMENT SERVICES DATE ISSUED: 7/24/2006
- =- = ' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 2S110DC -02400
SITE ADDRESS: 11565 SW DURHAM RD ZONING: C -
SUBDIVISION: SDR1999 - 00022 WILLOWBROOK II LOT: JURISDICTION: TIG
Project Description: 3 sign Iightings.
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: 3
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:
OREGON COMMUNITY CREDIT UNION ES & A SIGN & AWNING
BOX 77002 1210 OAK PATCH RD
EUGENE, OR 97401 EUGENE, OR 97402
Phone: Contact #: PRI 541 - 485 - 5546
FAX 541 - 485 -5813
FEES
Description Date Amount Reg #: ELE 20- 243CLS
[ELPRMT] ELC Permit 7/24/2006 $160.20 LIC 163470
[TAX] 8% State Surcharge 7/24/2006 $12.82 SUP 305SIG
Total $173.02 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: � G� 'Y.1J Permittee Signature: 7fl � Cct r /
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 FOR OFFICE USE ONLY
City of Tigard R EC E 1 ®`` E A' Received h , - ,Q G OO
Date/By: ' r !� �.`L.(� Penni N
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review [
Phone: 503.639.4171 Fax: 503.598.1960 l I Date/By: 5 P & — 6rJ / /7
Inspection Line: 503.639.4175 JUL V 2 `a 21 ► 0 I Date Ready /By: Jnris: ® See Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIGARD Notified Method: % i!/x Supplemental Information
naBIT. N L91VISION PLAN REVIEW
❑ New construction 0 Addition /alteration /replacement Please check all that apply:
El Demolition I�Other: SibiV s ['Service over 225 amps, comm'l Hazardous location
T� ❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1 - and 2 - family dwellings 4 or more new residential
❑ I - and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑Buildin over three stories [Weeders, 400 amps or more
El Multi family 0 Master builder 0 Other:
['Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION DEgress/lighting plan RV park
❑Health -care facility ['Other: no.: Job site address: I I .) L, S(,v'j�,tR,�, Submit 2 sets of plans with any of the above.
City /State /ZIP: 11 6 tts, 42- The above are not applicable to temporary construction service.
^'�Y l FEE SCHEDUL
Suite /bldg. /apt. no.: Project name: 0 0604 am„ civil-- „
U11t1� Description I Qty. Fee. I Total
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: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.:
Limited energy, non- residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
I A , `.^� , �, dwelling, service and /or feeder 90.90 2
N �” 3 ( / / S Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I I� TENANT 201 amps to 400 amps 106.85 2
�, 401 amps to 600 amps 160.60 2
Name: 0t04 COatMV &A IN s .4 Drr um 1424 601 amps to 1,000 amps 240.60 2
�,v c " 1
Address: PO 11 002„ Over 1,000 amps or volts 454.65 2
`� / Reconnect only 66.85 2
City /State /ZIP: w ,. , 7
L e 40 ( Temporary services or feeders installation, alteration, and /or
) /�y . Fax: ( ) relocation
(
Phone: �) U�3' 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 100.30 2 _
intended for sale, lease, rent, or excjAnge, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: 141 A Date: Branch circuits — new, alteration, or extension, per panel
KAPPLICANT 1 ACONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: e t-A- I( „„,,,, A,,4Q f,W � •4 IN� branch circuit
/ " B. Fee for branch circuits
Contact name:UwQ, i kerz without service or feeder fee,
first branch circuit 46.85 2
Address: (Z(() 04.74. Pkix_44.. go Each add'l branch circuit 6.65 2
City/State/ZIP: Miscellaneous (see
y E'1 �' n 2. 7µo3 - Miellan (service or feeder not included)
�
"
, + Pump or irrigation circle 53.40 2 -
Phone: (I'i () d.(g j � Fax: : 4141 ){� � 5"� 3 Sign or outline lighting 3 53.40 146.2,02
E -mail: n . , , �, ' e S . Signal circuit(s) or limited-
` ONTRACTO �* energy panel, alteration, or
extension. Describe: Page 2 2
Business name: e&r.,4- t)14 "In As twat, -
Address: 1240 c 11 ,. Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State /ZIP: Ex 40,46. 1 0 0_. q1 'j62. Investigation per hour (1 hr min) 62.50
Phone: ( p 4r .t. T- Fax: ( 1) Of., c3 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: 6; Li 70 ectrical Lic.: Suprv. Lic.: SOgSt
( )) / � Subtotal 1(06,, Suprv. Electr signature, require ��` l r� 1/ (/ ��� Plan review (25% of permit fee) Zia
12 Pri nt name: r✓O 1 Cs)
Date�C State surcharge (8% of permit fee) ' g Z"
r `'�Tr TOTAL PERMIT FEE (1'.�.02....
Authorized signature: ♦ - — Thi permit application expires if a permit is not obtained within 180
"' days after it has been accepted as complete
Print namqai g€1Zkee— !' I Date: * Fee methodology set by Tri- County Building industry Service Board
** Number of inspections per permit allowed.
i. \ Building \ Permits \ELC- PermitApp.doc 12/03 440- 4615T(10/02/COM /WEB
-- 1
CITY OF ��n m m m~po�� n nn�m��n���
BUILDING DIVISION A PERMIT #: ELC2006-00403
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/24/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 ‘4.JWV AL.
INSPECTION WORKSHEET FOR DATE: 10/5/2006 TIME: 7:00Ah4 PAGE: 87
'
SITE ADDRESS: '11565 SW DURHAM RD11O CLASS OF WORK:
SUBDIVISION: SDR1999 LOT #: TYPE OF USE:
PROJECT NAME: OREGON COMMUNITY CREDIT UNION
DESCRIPTION: Dn/Qo lightings.
OWNER: PHONE #:
CONTRACTOR: ES & A SIGN & AWNING PHONE #: 541~485-5546
Inspection Request Scheduled For: Date: -10V5/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 037705'01 541-486-5646 N
Corrections/Comments/Instructions:
----
)(I PASS [l PARTIAL APPROVAL n CANCEL I I NO ACCESS
| | FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: G--- Isi o&& L... " Date: 3 01 61 6 Phone #: (503) 718'244(
~ ^ ' '