Permit CITY OF T ELECTRICAL PERMIT
PERMIT #: ELC2001 -00106
' DEVELOPMENT SERVICES DATE ISSUED: 02/23/2001
---' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 101 AC -01900
SITE ADDRESS: 12615 SW 72ND AVE
SUBDIVISION: LOWE'S HIW, INC ZONING: C -G
BLOCK: LOT : • JURISDICTION: TIG
Project Description: Electrical permit for the installation of 5 exterior wall signs. (see SGN2001 -00037 thru 00041)
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: 5
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVCI 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:
LOWES HIW, INC VANCOUVER SIGN COMPANY, INC
HWY 268 EAST 6615 SW HWY 99
NORTH WILKESBORO, NC 28659 VANCOUVER, WA 98665
Phone: Phone: 360- 693 -4773
Reg #: ELE 37 -46CLS
LIC 000006
SUP 525SIG
FEES Required Inspections
Type By Date Amount Receipt Rough -in
PRMT CTR 02/23/2001 $267.00 2720010000( Elect'I Final
5PCT CTR 02/23/2001 $21.36 2720010000(
Total $288.36
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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE Se12 A PP ISSUED BY: ` _ C
OWNER INSTALLATION ONLY ik
The installation is being made on property I own which is not intended for sale, lease, • ent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:OOpm for an inspection the next business day
, VI -s: 3 6 /1/ / - 17 _
" Electrical Permit Application y1
Datereceived: - 1 r Permit no.: L c2 . ;.
,jr,..'l'i'l City of Tigard Project/appl.no.: Expire date: O el 16 43
CityojTigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: 1 Receipt no.:
Phone: (503) 639 -4171 ----
Fax: (503) 598 -1960 ( ( r%j Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial /industrial 0 Multi- family 0 Tenant improvement
0 New construction 0 Addit ion /alteration/replacement &Other: sl b ti.l 0 Partial
JO11 SITE "INFORi%IATION
Job address: 1061s Sc..) 7z /l Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: 'Block: 'Subdivision:
Project name: / p Lie s 77 Gig A p 'Description and location of work on premises: S Ex re e r O . h/ja-,, L. Sz-c J s
Estimated date of completion/inspection: 3 tr e r ks
CONTRACTOR APPLICATION FEE SCHEDU,E
Job no: Fee Max
Business name: VIM) OIAve to 51- 6 N 6o . Description Qty. (ea.) Total no. insp
New residential - single or multi- family per
Address: 6 to 1 c /V E /1 11 dwelling unit . Includes attached garage.
City: V/Nvcou vE' - I State:1,,4 ZIP: e1 g665 Service included:
Phone: T60 693 y "'if [Fax: /1,06132/1/$-1 E -mail: 1000 sq. ft. or less 4
Each additional 500 sq. ft. or portion thereof
CCB no.: 631s 1 Elec. bus. lic. no: 3 7 -y6 Ct-S Limited energy, residential 2
City /metro lic. no.: 2 'lb Z Limited energy, non- residential 2
5 .C_ A / LA Q Each manufactured home or modular dwelling
Signature of supervising electrician (required) Date Service and/or feeder 2
Sup. elect. name (print): License no: Services or feeders — installation,
• alteration or relocation:
200 amps or less 2
Name (print): a, L o tr Te 3 N 1 lid TA)C_ 201 amps to 400 amps 2
401 amps to 600 amps
2
Mailing address: N W `f t,(°p $ Eft `b 601 amps to 1000 amps 2
City: % , U3 A kEshora I Sta 1 ZIPS9 Over 1000 amps or volts 2
Phone: K) q 1 Fax: E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to htstallation , alteration, orrelocation:
200 amps or less 2
20
ORS 447, 455, 479, 670, 701. 201 1 amps to 400 amps 2
Owner's signature: Date: 401 to 600 am s 2
Branch circuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: 'State: • 'ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E -mail: Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Misc . (Service or feeder not included):
O Service over 225 amps- commercial 0 Health -care facility Each pump or irrigation circle 2
❑ Service over 320 amps- rating of 1&2 ❑ Hazardous location Each sign or outline lighting S S3 Ya 264-0 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel.
O System over 600 volts nominal more residential units in one structure alteration, or extension* - 2
O Building over three stories ❑ Feeders, 400 amps or more *Description:
O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egress/lightingplan ❑ Other. Per inspection 1
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Permit fee $ 'L 6 7 . U d
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application
❑ Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $
y
Credit card number:
/ / w ithin 180 days after it has been State surcharge (8 %) .... $ 2 (. 3 b
Expires accepted as complete. TOTAL $ Z$ fr. 34
Name of cardholder as shown on credit card
$
Cardholder signature Amount 440-4615 (6/00/COM)
Electrical Permit Fees: Limited Energy Fees: - -
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total 4, Check Type of Work Involved:
Residential - per unit
1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40 1 n Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular ❑ Garage Door Opener
Dwelling Service or Feeder $90.90 2
Services or Feeders ❑ Heating, Ventilation and Air Conditioning System*
Installation, alteration, or relocation
200 amps or less $80.30 2 n Vacuum Systems'
201 amps to 400 amps $106.85 2
401 amps to 600 amps $160.60 2
601 amps to 1000 amps $240.60 2 n Other •
Over 1000 amps or volts , $454.65 2
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each system $75.00
200 amps or less $66.85 2 (SEE OAR 918 - 260 -260)
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75 2 Check Type of Work Involved:
Over 600 amps to 1000 volts, ❑
see "b" above. Audio and Stereo Systems
Branch Circuits ❑ Boiler Controls
New, alteration or extension per panel
a) The fee for branch circuits
with purchase of service or n Clock Systems
feeder fee.
Each branch circuit $6.65 2 ❑ Data Telecommunication Installation
b) The fee for branch circuits
without purchase of service ❑ Fire Alarm Installation
or feeder fee.
First branch circuit $46.85
Each additional branch circuit $6.65 ❑ HVAC
Miscellaneous ❑ Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40
Each sign or outline lighting 5 $53.40 ZG / .OD ❑ Intercom and Paging Systems
Signal circuit(s) or a limited energy
panel, alteration or extension $75.00 ❑ Landscape Irrigation Control
Minor Labels (10) $125.00
Each additional inspection over ❑ Medical
the allowable in any of the above ❑ Nurse Calls
Per inspection $62.50
Per hour $62.50
In Plant $73.75 ❑ Outdoor Landscape Lighting
Fees: ❑ Protective Signaling
Enter total of above fees $ 26 I' D O n Other
8% State Surcharge $ �/ • 34 Number of Systems
25% Plan Review Fee
See "Plan Review" section on $ No licenses are required. Licenses are required for all other installations
front of application.
Fees:
Total Balance Due $ Zer- 3%'
Enter total of above fees $
❑ Trust Account # 8% State Surcharge $
Total Balance Due $
i:\dsts \forms \elc- fees.doc 10/09/00
•
CI, OF TIGARD Electrical Permit Application Plan Check#
13125 SW HALL BLVD. Recd By
TIGARD OR 97223 Date Recd
Date to P.E.
Phone (503) 639 -4171, x304
Date to DST
Inspection (503) 639 -4175 Print of Type Permit #
Fax (503) 598 -1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of business) Lo IA-1C-.5 776 Service included: Items Cost Sum 4
Address (2 6 /S Sw 7-Z . /1 4a. Residential - per unit
CI /StatelZi 'TT G AR D, i7 r- 1000 sq. ft. or less $ 117.75 4
City/State/Zip p Each additional 500 sq. ft. or
portion thereof $ 26.25 1
Commercial Residential ❑ Limited Energy $ 60.00
Each Manned Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2
(Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders
information for COT data bye) Installation, alteration, or relocation
Electrical Contractor V A'r►Cou Ss c,i., (,c, 200 amps or less $ 64.25 2
Address G 4 is' Cry `j't 201 amps to 400 amps $ 85.50 2
City VA State Zip 4 ,944 401 amps to 600 amps $ 128.50 2
ty p 601 amps to 1000 amps $ 192.50 2
Phone No. 3G o C'1 3 Y 7 f-J Over 1000 amps or volts $ 363.75 2
Job No. Reconnect only $ 53.50 2
Elec. Cont. Lice. No. 3 7 't(' CLS Exp.Date 4c. Temporary Services or Feeders
OR State CCB Reg. No. A 313 Exp.Date tl Z'( Z Installation, alteration, or relocation
COT Business Tax or Metro • a Exp.Date 200 amps or Tess $ 53.50 2
/ , 201 amps to 400 amps $ 80.25 2
Signature of Supr. Elec'n ` . . v4 401 amps to 600 amps $ 107.00 2
Over 600 amps to 1000 volts,
10 /17 /O 2-'
see "b" above.
s
License No. IS -Si � Exp.Date
Phone No. 3Ga G 3 1(1-7-, 4d. Branch Circuits
New, alteration or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name Each branch circuit $ 5.35 2
b) The fee for branch circuits
Address without purchase of service
City State Zip or feeder fee.
Phone No. First branch circuit $ 37.50
Each additional branch circuit $ 5.35
The installation is being made on property I own which is not 4e. Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or irrigation circle $ 42.75
Owner's Signature Each sign or outline lighting S' $ 42.75 2 (3 . 'fir -
Signal circuit(s) or a limited energy
if required):*
panel, alteration or extension $ 60.00
3. Plan Review section
( Minor Labels (10) $ 107.00
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over
4 or more residential units in one structure the allowable in any of the above
Service and feeder 225 amps or more Per inspection $ 50.00
Per hour $ 50.00
System over 600 volts nominal In Plant $ 59.00
Classified area or structure containing special occupancy as
described in N.E.C. Chapter 5 5. Fees:
5a. Enter total of above fees $ 2(3.7r
* Submit 2 sets of plans with application where any of the above apply. 740,8%; Surcharge (.05 X total fees) $ I Gr. 1 G
Not required for temporary construction services. Subtotal $ Z. 26..7 -I
5b. Enter 25% of line 5a for
NOTICE Plan Review if required (Sec. 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account #
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ 7,24
is \fists \forms \electric.doc
7,5LA
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
3-24 BUP
Date Requested AM PM BLD
Location /U' /5 Sw 7 -., 11 Suite MEC
-
Contact Person Ph 360 69,1773 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC aGui -AO �D 6
Retaining Wall ELR
Footing Access:
Foundation ' / FPS
Ftg Drain / AA/ Go-t , , D
Crawl Drain Inspectio Notes: SGN ..200/ G . 7
Slab SIT 37
Post & Beam 3
Ext Sheath /Shear
Int Sheath /Shear �( o
Framing U /
Insulation '
Drywall Nailing (s) c y A / A c ,- v cJ�s
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS ART FAIL
CEI ECTRICC/ L
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
440 •ART FAIL
Backfill/Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: ' ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk
Date i Inspector _
Other _ _— — Ext
Final
PASS PART FAIL D • NOT REMOVE this inspection record from the job site.