Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2001 -00318
l's DEVELOPMENT SERVICES DATE ISSUED: 6/18/01
'�', 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S103DC - 05900
SITE ADDRESS: 13680 SW 115TH AVE
SUBDIVISION: VIEWMOUNT ZONING: R - 4.5
BLOCK: LOT : 047 JURISDICTION: TIG
Proiect Description: Installation of one 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: 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:
PROCK, TIMOTHY L AND MULTI -LIGHT SIGN CO.
CHAN, LINDA L 809 N E LOMBARD
13680 SW 115TH AVE PORTLAND, OR 97211
TIGARD, OR 9722
Phone: Phone: 281 -3083
Reg #: LIC 64107
SUP 343SIG
ELE 26 -90CLS
FEES Required Inspections
Type By Date Amount Receipt Wall Cover
5PCT CTR 6/18/01 $4.27 2720010000( Elect'I Final
PRMT CTR 6/18/01 $53.40 2720010000(
Total $57.67 EXPIRED
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 c .pi- o - - ules or direct questions to OUNC at (503)
246-6699 or 1-800- 332 -2344.
Permit Signature: Iss ed By: -
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 639 -4175 by 7:00pm for an inspection the next business day
:*
s
Electrical Permit Application P ermit no.:
D atereceived: 6 tic D / L / — a , 3/ g
� I ` City of Tigard Project/appl. no.: Expire date:
Recei t no.:
Address: 13125 SW Hall Blvd, Tigard, OR 97223
City of Tigard Date issued: By: I p
Phone: (503) 639 -4171 Case file no.: Payment type:
Fax: (503) 598-1960 O tCg
Land use approval: 5 ta� I — D
TYPE OF PERMIT
❑ Multi-family ❑Tenant improvement
❑ 1 & 2 family dwelling or accessory a Commercial/industrial y ❑ Partial
LI New construction ❑ Addition/alteration/replacement ❑ Other:
JOB SITE INFORMATION
Job address: / '8C 51. C 1 4OV 77(,4r( Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: IBlock: s ubdivision: , / f
Project name:'77 q(D A iveyig 1 I Description and location of work on premises: /DZ) Jt r (�,' 7 a ,
, / N.
Estimated date of completion inspection: rnv , , FEE SCHEDULE CONTRACTOR APPLICATION — `* Fee Max
Job no: A
Business name: Description Qty. (ea.) Total no. insp
irie: �(� it (�L l J New res - single or multi- family per
Address: 'Q 7 X,' Minh d dwelling unit. Includes attached garage.
City:�(y�' f//p n t J State I ZIP: Q / , // Service included: 4
't
Phone: i 1000 sq. ft. or less 3 I Fax: I E-mail: Each additional 500 sq. ft. or portion thereof
CCB no.: Zn L// 1)/2 I Elec. bus. lic. no: ,3 93 Limited energy, residential 2
City /metro li . 0.:
Limited energy, non - residential 2
i J's/ O, Each manufactured home or modular dwelling 2
....weir ./../, —.OW -..V., _ — – Da 1 Service and/or feeder
Si :nature of su.rsing electrician (required) Services or feeders – installation,
(print): License no: al teration or relocation:
Sup. elect. name (p ): 2
PROPERTY OWNER 200 amps or less 2
�7,, 201 amps to 400 amps 2
Name (print): %CCt ' Sf I C /1 / 401 amps to 600 amps 2
Mailing address: ! 3(O rl � 5/4.), eif, f 601 amps to 1000 amps 2
/ S tatr�l,�'� I ZIP: ( I , Over 1000 amps or volts
City: p l���CC
Phone: (pa sfr675 I Fax: I E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
installation, alteration, or or relocation: 2
which is not intended for sale, lease, rent, or exchange according to 200 amps or less 2
ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 2
Owner's signature:
Date: 401 to 600 amps
Branch circuits - new, alteration,
or extension per panel:
Name: $ (u)/U / ( 7i'7' 2 L� e J A. Fee for branch circuits with purchase of 2
V service or feeder fee, each branch circuit
Address: B. Fee for branch circuits without purchase
City: I State' I ZIP: B.
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): 2
❑ Health -care facility Each pump or irrigation circle 2
❑ Service over 225 amps- commercial Each sign or outline lighting i
O Service over 320 amps -rating of 1 &2 O Hazardous location Signal h s circuit(s) outline n a figh ting energy panel,
family dwellings 0 Building over 10,000 square feet four or Sia cir ui (s) or a li 2
O System over 600 volts nominal more residential units in one structure
O Building over three stories 0 Feeders, 400 amps or more *Description:
U Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above: I
O Egress/lightingplan 0 Other: Per inspection 1 i
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Permit fee $ 49
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application
Plan review (at _ %) $
O Visa 0 MasterCard expires if a permit is not obtained State surcharge (8 %) .... $
Credit card number: / / within 180 days after it has been TOTAL $
Expires accepted as compl P1 R E
Name of cardholder as shown on credit card $
4404615 (6/00/COM)
Cardholder signature Amount