Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00448
COMMUNITY DEVELOPMENT DATE ISSUED: 7/3/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S127DD-00100
SITE ADDRESS: 09730 SW CASCADE AVE ZONING: C -G
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: SHANE CO
Project Description: (4) 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: 4
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:
T MICHAEL + ASSOCIATES LTD SECURITY SIGNS INC
ATTN: JOHN WEGMAN 2424 SE HOLGATE BLVD
9200 E MINERAL AVE, SUITE 200 PORTLAND, OR 97214
ENGLEWOOD, CO 80112
Phone: Contact #: PRI 503 - 546 -7114
FAX 503 - 230 -1861
FEES
Description Date Amount Reg #: ELE 26- 560CLS
[ELPRMT] ELC Permit 7/3/2007 $213.60 LIC 122809
[TAX] 8% State Surcharge 7/3/2007 $17.09 SUP 383 SIG
Total $230.69 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 B / j 41 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.
4.
Electrical Permit A li ..atli l� y � I OR of 1 IC L i s,: o r_�'
City of Ti and Received
g Da t eB . 7 .3 Permit
13125 SW Hall Blvd., Tigard, OR 97223 JUN 2 9 200 'i- Q — ��
Plan Revi= Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 ' 'r'1 � i•`• Date/B
Inspection Line: 503.639.4175 CITY OF TIG ,,1� , '_�_� i Date R . adyBy: Inns; " RI See Page 2 for
Internet: www.ci.tigard.or.us BUILDING ERIN* V Notified/Method: Supplemental Information
?' s?� €e'�3_ �.e�a >.;�;F•yti',%�;^"- 'tom'::. _ - a- ;g- - +.ucve'+ -- �..;v� „�.. e! �� +:��- ..•usvf:;�rg�,_��- .•..� ==,� °a�; j,: �;�wryvs� � i.- .,�,.a;..- s,:�., _ „� - <f ,�
r _r fi . = ` r .w , r.,. dEZ ms s sEdEg5AOkg:; - a.,, 116: s r - .. iT... .:. n €�;.., ' ,
��2— `.�4a.�,•_�����..��,����'P,.,� . ��.a�`.;`�'' „�' t ��.'�<RrI:,� ;�� : aPLN�REVIEW �° �:���,-.
„ New construction ❑ Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑ Other:
0 Service over 225 amps, comet [(Hazardous location
s _ ,,, � u r ,,, _� ,.< r n -:� _� -... . ;« r ^f . [(Service over 320 amps -rating ❑ Buildng over 10,000 sq. ft.,
: %- ; CATEGORYx4OF. eli TR ' �t °• :011 »”" ,,:
,,,, .' , .�.., - -,, - 4,._,.., S _UCT'ION , .. - r 0 . m .., tY , r,,. r Ag of 1 -and 2- family dwellings 4 or more new residential
❑ 1 - and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family ❑Master builder ❑Other: [(Building over three stories [(Feeders; 400 amps or more
Via . . _ , . _ builder YI E - � r , k ¢ [(Occupant load over 99 persons ❑Manufactured structures or
._ ` t ,,,_ a e JOB S1TE'�INF r - a 5 x ?"., : - ..F Egress/lighting AND LOCATIO , y ` Y t , .r gress/lighting plan RV park
Job no.: Job site address: � ❑Health -care facility ❑Other: 2
�^^ /��.,�, Sub mit sets of plans with any of th
`yJ� _ p y the above.
City /State /ZIP: \ � \ \ \ ���/�� t , r /� I ( /J�� //�]�� The above are riot applicable to temporary construction service.
Suite/bldg. /apt no.. Project name: \/ tnta FEE.„ SGHED.UM.SE �-t , MMI
Description I Qty. I 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: I 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
E3 S' °a-,"' N u, ✓•i.`fi'1,5' : :.� ... • ' - Fr't''," '` :} ! v ;r.''HS e :
,?' �• , .: ' , -;i DES_ CRIP7TUNYO, , Ri i
,. , r ,.,. , ' ^ %. F , •,
,.� �:�r + �,�+`•:x.. ,.� -` �, - ..F.� -- ,.- ,..,�.�._,���._. „_., x?'�: -. E ach manufactured or modular
4 a )(x. �.( o / �� ]GA L dwelling, service and/or feeder . 90.90. 2
�- lJ ll ! - Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
`wr 4f ' z y `• "=E' .„ . ° rgA S '". ' ir- - .y. 201 amps to 400 amps ® i< ^ PROPERTY ' f _: - , a i aw P P 106.85 2
t�= _'�s��:.. -,Kra. - _ s: �OWNER�: ����pe,.° � :;��,�.��r': ®+ .= ,TENA 1 VTs��.�� g�.y "" . �`
" "" r5r mR 401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65. 2
Reconnect only 66.85 2
City /State /ZIP: Temporary services or feeders installation, alteration, and/or
Phone: ( ) I Fax: ( ) relocation
• 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 600 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
o , , '. .. k,t ° -° -h in
5 . .4,' 'c ,,,- ^ . c ,. s I C A NT" 49i €P, ® -' _ A. Fee for branch circuits with
a'�:��3 a:. m.:•,'.._ �...,.- -. 'N7- 3c. .- ... '`�, CO,.NTAGT'.'EkEILS U11i � .� ' ��; , :;��:rt
service or feeder fee, each 6.65 2
Business name: 2 3Q\ .t �‘g9s branch circuit
B. Fee for branch circuits
Contact name: A � , �d c pf) without service or feeder fee,
Address:
' each branch circuit 46.85 2
Each add'I branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
fL �r ``L�' + _ j
f,/'„ Pump or irrigation circle 53.40 2
Phone: (r 3) gL/ Fax: ( 76 1 1 Sign or outline lighting ' 53.40 2
E -mail: o 9 e << .Zr.� D e..; secirk Signal circuit(s) or limited -
L 9 ." ESZ "' �'tV
�� ;_��.:��- �:"' ��o s��? 'i~.�.CONTRACTQR..'��k "�it��r �u- '�:*�� �+ q.M energy P anel, alteration, or
extension. Describe: Page 2 2
�
Business name : S
Address: 9- ` Each additional inspection over allowable in any of the above •
" ` �1 /i j� P e r inspection 62.50
'City /State/ZIP . - - o y Q '7 /f�TO Investigation per hour (1 hr min) 62.50
Phone: (i ! - 7, I ,l F / • n 2� 1 I `�Ol J am/ _ f Industrial plant per hour 73.75
l(J T Gam_ 7� x.».. - *ten i ^'= ` r
:;t�€��ia �r, ELECTRICAL `�'PEItM1T�(l?EES,„ `;. �-�-�'
CCB Lic.: I ZZ �O9 Electrical Lic.: - ao '. 4 Suprv. Lic.: �v)(' k 3 4 °.x
� � subtotal A 1 3 . 4pLv
Suprv. Electrician signature, required: � i Plan review (25% of permit fee)
i (� L? I Date: State surcharge (8% of permit fee)
Print name: Stt h 8% f f
7-.. ;
�, �l L TOTAL PERMIT FEE A30,
Authorized signature: —: � 1 This permit application expires if a permit is not obtained within
M � r ,, days after it has been accepted as complete
t 1 1��i.
Print name: t�, t. Date: • Fee methodology set by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed.
is\ Building \Permits\ELC- PermitApp -doc 12/03 . 440.4615T(I 0/02/COM/WEB
•
S
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
4 , S EN T4IAI; WORkil5 TI ` ,< r P .
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
El Burglar Alarm
; %❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
FiGo IAL�W, ®WO ONS„M?;
Fee for each commercial system $75.00
(SEE OAR 918 - 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
i \ Building \Pertnits\ELC- PermitApp.doc 04/03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007-00448
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7f3/2007
Phone: (503) 639-4171 -"spot,
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 1002007 TIME: 7:01AM PAGE: 57
SITE ADDRESS: 09730 SW CASCADE AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: SHANE CO
DESCRIPTION: 0) Sign lighting.
OWNER: T MICHAEL + ASSOCIATES LTD, PHONE #:
CONTRACTOR: SECURITY SIGNS INC PHONE #: 603-546-71141
Inspection Request Scheduled For: Date: 10/512007 Pour Time:
Code # Inspection Description - Confirm # Contact # Message
199 Electrical final 056996-01 503329-5995 N N Y
Corrections/Comments/Instructione: N---- WAR\L "7\
LA)
PASS n PARTIAL APPROVAL CANCEL 7 NO ACCESS
FAIL j CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: 01 NO6 Okr Date: 1016101 Phone #: (503) 718- vfLit,
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007-00448
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/312007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/18/2007 TIME: 7 :00AM PAGE: 36
SITE ADDRESS: 09730 SW CASCADE AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: SHANE CO
DESCRIPTION: (4) Sign lighting.
OWNER: T MICHAEL + ASSOCIATES LTD, PHONE #:
CONTRACTOR: SECURITY SIGNS INC PHONE #: 503-546-7114
•
Inspection Request Scheduled For: Date: 9/18/2007 Pour Time:
Code # Inspection Description onfirm °# Contact # Message
199 Electrical final 055873 -01 503-546-7114 N
Corrections /Comments /Instructions:
Rol,) Dr A 6 5 it S /IN bisc6NNt�V_
The electrical installation defects noted
on this report shall be corrected and
an inspection request made within 20
calendar days per OAR 918 - 271 -0030
I I PASS n PARTIAL APPROVAL ❑ CANCEL [l NO ACCESS
FAIL n CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED
Inspector: Cr m N g l Date: CI(I 1,1 O- I Phone #: (503) 718- - 100