Permit A
CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00645
A re DEVELOPMENT SERVICES DATE ISSUED: 10/6/2004
"--" 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S136DC-02504
SITE ADDRESS: 07295 SW DARTMOUTH ST
SUBDIVISION: PP1995 - 013 ZONING: C -
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of (1) branch circuit for 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:
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: 1 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:
SUPERVALU HOLDINGS INC HORIZON SIGNS & REPAIR
BY BURKE + NICKEL 2048 LANSING AVE NE
3336 E 32ND ST #217 SALEM, OR 97303
TULSA, OK 74135
Phone: Phone: 503 - 581 - 6734
Reg #: LIC 134490
ELE 24 -411 CLS
FEES SUP 630S1G
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 10/6/2004 $46.85
[TAX] 8% State Surcharge 10/6/2004 $3.75 Rough -in
Elect'I Final
Total $50.60
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: ('/ - Permit Signature: _- P/(C,(IA 1/
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
D
OCT— D7- 201194 eB:59 Al �e a�i�1T3 r.n�
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City of 'Tigard 11
, / 4 Q �' Seefnit No.6�ra�oo 6 J ! 6 "
13123 aW ttall 131vd.. Tigard PA 9721 .. ..ur
Roue: 303.639.4171 Fasc SQ3.39e,1 v l b 2004 teas sYsviaw mftm `'t Othts Nunn Nunn t:npeadoe Licsa 639.4175 BelaDeta ResdY>T"9 **Pap r
&serest: rtwtr,cd. 5 .tien t orMs (: d F TIC A a 1�9, G , amend imam P _.
PS 1, '- r, s 3a,< Lv to ".; Cif 1 ,344 lF T Y S ^ }4P tM 4 " -"tM �#
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}�� i'� �f'si;'�Sa ='�. � " � ..4. �� 4 fiS?i�j -J E ' $ � %fFS� � fS��� µ� � 'r� 3 . v ,. `�. . . ��; k " �R `�" ,r� y�--+ : ,,
New construction I • Adriitioo /elttttetisnheplatemerd Plano cluck adl ilia apply:
Cl Demolition so Othpt C.)01vvlca over 225 saps. carnal ❑t4+uaedeua lecation
m- , 1f sit ts ? .vµ44 y ,usF. r � t.sa < g; nielli 'WIT 3 aatpa - ntttano 0 Sultana ova l0 4 R.,
01-TAk SI3'nrTax Pi 'st '''e' .1. byt "`'.* ;` »1 ' '' 1 d1 'and2dat16i dwarf 4arIrannewnee
it :. . � ,3�. '� ..,� "�: '.�. Fe- :.�' 1Y •
II i- and 2 -Eddy dwwellm$ c'.'. ", sucielhodustrild II As<eeuory buiddios ®llytdeal ova 600 volts aennbsat odds In sae sSauantrd
t frond Mash NNW III d ies ova thlea dories D Feeders, 400 asap
III t .w M 10 ;„ uc ? .,�y 1 •I r r0,, ,".. ?fi e,, ? J Yr• sN - 11.7 ,, * 7 4 j ®oFVtYpa It ovtr 99 persons ❑ atfatttuad W'
' ` 4. � ll,4 . .f'i " , fi t se, 4, ` �4 "t' i le r + ^ f 4-4, 4 ,s � 3� i � > yy .4. � ry� iotaing plan
d ^ I .Y> ,r t ai] + «.cibier [. ,¢.ifiy,Gw x«.� . i } w + >.r r , ;.w, "tit � .r � }.7rtitr.�lii>'�.: i�ass•'[tatdirtg RV pork
Job no.: Sob site addre - :- • . W, DA , e r - v DFIadt1►�tto Suety
n .g `e Laura a ear aryl= what any of the above.
City/State/ZIP: rt�tO t! 4L e3 2,7-3 23 The above are not applicable to tamper consantotlon
S'ailQibld$./tgrtl Qo.: P1't7jiCt AAt"6sl: ,. .
o.,et p
crew utted/direetions to job site: New raddetWal dusk- • nily & ilos ondfl
Includes attrashed 11aa'tlga
1,000 t!, or len 143, l3 4
Ea. tddrl SOYA I. R. a' • -• ion Subdivision: Subdivision: II. 1'3 ( 1
I intsud ea
drgg rwidmdel 13 2
1' , i' S a3� :4?Ix h iii S }W4+; 11 3 2 ��• mlede llartitaid9AtldT 73.tQ i
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tierdetn or feeders Isatallatl , olttsrallo in a, - • -r',,
�} �< , 200 ....,. s a lase 90.30 it E �.' tn' st� "cn1 ,�c „sr1 Y"fr i 41 ,31 , +£ ' tir9 a i -�.> 4 ,4'.r. X3 ' ': 201 , to 400am. 1
, g,.„ , , i tv t 44 ++ m!r4%- „G.,t,� war}. q, >4 . l: r 4 ...W ` m ts , a 401 .09600 160.60 2
Voete: t_,_„•. a ,,,111111111•111 246.60 MIN 2
Address: Over 10"JO , .6 a volts
444413 MEI ' 2
Reconnect only 66.113 2
City/Stara/ZIP: Tsatproary eervkou or Nudes inetaliatlos Year s, ' r
11wu ; ( ) Ftd {, ( ) 100 ., erase 6685 i
Owner lnstellatien; 1” f` { tied in betel made on property t d own which in not 201 amps to 400 , - En 100 ; 3
in :0nd ibr sale, imam tent, or exchange, soon +dins to ORS 447, 449, 670, sad 701,
Oweter 1- . snip 2
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Btu:41M - . ( t\ ) -1 4ptu>' R 4+RDF�I
branch ®(rats 1
H. Paz for branch airopits
Contact aims; A- W Mott; service or tbedar fee•, y
7 each 5 rah circuit / 46.$3 1
Acidrem LG5' 1 ,v , , • sites (f Eseha8d'1 6.63 E
City / tatorztP: 1 P , _ n� 97 2 Miscellaneous (service or fader not intelYaad)
Phone: ( ) _ I Pump or III ion, chrole 13.40 2
E -reii si;a or ct►lline lt11tf ; 53.4
u Rw1.: �r 7� n ” �a gu t' * ' Paul' a)n Of limited- ,
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2
a rlasulon. Describe: Paps 2 2
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Address. R a • .e.... tadlt brapendon over anowu , > In . , (tithe 6. e4 Per inspection 62.50
City/SWAMP: ♦ 0 + + / Invest ion .. haw (I hromJ b2.l0
Phone: { ;St13) . f — — Industrul t has Mil 3 73 mum f
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sum,E - • .: hire, � -' !D I dS Plan review(2S%otpetmiti'se) • ...i. Its i�L
Print Marne: 77714, cy / 401 Data $ttae=rename dais aloe/ma Ste) , '. 7s
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I� r TOTAL PERMIT FEE - r , (� p
tltotize9d
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Print arena: / days agar It Au bum accepted or aagtp}rW
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