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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2006 -00011 -,' DEVELOPMENT SERVICES DATE ISSUED: 1/9/2006 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171 PARCEL: 2S110DC -02300 SITE ADDRESS: 11545 SW DURHAM RD B -6 ZONING: C -G SUBDIVISION: WILLOWBROOK BUSINESS PARK LOT : JURISDICTION: TIG Project Description: (5) sign /out line 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: 5 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: SIGNCRAFT LLC 9033 SW BURNHAM TIGARD, OR 97223 Phone: Contact #: PRI 503 - 639 - 4910 FAX 503 - 639 -4999 FEES Description Date Amount Reg #: LIC 155420 [ELPRMT] ELC Permit 1/9/2006 $267.00 ELE 34- 674CLS [TAX] 8% State Surcharge 1/9/2006 $21.36 SUP 75SIG Total $288.36 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: -, -- Permittee Signature: i / � " 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. . ON Electrical Permit Application a ' r r �. 3 .c Wash County Phone: 503 - 846 -3470, Fax: 503 - 846 -3993, Inspection Request: 503 - 846 -3699 155 N. 1 AV, Suite 350 -12, Hillsboro, OR 97124 www.co.washington.or.us OR F60 Land Use Ap Project # Permit # �, Z ,2 J 2) l TYPE . 'OF WORK PL "AN. • ❑ New construction ❑ Addition /alteration /replacement Please check all that apply: /� � � �y ❑Service over 225 amps, comm'i ['Hazardous location ❑ Demolition ther:( DUST - I L` t / l J v N ['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 • ❑System over 600 volts nominal units in one structure ❑ 1 and 2 family dwelling 3Eommercial/industrial ❑ Accessory building ['Building over three stories ❑Feeders, 400 amps or more ❑ Multi - family ❑ Master builder ❑ Other: ['Occupant load over 99 persons ❑Manufactured structures or ❑Egress /lighting plan RV park • • • JOB SITE INFORMATION' AND.'LOCATION ['Other: . . ❑Health - care facility Job no.: Job address: / / �5 .SOU Durham ES *r,-,,,,, b mit 2 sets of plans with any of the above. t�l service. above are not applicable to temporary construction s City/State /ZIP: T 1,9 av-A J o 2 577 ,— / FEE. SCHEDULE i Suite/bldg. /apt. no.: 3 (/� Project name: Tf( M t Description Qty. Fee. Total New residential single or multi- family - per dwelling unit. Cross street/directions to job site: Dar k a I t.-1-0) ` J CI i' Include square footage for attached garage. I 1,000 sq. ft. or less 150.00 4 Ea. add'l 500 sq. ft. or portion 42.00 Subdivision: 1 Lot no.: Limited energy, residential 60.00 2 Tax map /parcel no.: Limited energy, multi- family 66.00 2 Each manufactured or modular 102.00 2 DESCRIPTION OF. WORK. ' . ' dwelling, service and/or feeder Services or feeders installation, alteration, and/or relocation 1400 kU r el - eG t'Y I G S 110 S 4 CAI 5 200 amps or less 90.00 2 . �� _ amps to amps 320.00 2 [yPROPERTY OWNER'• 401 amps to 600 amps 180.00 2 • � ,. � .. ❑ TENANT' �� _ 7� 1o.� q r ( n 601 amps to 1,000 amps 270.00 2 Name: 1 �U ! t' aoct1 -a ( ©8d Over 1,000 amps or volts 504.00 2 Address: Reconnect only 78.00 1 Temporary services or feeders installation, alteration, and/or City/State /ZIP: relocation 200 less 78.00 2 Phone: (.9l ) e( 73 , 023 sr Fax: ( ) amps 201 1 amps to 400 amps 108.00 2 Owner installation: This installation is being made on property that I own, which is not 401 amps to 600 amps 150.00 2 intended for sale, lease, rent, or exchange. Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ feeder fee, each 8.50 APPLICANT•' branch i u a ee e .. �:._• "� ' _ � � � •� � �CUNTACT� PERSON' .� branch circui t 2 CSItm 0 v +l10don -h B. Fee for branch circuits Business name: gall without service or feeder fee, 60.00 Contact name: g ej Ge V V I it co >4 , first branch circuit 2 Address: l 5Z+.t ! ( Du r I civil vi Each add' l branch circuit 8.50 ( - (p Miscellaneous (service or feeder not included) City /State /ZIP: 7-7 ar U Q i2 01-722_14- Pump or irrigation circle 60.00 2 Sign or outline lighting -6e'Ot1 2 Phone: (5 s _ 11. Z Fax: ( ) Signal circuits) or limited- y f / E - mail: (Af I I( Co x h (@ . ©m 5 il.e -f- energy panel, alteration, or 60.00 extension. Describe: ' C 2 ��� ^ s Each additional inspection over allowable in any of the above e Business name: S f Y) Q evl Y C(/ 1 AV( V . Per inspection 90.00 Address: D33 S /,t) g YVJ ha Investigation fee (SEE COMPLIANCE) City/State /ZIP: V V arcs o/2 g 7222 Other "ELECTRICAL, PERMIT FEES *' -> Phone: 31 (0 -7 , 461 Fax: (b3 ( , Loll Subtotal $ " Go Lic. no.: 3/4 -6, 7 Li _ (,Is CCB lie. no.: j 5342_0 Plan review (25% of permit fee) S Supervising uire electrician EJ n signature, required: State surcharge (8% of permit fee) $ ...5"‘ TOTAL PERMIT FEE s � u A () (j (<i,') -y I • �' - Print name: D ate: This permit application expires if a permit is not obtained Authorized within 180 days after it has been accepted as complete signature: * Fee set by Tri -County Building Industry Service Board ' Print name: 6h e c %j Date: (' q ' 0S "* Number of inspections allowed per permit. 440 -4615T (7 /03 /COM/WEB) CITY OF TIGARD BUILDING DIVISION PERMIT #: 2 06' 06061 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 /nuau Inspection Requests (24 Hrs.): (503) 639 -4175 = A ! I \ INSPECTION WORKSHEET FOR DATE: _13 .d 6 TIME: PAGE: SITE ADDRESS: ■%Sy,S Sus b .RA*1tNl, PJ r -6 CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: S%c\A CAW*" L,LC, • PHONE #: Inspection Request Scheduled For: i .-te: Pour Time: Code # Inspection Description Con ' m # Contact # Message ■St,‘ . \ 4NIT. Corrections /Comm- -•. - _ • •,: tea% cb i \\\Za' • • 11I PASS U PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS [ I FAIL ❑ CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: r U V k*I3 LE Date: Ili 31 OA Phone #: (503) 718- Z"� CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2006-00011 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/912006 Phone: (503) 639-4171 „.... 40, 0 11 1 t Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 1/11/2006 TIME: 7:01AM PAGE: 41 SITE ADDRESS: '11545 SW DURHAM RD B - 6 CLASS OF WORK: SUBDIVISION: WILLOINBROOK BUSINESS PARK LOT #: TYPE OF USE: PROJECT NAME: DR VVILLCOX DESCRIPTION: (5) sign/out line lighting. OWNER: DURHAM/99 ASSOCIATES LTD PHNSH, PHONE #: CONTRACTOR: S$GNCRAFT Lie PHONE #: 503 Inspection Request Scheduled For: Date: 1/11/2006 Pour Time: • Code # Inspection Description Confirm # Contact # Message 199 Electrical final *024759-03 503-88B-0214 Corrections/Comments/Instructions: C.JO Ft vt.)t)aX.. #0 C_ALL P.JE irc'S es fl PASS 0 PARTIAL APPROVAL El CANCEL 0 NO ACCESS &FAIL RCALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inspector: C-I - Akt Date: \ -\\y-o Phone #: (503) 718- 2496