Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2008 -00059
COMMUNITY DEVELOPMENT DATE ISSUED: 2/1/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223. 503.639.4171
PARCEL: 2S101BB -01300
SITE ADDRESS: 11950 SW GARDEN PL 100 ZONING: C -G
SUBDIVISION: CROW PARK 217 LOT : 001 JURISDICTION: TIG
PROJECT: PARK 217 BUSINESS CENTER
Project Description: electrical connection for (1) LED message center
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:
GVA KIDDER MATTEWS TUBEART SIGNS
ONE SW COLUMBIA ST. 4243 -A SE INTERNATIONAL WAY
PORTLAND, OR 97258 MILWAUKIE, OR 97222
Phone: Contact #: PRI 503 - 653 -1133
FAX 503 - 659 -9191
FEES
Description Date Amount Reg #: ELE 37- 554CLS
[ELPRMTJ ELC Permit 2/1/2008 $53 40 LIC 70956
[TAX] 12% State Surchar 2/1/2008 $6.41 SUP 366SIG
Total $59.81 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable laws All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for
more than 180 days ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in
OAR 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain copies of these rules or direct questions to OUNC a .i 246. :699 or 1 800 332 2344
Issued By: �It � P_ermittee Signature:'
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Electrical Permit Application " r = FOR OFFICE USPONLY ' ', b ` , . .
~ City of Tigard Dat By QUA, Permit No Le --
q 13125 SW Hall Blvd., Tigard, OR 97223 P lan Review
71
Phone 503.639.4171 Fax: 503 598.1960 l ate/B Other Pei nit
T IGARD Inspection Line 503 639.4175 Date Ready /By funs ® See Page 2 for
Internet' www.tigard - or.gov Notified /Method Supplemental Information
° ,' a�,° _ `,b:$ =r -!.. „ - , ; `1,, ' ".. : ,1 ', x,44. ' �,.,.
-y� ; PYP..OF WORK - . r �- ' "PL`A'N RED lEV� ,- �
❑ New construction ' Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below)
❑ Service or feeder 400 amps or more ❑ Building over three stories.
['Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards
• 1c /-' '''' ' " "A CATEGORY -OF ..CONSTRUCTION ' _; ' t.' exceeds 10.000 amps at 150 volts or ❑ Floating buildings
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ I- and 2- family dwelling 0 Commercial /industrial ❑ Accessory building amps for all other installations buildings
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump, ❑ Installation of 75 KVA or
e' ,', v ', * a., r ,,. f r 4,,,, El Emergency system larger separately derived system
. 4 J OB x SITE '' IV ¢ lkri ' LOCA T IO - N : = °
' �w'; - , s , o?.� , 4 I � ._ . - A �, ._ Atii z' r Via' .. n ['Addition of new motor load of ❑ . ,.E.. I.2.. . 3 ..
Job no : '} I o ! 4a /1 Job Site address. ) t / 6 s 6, I
1001 or or more occupancy
P Six or more residential units ❑ Recreational vehicle parks
City /State /ZIP: f; J 0 i 9 �� "2 0 Health-care facilities El Supply voltage for more than
„it J ❑ Hazardous locations 600 volts nominal
Suite/bldg. /apt. no.: kx) Project name: 1?4,,Lm.1--4._ f ❑ Service or feeder 600 amps or more
I °' ' , ',, ;F e' E- :Scir_EI) UL p ! "-: „y„;ti , ' r :,,, , ,
s ite:
Cross street /directions to job F� ° - �� I ` °'
J D escription I Qty. I Fee. I Total . � ° 1 it
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq ft or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no :
Limited energy, residential
°'' I - i DESCRIPTION' OF: °`WORB (with above sq. ft) 75.00 2
Limited energy, multi-family
6- ( r"; (, f . P4-- -' �'' (i') L, .E.'' residential (with above sq ft ) 75 00 2
Services or feeders installation, alteration, and/or relocation
/'1A G S ` 200 amps or less 80.30 2 -
PROPERTY QOWNEB' °: - °; °' � ° i- 'D` EIVA°NT "; ;f °"' 201 amps amps 106 85 2 s to 400 am
,: "A� "�.„ .x ®�=a� � . , . ,� r �, ���'a ' ,,: ' �t � ' �no�° ��. � ^ �p� ���' °,',�, p P
Name: Cr V A f ci A i,, S 401 amps to 600 amps 160 60 2
601 amps to 1,000 amps 240.60 2
Address: r '
,� Si, t 1 C r s� ; / e' ?Sc. Over 1,000 amps or volts 454.65 2
•
City /State /ZIP: �� 4- � / D I1 e $- $ Temporary services or feeders installation, alteration, and/or
V( relocation
Phone: ( ) Fax: ( ) 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 599 amps 133 75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
:4,,z,:-.;, APPLICANTS j.,:;-,,g3,,:,',',. r E ; ' *I tv.„,0,,g9INTACIFTg,scIN'',:;r4.,;;I, above service of feeder fee,
each branch circuit 6.65 2
Business name: ` ' u A t- � s B Fee for branch circuits
Contact name: without service or feeder fee,
Z - , 4 -e A (J s' �-j e_ first branch circuit 46 85 2
Address. Ch ti _ r � � Each add'l branch circuit 6.65 2
y t a--.0. °t 'J Miscellaneous (service or feeder not included)
City /State /ZIP: /4., 1 c.., a..t c ,R OR. 4 7:).■),r'l.. Each manufactured or modular 90 90 2
/ dwelling, service and /or feeder
Phone: (S ) c S '3 _ it 3-- Fax: : (5"3 ) G6" _ c 1((1 ( Reconnect only 66.85 2
E -mail: r q , t k r j e 6,a, �„ i- c ,,,, 1 Pump or irrigation circle 53.40 2
: ` ' - •' "l'° 1:, Sign or outline lighting
�" �" . . y. - ' ,,= Ry ; x CONTRACTOR n . �> ° 53 40 2
_ '� .� �,�'" try '� w; ' g
Business name: ,, A Signal circuit(s) or limited -
bc /4 1 �; e p �e As 5 energy panel, alteration, or
Address: l extension. Describe Page 2 2
S "- --.- -e
City /State /ZIP: S cw`—t._ Each additional inspection over allowable in any of the above
Per inspection 62 50
Phone: ( ) S Fax: ( )
a' S D.........Q Investiganon per hour (I hr mm) 62.50
CCB Lie.: 7-6 9 5- 6 Electrical Lic.:3? -3S'- /ens Suprv. Lic.: C,( - 5/ 6, Industrial plant per hour 73.75
'. • s; ' ',.ELECTRICAL', PERMIT' FEES' ",'' ;` ,- . -"'
Suprv. Electrician signature, required: - 5-5 r'( U 2:e .6;
otl
Plan review (25% of perm fee
Print name: / Date: l
���"� L. ( � 0� 0 p
- 2 State surcharge (I2% of permit fee). G .4
Authorized signature: ,,--"/"
- - ". / — — TOTAL PERMIT FEE ST ,
/ This permit application expires if a permit is not obtained within 180
Print name: Date:
lei A � I r A 3 t A p/G days after it has been accepted as complete.
* Number of inspections allowed per permit
I \Budding \Pei mils \ELC- PermuApp doc 05/23/06 440.46 15T( I I /05 /COM /WEB
-7--
CITY OF TIGARD
BUILDING DIVISION .
PERMIT #: E
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 211/20013
Phone: (503) 639-4171 kmotivoi
Inspection Requests (24 Hrs.): (503) 639-4175 4. 'AL
INSPECTION WORKSHEET FOR DATE: 3/28/2008 TIME: 7:01AM PAGE: 21
SITE ADDRESS: 11960 SW GARDEN PL 100 CLASS OF WORK:
SUBDIVISION: CROW PARK 217 LOT #: 001 TYPE OF USE:
PROJECT NAME: PARK 217 BUSINESS CENTER
DESCRIPTION: electrical connection for (1) LED message center
OWNER: OVA KIDDER MATrta\k's,, PHONE #:
CONTRACTOR: TU3EART SIGNS PHONE #: 603-653-1133
Inspection Request Scheduled For: Date: 3/28/2008 Pour Time:
Code # Inspection Description Confirm4 Contact # Message
199 Electric:al finai 067479-02 503-653-1133
Corrections/Comments/Instructions:
6 S • ■■■_ - • _
j
N •
•
PASS I I PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
I FAIL CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: C)'■ 066 Date: 3 '1 Phone #: (503) 718- 204