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Permit
C ITY OF TIGARD ELECTRICAL PERMIT ^" - PERMIT #: ELC2004 -00692 . 1 DEVELOPMENT SERVICES DATE ISSUED: 10/28/2004 .�:� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1 S135DD -04400 SITE ADDRESS: 11900 SW GREENBURG RD BLDG 1 SUBDIVISION: ZONING. C - BLOCK: LOT : JURISDICTION: TIG Project Description: Sign in driveway. 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: BC ASSOCIATES SIGNCRAFT LLC 11900 SW GREEN BURG 9033 SW BURNHAM TIGARD, OR 97223 TIGARD, OR 97223 Phone: 503 - 245 -6513 Phone: 503 - 639 -4910 Reg #: L1C 155420 ELE 34- 674CLS FEES Description Date Amount Required Inspections [ELPRMT] ELC Permit 10/28/200 $53.40 [TAX] 8% State Surcharge 10/28/2004 $4.27 Elect'I Final Total $57.67 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: 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 Electrical Permit Application , Date received _.-: - 7 Permit no.:(G . i it, - O i .7 2 2 . _ ,.'il�ln City of Tigard Project/appl.no.: Expire date: City of Tigard Address: 13125 SW Hall Bl d E' ® Date issued: By: Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 OCT 2 8 2004 Case file no.: Payment type: Land use approval: G6T OF TI ARD . „ . TYPE OF PERMIT , ❑ 1 & 2 family dwelling or accessory ❑ Commercial /industrial ❑ Multi- family ❑ Tenant improvement ❑ New construction ❑ Addition/alteration/replacement Cl Other: Cl Partial . • •.JOB SITE.INFORMATION` - _ • ' Job address: / / 9 QQ SLj c 5- pi b-A-c-- Bldg. no.: --- Suite no.: — Tax map /tax lot/account no.: I S � 3 S 1� l) Lot: Block: I Subdivision: 0 Project nameSto pA ySic t`a„sl Description and location of work on premises: __ , .a` L l "A Estimated date of completion /inspection: 0/4---11. • '.‘1 .. ` . ,.. ' CONTRACTOR . APPLICATION -01 ' .' s " ::.: - ;'FEE 'SCHEDULE, Job no: Fee Max ` Description Qty. (ea.) Total no. insp Business name: �.tG. f G� �1 0 3 3 .s W te, U- te r\lea— 1Cx Newgniresidential Includes tt ched multi-family per - Address: dwelling unit. llncludes attached garage. City: — j-1` -0 Lt -,r I State:Q I ZIP: 9 22.3 ' Service included: Phone: r0 3 S (, (v I Fax: 4 4 . i( E -mail: 1000 sq. ft. or less 4 ' Each additional 500 sq. ft. or portion thereof CCB no.: f5 4010 I Elec. bus. lic. no: 34 -( 4- Cc s G Limited energy, residential 2 City /metro lic. no.: 3 Z (D 1 Limited energy, non - residential 2 • ` - 7-. , N. Each manufactured home or modular dwelling Signature of supervising electrician (required) Date i obAs- -- Service and/or feeder 2 Sup. elect. name (print): p , s ',, j License no: - 5 j r_c_, Services or feeders - installation, alteration or relocation: 'PROPERTY, OWNER. 200 amps or less 2 Name (print): / 2 , c , Ass ©c .„`a- 4-e s 201 amps to 400 amps 2 Mailing address:© / /goo $ x ) � 5 601 amps to 401 amps to 1000 amps 2 1000 amps 2 City: -I { 0A0,,v---d I State: 0 ( ZIP: y 7 2.2. 3 Over 1000 amps or volts 2 Phone: 29 » ('s i 3 'Fax: I E - mail: Reconnect only l Owner installation: The installation is being made on property I own Temporary services or feeders - which is not intended for sale, lease, rent, or exchange according to installation, alteration, or relocation: 20 amps or less 2 ORS 447, 455, 479, 670, 701. amps to 400 amps 2 Owner's signature: Ova �'_n.¢.A_rt cy■ '---o- Date: (o /'2 /d 201 1 401 to 600 amps 2 ' ` . ENGINEER , -' _ Branch circuits - new, alteration, or extension per panel: Name: ` G 1 C O C t E Y-CJ 1 y .QLIr' ,n A A. Fee for branch circuits with purchase of Address: pc, t3 Z 3 -j gt . service or feeder fee, each branch circuit 2 City: 1-' Oc.✓d- I State:Oi ( ZIP: q' 7 2g / B. Fee for branch circuits without purchase of service or feeder fee, first branch circuit: 2 Phone: , .2p.2 Fax: 684.' 3, E - mail: Each additional branch circuit: . . PLAN REVIEW (Please check all' apply) Misc. (Service or feeder not included): ❑ Service over 225 amps- commercial ❑ Health -care facility Each pump or irrigation circle 2 ❑ Service'over 320 amps - rating of 1&2 ❑ Hazardous location Each sign or outline lighting - if 2 family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, ❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2 ❑ Building over three stories ❑ Feeders, 400 amps or more *Description: ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above: ❑ Egress/lightingplan XOther: Per inspection I- Submit sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other �r� Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ J V J ❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $ - Credit card number: / / within 180 days after it has been State surcharge (8 %) $ ( 1 , 1 a Expires accepted as complete. TOTAL $ 7 - Name of cardholder as shown on credit card $ Cardholder signature Amount 440 -4615 (6/00 /COM) - ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total y Check Type of Work Involved: Residential - per unit 1000 sq. ft. or less $145.15 4 n Audio and Stereo Systems Each additional 500 sq. ft. or portion thereof $33.40 1 ❑ Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular n Garage Door Opener Dwelling Service or Feeder $90.90 2 Services or Feeders ❑ Heating, Ventilation and Air Conditioning System* Installation, alteration, or relocation 200 amps or less $80.30 2 n Vacuum Systems 201 amps to 400 amps $106.85 2 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 2 7 Other Over 1000 amps or volts $454.65 2 Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY Installation, alteration, or relocation Fee for each system $75.00 200 amps or less $66.85 2 (SEE OAR 918 - 260 -260) 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see "b" above. 7 Audio and Stereo Systems Branch Circuits n Boiler Controls New, alteration or extension per panel a) The fee for branch circuits with purchase of service or n Clock Systems feeder fee. Each branch circuit $6.65 _ 2 n Data Telecommunication Installation b) The fee for branch circuits •without purchase of service n Fire Alarm Installation or feeder fee. First branch circuit $46.85 _ Each additional branch circuit $6.65 n HVAC Miscellaneous n Instrumentation (Service or feeder not included) Each pump or irrigation circle $53.40 n Intercom and Paging Systems Each sign or outline lighting $53.40 Signal circuit(s) or a limited energy panel, alteration or extension $75.00 n Landscape Irrigation Control Minor Labels (10) $125.00 Each additional inspection over n Medical the allowable in any of the above �1 Nurse Calls Per inspection $62.50 I I • Per hour $62.50 In Plant $73.75 n Outdoor Landscape Lighting Fees: n Protective Signaling Enter total of above fees $ n Other 8% State Surcharge _ . $ Number of Systems 25% Plan Review Fee * No licenses are required. Licenses are required for all other installations See "Plan Review" section on $ front of application. Fees: Total Balance Due $ Enter total of above fees $ ❑ Trust Account # 8% State Surcharge $ Total Balance Due $ All New Commercial Buildings require 2 sets of plans. i:\dsts \forms \elc- fees.doc 08/30/01 CITY OF TIGARD 24 -Hour BUILDING Inspection Lifer: (5t;3) 639 -4175 INSPECTION DIVISION Business Line: 1503)639 MST ' BUP Received a) / &`7 , Date Requested /r /2- AM PM BUP Location // 904t J Suite MEC Contact Person Ph ( 1. ) Z.01 Igo° ' PLM Contractor + Ph ( ) SWR BUILDING Tenant/Owner 1i .t) i ) se7 Pi a4.• r 3' ?ELC 2 D0 Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL _ T I Service Rough -In UG/Slab Low Voltage Fire Alarm 1110 111 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. 'E7�•ART FAIL SITE Please call or rein pection RE: 111 Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date / 6 Inspector /41 Ext Other: Final DO NOT REMOVE this inspection record front! the Jo site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business ne: =(503) 639 -4171 MST Li BUP Received p Date Requested / 1 1 1 AM PM BUP Location 1 ( q� Suite MEC Contact Person Ph ( ) 3 — 3705;6 PLM Contractor �) Ph ( ) SWR BUILDING Tenant/Owner 5 w 7 n ELC 2/ �D Footing - , - Foundation ELC. Access: Ftg Drain Q n ELR Crawl Drain 5l C—A/ C/\,`'' i Slab Inspection Notes: A )," r iv cf' SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final - PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough-In Line Gas Line Smoke Dampers Final P ASS PART FAIL )21 ELECTRICAL Service Rough -In c 1 J– tic, l - j o ,/ / /A,/ X UG/Slab Low Voltage (LG 0 6 9 - (.- F • 11 J /V-6 c/ / 3 1,5 poLG » GN Fire Alarm / Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. "M PART FAIL SITE ❑ Please call for reinspection RE: ❑ Unable to inspect – no access Fire Supply Line ADA Approach/Sidewalk Date // v Inspecto A #A1 . Ext Other: Final DO NOT REMOVE this inspection record from the j site. PASS PART FAIL