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Permit
' } v, " PERMIT #: ELC2007 -0016 • ' F '� = COMMUNITY DEVELOPMENT DATE ISSUED: 3/15/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S102AA -00600 SITE ADDRESS: 12045 SW HALL BLVD 7- ELEVEN ZONING: CBD SUBDIVISION: TIGARD HIGHWAY TRACTS LOT : 012 JURISDICTION: TIG PROJECT: 7- ELEVEN CORP Project Description: (1) sign lighting. Job No. 5652 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: 7- ELEVEN CORP ES & A SIGN & AWNING 2711 N HASKELL 12100AK PATCH RD DALLAS, TX 75206 EUGENE, OR 97402 Phone: 253 796 - 7169 Contact #: PRI 541 - 485 - 5546 FAX 541 - 485 -5813 FEES Description Date Amount Reg #: ELE 20 - 243CLS [ELPRMT] ELC Permit 3/15/2007 $53.40 LIC 163470 [TAX] 8% State Surcharge 3/15/2007 $4.27 SUP 305SIG Total $57.67 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 t ort in OAR 952 - 001 -0010 through OAR 952 -0 01 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246. 99 or 1.800.332. . A' . Issued :y: AL JA L/_ , , Permittee Signa ig J ` 'AP' _ a 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 F OR'OFFICE USE ONLY" -" RECEIV i -' iveit ' • s // • City of Tigard Date /Byl — r� D 7 , Permit No.: G� ?��C�P/ Ir 13125 SW Hall Blvd., Tigard, OR 97223 Ian Rev MAR 1 4 20 Other Permit Phone: 503.639.4171 Fax: 503.598.1960 Date /B TIGARD Inspection Line: 503.639.4175 Date Ready /By: 3 El See Page 2 for Internet: www.tigard- or.gov C ITY OF TIGtq i� ot /M e thod : / (1 Supplemental Information Pl AN(VING /EN PLAN REVIEW TYPE OF WORK ' . ` Please check all that apply (submit 2 sets of plans w /items checked below): El New construction ❑ Addition /alteration /replacement ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition El Other: where the available fault current ❑ Marinas and boatyards. ' CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural El 1- and 2- family dwelling Commercial /industrial El Accessory building amps for all other installations. buildings. El Multi - family ❑ Master builder El Other: ❑ Firc pump. ❑ Installation of 75 KVA or ❑ Emergency system. larger separately derived system. . - , - ' JOB SITE INFORMATION AND LOCAT,fON _ ❑ Addition of new motor load of ❑ "A ", "E ", "I -2 "t -3 ". Job no.: �1 ..) Job site address: 0.01/ 5 S L� �.-h 1 I D I vd 100H ore. occupancy. ❑ °( < ❑ more or more residential units. Recreational vehicle parks. City/State /ZIP: I r`,{ D ✓ 9 7 a . El Health-care facilities. ❑ Supply voltage for more than l � ❑ Hazardoardous locations. 600 volts volts is nominal. Suite /bldg. /apt. no.: Project name: 7 _ 0 e „if, 6---, ❑ Service or feeder 600 amps or more. FEE SCHEDULE ' ` ' ". Cross street/directions to job site: Cif o SS . • f' p�� - tier ern 6,1 Description I Qty. I Fee. I Total I • * New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. it. or less 145.15 4 Ea. add'l 500 sq. ft. or portion 33.40 l Tax map /parcel no.: Limited energy, residential DESCRIPTION OF WORK ; (with above sq. ft.) 75.00 2 n / J / Limited energy multi- family 75.00 2 l eee -w-e- a vt- / j (4C/ C i i 1 (II not (VI ki PLICKA- residential (with above sq. ft.) Services or feeders installation, alteration, and /or relocation 5(, l c�-e,k,,�� S 200 amps or less 80.30 2 ,„ Y ❑" PROPERTY - OWNER - .. . . -- ` , ❑. TENANT _ 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: / /� 0,e 0 PCt d 601 amps to 1,000 amps 240.60 2 Address: a q i t! /1/ 1---I e_e_t I Over 1,000 amps or volts 454.65 2 ` O 4 Temporary services or feeders installation, alteration, and /or City/State /ZIP: Da ( ((�5 ; X 5 relocation Phone: q5 7 fir _7/, . 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 . ; ' °- ❑ APPLICANT . . - ' ❑. CONTACT PERSON above service or feeder fee, 6.65 2 fQ �� each branch circuit Business name: i�� br_•/- S ) I ` L ... G2 B. Fee for branch circuits without service or feeder fee, Contact name: I (t1a___ t v .c 1 ( first branch circuit 46.85 2 Address: / - ?_/(3 0 tu g p, h kj Each add'l branch circuit 6.65 2 Miscellaneous (service or feeder not included) City /State /ZIP: L ✓✓ .e e L/l - 9 71/Q ,,. Each manufactured or modular 90.90 2 dwelling, service and /or feeder Phone: (511/ ) 2 (,5(,5/.1/) � • 6)3 f ) Fax: : (� Reconnect only 66.85 2 � E- mail: .aj..e I- - I)(' p,S Gt, g i s I (-j /1-'-' Pump or irrigation circle 53.40 2 CONTRACT Sign or outline lighting ( 53.40 53, 2 Signal circuit(s) or limited - Business name: Ei f q // si..--'�t/v� - 5 energy panel, alteration, or Address: (9 t ■ I' "r( Z 1 h V Gt l∎ P e, t / _ : GI r /t extension. Describe: Page 2 2 / City/State /ZIP: Each additional inspection over allowable in any of the above L f 7 � �' Per inspection 62.50 Phone: ( /) l L f Fax: eqi ) </y9 - --- S-/ 3 Investigation per hour (1 hr min) 62.50 CCB Lie.: Electr Lie.: Su Suprv. Lie.: �fn3 f ?© �0:1�CGS p l 5I E7 Industrial plant per hour 73.75 �( - ELECTRICAL PERMIT FEES - _, . Suprv. Electrician signature, required: 1 �p j�� .� �� Subtotal: 51, + 0 / %v ` C Plan review (25% of permit fee): Print name: r � e df 0 l Date: 3 . b 7 f / 0 /// � State surcharge (8% of permit fee): 7 a7 Authorized signature: 0 , L (�`,� Lei �� TOTAL PERMIT FEE: 5 7 .47 '� G This permit application expires if a permit is not obtained within 180 Print name: ( ,,k) d--,.., ( I Date: 3 ---0 days after it has been accepted as complete. * Number of inspections allowed per permit. 1: \ Building \ Permits \ELC- PennitApp doc 05/23/06 440- 4615T( I I /05 /COM /WEB CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2007 -00161 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/15/2007 Phone: (503) 639 -4171 A Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/13/2007 TIME: 7:00AM PAGE: 58 SITE ADDRESS: 12045 SW HALL BLVD 7- ELEVEN CLASS OF WORK: SUBDIVISION: TIGARD HIGHWAY TRACTS LOT #: 012 TYPE OF USE: PROJECT NAME: 7- ELEVEN CORP DESCRIPTION: (1) sign lighting. Job No. 5652 % OWNER: 7- ELEVEN CORP, PHONE #: 253- 796 -7169 CONTRACTOR: ES & A SIGN & AWNING PHONE #: 541 485 - 5546 Inspection Request Scheduled For: Date: 7/13/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 051895 -01 541- 485 -5546 Y Corrections/Comments/Instructions: - €_ . 1 5 PASS ❑ PARTIAL APPROVAL CANCEL n NO ACCESS U FAIL ❑ CALL FOR INSPECTION I ( ADDITIONAL FEES ASSESSED Inspector: 711-1 A/ Date: - 73/ Phone #: (503) 718 -