Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2001 -00178
r .'Il
DEVELOPMENT SERVICES DATE ISSUED: 04/05/2001
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 25101 AC -01400
SITE ADDRESS: 07125 SW HAMPTON ST
SUBDIVISION: BEVELAND NO. 2 ZONING: MUE
BLOCK: LOT : 020 JURISDICTION: TIG
Project Description: Installation of (2) sign lightings.
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: 2
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:
REMAX/EQUITY GROUP • MARTIN BROS SIGN INC
7125 SW HAMPTON ST. 3165 COMMERCIAL ST SE
TIGARD, OR 97223 SALEM, OR 97302
Phone: Phone: 364 -2211
Reg #: LIC 64761
SUP 399SIG
ELE 24 -23CLS
FEES Required Inspections
Type By Date Amount Receipt Wall Cover
PRMT CTR 04/05/2001 $106.80 2720010000( Elect'l Final
5PCT CTR 04/05/2001 $8.54 2720010000(
Total $115.34
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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE ISSUED BY:
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
A4 .
Electrical Permit Application / /
Date received: 1- 9 O/ Permit no W/. / 7e
4,1,3 City of Tigard
Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
TYPE- OF-PERMIT— — ---- _- _— _-- __r.- .-- - - -._- __--- , - - - --
❑ I & 2 family dwelling or accessory *ommercial/industrial ❑ Multi- family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration /replacement ❑ Other: , ❑ Partial
• JOB SITE INFORMATION
Job address: 1 I QS S 44o1J'».tp}81n Bldg. no.: , Suite no.: Tax map /tax lot/account no.:
Lot: ('jOb IBlock: Subdivision:
Project name: k,ryto —t ® 6.0413escription and location of work on premises: a ins - I W4. +''
Estimated date of completion/inspection: (.L040
CONTRACTOR APPLICATION FEE SCHEDULE
Job no: • Fee Max
Business name: ' 1'r1slA i n "''''"33 A 61147.4 Description Qty. (ea.) Total no. insp
�- .. New residential - single or multi- family per
Address'
"�1 �� ash. dwelling unit. Includes attached garage.
City: t� l l Stater ZIP: 9"'jBpa,.. Service included:
Phone: 3434 — AA i i Fax:3b14 _y3/ E -mail: 1000 sq. ft. or less 4
CCB no.: 4 I Elec. bus. lic. no: a q ..A3 Each additional 500 sq. ft. or portion thereof
Limited energy, residential 2
City /metrolic.no.: . Limited energy, non- residential 2
I -4i.— 0 / Each manufactured home or modular dwelling
Sig ture f ervising electrician (required) Date Service and/or feeder 2
Sup. ect. name (print): iyive PA. 44,4445 Licenseno: .:" 4/ 4, Services or feeders — installation,
alteration or relocation:
• PROPERTY OWNER • 200 amps or less 2
Name (print): �/ •� / 201 amps to 400 amps 2
�A'r " a+"8"' 401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: I State: I ZIP: . Over 1000 amps or volts 2
Phone: I Fax: I E -mail: Reconnect only 1
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, orrelocation:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
ENGINEER Branch circuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: • I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: • 2
Phone: Fax: E -mail:
Each additional branch circuit:
- PLAN REVIEW (Please check all that apply) Misc . (Serviceorfeedernotincluded):
❑ 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 p` 53Yo /04 hso 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 ❑ Other: Per inspection I I I I
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Permit fee $ /O(P • W
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application
❑ 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 %) .... $ g` 5 Y ,
Expires accepted as complete. TOTAL $ v 1
Name of cardholder as shown on credit card
$
Cardholder signature Amount 440-4615 (6/00 /COM)
Electrical Permit Fees: Limited Energy Fees:
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
P Restricted Energy Fee $75.00
1 Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total
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 n Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular I Garage Door Opener
Dwelling Service or Feeder $90.90 2
ti
Services or Feeders n Heating, Ventilation and Air Conditioning System"
Installation, alteration, or relocation
200 amps or less $80.30 2
201 amps to 400 amps • $106.85 2 I I Vacuum Systems
401 amps to 600 amps $160.60 2 i•.
;, ''
I� " Other° . .; '
601 amps to 1000 amps $240.60 2 I I
Over 1000 amps or volts , $454.65 2 -
Reconnect only ' . ..... . $66:85 2 ;` "r ; r „ t •:
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 . - • " n �
Check Type of Wock�lnvolved: . � �: *
Over 600 amps to 1000 volts,
see "b" above. I l--I I Audio aril Stereo.Systems , • , , • ' . ••
Branch Circuits
alteration or extension per panel n Boiler Controls •
a) The fee for branch circuits .
with purchase of service or I - Clock Systems
feeder fee.
Each branch circuit $6.65 .2 , r • I •• I 4 Data Telecommunication Installation
b) The fee for branch circuits
without purchase of service Alarm Installati. "
or feeder fee. Q.4
First branch circuit $46.85 �
Each additional branch circuit $6.65 I 1 HVAC
Miscellaneous Instrumeritation • e A" ` •
I l
(Service or feeder not included)
Each pump or irrigation circle $5 •
Each sign or outline lighting '.53.40 n Intercom and Paging Systems
Signal circuit(s) or a limited energy
panel, alteration or extension $75.00 I I Landscape Irrigation Control
Minor Labels (10) $125.00 �
Each additional inspection over I I Medical
the allowable in any of the above r -�
Per inspection $62.50 I I , Nurse Calls
Per hour $62.50
In Plant $73.75 [1 Outdoor Landscape Lighting
Fees: n . Protective Signaling
Enter total of above fees $ n Other
8% State Surcharge $ Number of Systems
25% Plan Review Fee t
See "Plan Review" section on $ * No licenses are required. Licenses are required for all other installations
front of application.
Fees:
Total Balance Due $ —
Enter total of above fees $
❑ Trust Account # 8% State Surcharge $ •
• Total Balance Due $
i:\dsts \forms \elc- fees.doc 10 /09/00
3 -i4
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24- Hour1ri'spection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested .- / AM PM BLD
Location 7 6y �( Z S � /4.— s Suite MEC .
Contact Person Ph , (/ Z Z/ I PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC 22a —' D / 7g-
Retaining Wall ELR
Footing Access:
Foundation FP
Ftg Drain SGN ■2v1,/ -GU
Crawl Drain Inspection Notes:
Slab G u a G a
�G/
Post & Beam
Ext Sheath /Shear y ..GU U Ce
Int Sheath /Shear
Framing
Insulation
Drywall Nailing �7 Yf G /f- 2 5" --
Firewall
Fire Sprinkler
Fire Alarm A Susp'd Ceiling
Roof
- Misc:
Final ___C!!!"%axgra‘W' ia ° 13 . 7 ("wilw r 1 7 4 7 ".1 7 45.170 515*""‘r . "
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final •
PASS PART FAIL
LECTRICAI ° C
Sry itfe
Rough In • SI7 A-
UG/Slab
Low Voltage
Fire Alarm
PASS P RT- FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk 6 — Inspector Ext Date
Other
Final
PASS PART FAIL DO NOT - REMOVE this inspection record from the job site.