Permit CITY OF TIGARD ELECTRICAL PERMIT
A PERMIT #: ELC2001 -00458
14 DEVELOPMENT SERVICES DATE ISSUED: 9/17/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S136AD -05901
SITE ADDRESS: 11455 SW PACIFIC HWY
SUBDIVISION: ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Proiect Description: Install new lighting for awning replacement.
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:
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: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 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:
DAYS INN OREGON ELECTRIC CONST /GROUP
ART HOWARD 1010 SE 11 TH AVE
11455 SW PACIFIC HWY PORTLAND, OR 97214
TIGARD, OR 97223
Phone: Phone:
Reg #: LIC 203
SUP 1302S
ELE 26 -95C
FEES Required Inspections
Type By Date Amount Receipt Ceiling Cover
PRMT CTR 9/17/01 $53.50 2720010000( Wall Cover
Elect'I Final
5PCT CTR 9/17/01 $4.28 2720010000(
Total $57.78
This Permit is issued subject to the regulations contained in the Tigard Munidpal 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 dired questions to
Permit Signature: Q/t/ }/-�/ - `�C� Issued By: ,,,4
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: 4// //°/°G/ 5 - 77a'( DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an, inspection the next business day .
SEP -12 -2001 14 08 P.01/02
' A Electr PermitA
-. _ Date received: - / O / Permit no.: 9c 2001— 40 4
f . .., City of Tigard /� Project/appl.no.: Expire dater
City ogTigard Address: 13125 SW Hall Blvd, Tigard, O' '•
Date issued: 9 7 O �� j / =
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.:' Payment type: •....._:
•
Land use approval:. • '
'FYPF OF PERM))
❑ 1 & 2 family dwelling or accessory Comtttereiallmdustrial ❑ Multi- family �Tet>ant iinprovemeaf ;,'�
O New construction Addition/alteration/replacement O Other. . C1 partial `
•
.IOI; SITE INFORMATION
Job address: 1 1 • 55 Rw P c i fic Hwy Bldg. no.: Suite no.: . Tax map/tax lot/account no.:
Lot: Block: Subdivision:
Project name: Da .e Tnn Description and location of work on premises: Install new lighting_
Estimated date of completion/inspection: •
CONTRA(I OR APPl.'CATION i 1:1; ti(Ifl:Ul 1.1:
Job no: 4 D RKoA/ - t.4=e7R/C'. Omar. tie- Mm
Business name: n Description Qty. (ea.) Total no. Imp
Address: Newreddentlal' eeormold- atmIyper ' u:
•
1 010 SE 1 1 th Av'e dh ellirrgene. Includesathechedger .
City: por d I State:oR 1 ZIP: 9 7 21 4 +cc
Phone: 714 — c A f) 0 I Fax: 3 4— 1 0 0-mail: 1000 sq. It or less . ' 4
Each additional S00 s portion
CCB no.: 203 E lec. bus, lie. no: 2 6 — 9 5C
q. f! °t p° thereof :: ' ?'t'; �► ; •
City /m n0.: T 99 Limited energy, residential . . • . ., ∎.; ,,,,,2,,..
Limited energy, am-residential • , .
9,- 12 — 01 Each manufactured home or modular dwelling •
'gnat= of supervisin - ciao (required) Date Service and/or feeder -. 2 •
Sup. elect name (print): Jim Johansen l.ieens211543S Services ar feeders — iasfallation
alteration orrelocstlon: '
•
200 amps or less .. 2
Name (prim): . 201 amps to 400 amps , 2
Mailing address: • 401 amps 600 amps 2
601 amps to 1000 amps 2„ _
City: j State: I ZIP: Over 1000 amps or volts .,..Z�.
Phone: ' I Fax: I E -mail: Reconnect only '1. :-.
Owner installation: The installation is being made on property I own Temporary r:. ;
which is not intended for sale, lease, rent, or exchange according to � 0a ' a110° ' °rr ^' ti
ORS 447, 455, 479. 670, 701. 200 amps or less :• 2
201 amps to 400 amps 2 ;
Owners signature: • Date: 401 to 600 amps ..2 • '
Branch circuits - new, alteration, . .
•
Name: or extension per panel: . ,
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit ; Z
City: I State: I nit B. Fee for branch circuits without purchase
Phone: Fax: E -mail: of service or fader fee, first branch circuit: t 1 4 6 ..8•6 '
• Each additional branch circuit I 1 6 —A c
PLAN REVIEW (Please c•hcck ail that apply) Misc. (Service or feeder act included):
O Service over 225 amps - commercial O Health -care facility Each pump or irrigation circle
CI Service over 320 amps - rating of l &2 Cl Hazardous location Each signor outline lighting 2 •
familydwellings 0 Building over 10,000 square feet four or Signal circat(s) or a limited energy panel, _
O System over 600 volts nominal more residential units in one structure alteration, or extension' . ..,2
O Building over three stories O Feeders, 400 amps or more *Description: _ . • , ih
O Occupant load over 99 persons . 0 Manufactured structures or RV park Fach additional over the al lowable in
O Egress/lighting Cl Other P asyof
Per inspection I ! i .: "= fe ;;
• Submit sets of plans with any of the above. . Investigation fee
The above are not applicable to temporary construction service. Other , - _,
Nor all jurisdictions accept csadit ands. please call iorirdu t+on for more infoivatian. Notice: This permit application Permit fee 3.50
O Visa O MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card numbs: / / within 180 days after it has been State surcharge (8%) .... $
Expose accepted as complete. TOTAL $
Name of cardholder as shower on credo card
Cardholder signature Amount 440 -1615 (GiOaC )M)
SEP -12 -2001 14 :08 P. 02/02
Electrical Permit Fees: . . Limited Energy 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 4, Type of Work Involved:
Residential - per unit
1000 sq. R or less $145.15 4 0 Audio and Stereo Systems
—
Each additional 500 sq. ft or
portion thereof $33.40 1 gttrgtar Alarm - , - ; ;
L imited Energy $75.00 ". %.1. ,"'
•
Each Maned Home cc Modular Door Opener'
OwelGng Service or Feeder $90.90 2 .
Services or Feeders 0 Heating, Ventilation and Air Conditioning System' •
Installation, alteration, or relocation •?' •'•,.; '1'.-" - .. • .
200 amps or less $80.30 2 a :z . .
201 amps to 400 amps ❑ $106.85 2 Vacuum Systems'
401 amps to 600 amps $160.60 2 Other
601 amps to 1000 amps $240.60 2 ;
Over 1000 amps or volts $454.65 2
yV . {i•
Reconnect only $86.85 2 y • : _
Temporary es
Servic or Feeders ' ' • ' . . • • • , • - . • 1 • ..- 4,,,•4...,,...,k • '
Installation, alteration, or relocation `T OF WOR INVOLVED = COMME ONL 4
200 amps or less $66.85 2 Fee for each system. ............... .•• W :.Sr75.00
201 amps to 400 amps $100.30 2 (SEE OAR 918-260 -260)
401 amps to 600 amps $133.75 2 • _
Over 600 amps to 1000 volts, Check Type of •
Work Involved:
see "b" above. • ..
. ri Audio and Stereo Systems .
Branch Circuits . • •
branch circuits New, alteration or extension Per panel Q Boiler Controls • _ �•.._._; • :.: } •
a) The tee for brcircuits - �,:
with purchase of service or .. -
feeder fee. Q Clock Syste _•-
Each branch circuit $6,65 2 0 - ... .
b) The fee for branch circuits Data Telecommunication Installation ..,
without purchase of service - ',. . n .. ?it . • .. "x. . :411.: 4.'j.;
or branch ci Fire Alarm Installation •
First
First branch circuit 1 $46.85 46 . $ 5
branch circui
Each additional brant 1 _ $6.65 • 6 - (S ❑ , HVAC • •
Miscellaneous . . . • ❑ _
(Service or feeder not included) ... . Instrumentation : •`
Each pump or irrigation circle -
Each sign or outline lighting $53.40 - 0 Intercom and Paging Systems .
Signal circuit(s) or a limited energy • • •
panel, alteration or extension $75.00.
Minor Labels (10) $125.00 Landscape Irrigation Control'
Each additional inspection over ' Q M edical.
the allowable in any of the above • t . • ... ' ; ' `� .. :: ^�.
Per inspection $62.60 Nurse Calls
Per hour -50 • — . . . • ...... • -
In Plant $73.75 - ID Outdoor landscape Lighting' . - -=
• Fees: .- - . -
Protective Signaling
Enter total of above fees $ 51 :co - � •
-
• other - - .. .. —
8% State Surcharge • $ 4 . 28 -
Number of Systems •
25% Plan Review Fee $ -
See "Plan Review' section on • No licenses are required. Licenses are required for all other installations
front of application.
Total Balance Due $ 5 . 7 8 Fees:
g Enter total of above fees ' - $ Trust Account # c. 0 3 .. ..
• 8% State Surcharge $
Total Balance Due .. $ -
i:Ndsts\fors\eic- fees.doa 10/09/00 . .. _
m .
TOTAL P.02
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24`Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested /6 AM PM BLD
Location // `7 �� P ,4- Suite MEC 1/
Contact Person AreL--6-• Ph R L{ 9 3 Z g PLM
7-
Contractor Ph SWR
BUILDING nan Owner D ,n ELC 2 O / O D yS�
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab
Post & Beam Pa S + SIT
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
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
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
-"ASS PART FAIL
SITE
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
Otheoach /Sidewalk Date fay 6U / p ` e � c le t r �ocvd G 5 Ext
ns cor ►^F
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.