Permit ELECTRICAL PERMIT
TTY OF TIGARD
PERMIT ISSUED ELC2008-00079
COMMUNITY DEVELOPMENT
DATE ISSUED: 2/27/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S136AD-06504
SITE ADDRESS: 11462 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: AMERICAS TIRE COMPANY LOT : 003 JURISDICTION: TIG
PROJECT: AMERICA'S TIRE COMPANY
Project Description: (4) SIGN LIGHTING
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: 4
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:
DISCOUNT TIRE ES & A SIGN AND AWNING CO.
4026 W. WHITTON 89975 PRAIRIE RD.
PHOENIX, AZ 85019 EUGENE, OR 97402
Phone: 602 - 272 -9356 Contact #: PRI 541 - 485 -5546
FAX 541- 485 -5813
FEES
Description Date Amount Reg #: ELE 20- 243CLS
[ELPRMT] ELC Permit 2/12/2008 $213.60 LIC 163470
[TAX] 8% State Surcharge 2/12/2008 . $25.63 SUP 514S1G
Total $239.23 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 1 : 11 • - ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 9 - 001 -0010 thr. . • h O • - 5 '01 -0100. You may obtain copies of these rules or direct questions UNC at 503.246.6699 or 1.800.332.2344.
Issue • By: % ►� / i !,� i Permittee Signatu‘ f ej ��_
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: 41111k / 4I ,■y.,m/ — 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.
S 6 a -cu8 3
E1ectFicw! Permit A lica • FOR OFFICE USE ONLY
City of Tigard
"' 4- --_.t., 1. J \tt <,
( -- t J /I a t 3 r Permit my " ,/
13125 W Hall BlvdTigardO `-� a n Revie
' /a 0 �
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Phone: 503.639.4171 Fax: 503.598.1960 Date/B : Other Permit:
TI G A R D Inspection Line: 503.639.4175 F E3 ' L . . ' 200 Date Ready/By: ME ® See Page 2 for
Internet: www.tigard- or.gov (( 2008 Notified/Method: Supplemental Information
TYPECIII/IiR1 1 t ;:'1, A PLAN REVIEW
❑ New construction ❑ Ad i i/il eer D'IL 4 1p C4 IyI ®N Please check all that apply (submit 2 sets of plans w /items checked below):
y ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ 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
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ['Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "l -2 ", ' l -3 ",
Job no.: - { i fc Job site address: I I 462.. 41#)1:7AUy L. 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/ State/ZiP: °' 0 R ❑ Health -care facilities. ❑ Supply voltage for more than
/ ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: pG' ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: 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. ft. or less 145.15 4
Tax map /parcel no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
DESCRIPTION OF W RK — (with above sq. ft.)
�! Limited energy, multi- family 75.00 2
L Gt �`Zf residential ior feeders (with above all ti
�lJJ Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
K PROPERTY OWNER I TENANT 201 amps to 400 amps 106.85 2
Name: ni/Clielti6 on 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 1p.1(02, ( Ju) Pgz,i/¢f!i Over 1,000 amps or volts 454.65 2
City / State/ZiP: / ?o� pa.. 91 y3 Temporary services or feeders installation, alteration, and/or
/ 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 exshange, 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: D ate: A. Fee for branch circuits with
plAPPLiCANT I ciKCONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: 6-9 611w *up koNsAid.- B. Fee for branch circuits
Contact name:
al ' without service or feeder fee, 46.85 2
• r /for- gQ e I first branch circuit
Address: f 240 QMe.- pima. Alp Each add'l branch circuit 6.65 , 2
Miscellaneous (service or feeder not included)
City/State /ZIP: ley/604(07j D 2 f7 Each manufactured or modular 90.90 2
/, dwelling, service and /or feeder
Phone: (911 ) 4-1:66.16 Fax: : (62# l€ � ..5a , 3 Reconnect only 66.85 2
E- mail: Ll.�i� € � fL �
/
�.r� 4 Cj esasi f/� a (aid{... Pump or irrigation circle 53.40 2
I CONTRACTOR Sign or outline lighting 4 53.40 2.4. 41102
• Business name: eS�q S�q/ * wNl
h D gA�
Signal circuit(s) er ration, d-
energy panel, alteration, , or
Address: /21 OkLPfV p li> extension. Describe: Page 2 2
City/State /ZIP: &u A va.- 92y'D2.... Each additional inspection over allowable in any of the above
/ Per inspection i 62.50
Phone: (5111)411";56,14 Fax. (52//) 4 i 65 i 3 Investigation per hour (I hr min) 62.50
CCB Lic.: /tl%O 3 y 70 . I Electrical Lic.2o. Su rv. Lic.: industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required Subtotal: 2/3 •(10
�r � �5� �a //23/0/ Plan review (25% of permit fee):
Print name: ' p[ Date:
State surcharge (12% of permit fee): 26.63
Authorized signature: TOTAL PERMIT FEE: Z 3 ?a 2,3
Print name :Mei"
! / This permit application expires if a permit is not obtained within 180
��� ��� Date: �3 /dg days after It has been accepted as complete.
• Number of inspections allowed per permit.
F.1 Building \Pennits\ELC- PermilApp.doc 05/23/06 440 -4615T(II /05 /COM/WEB
f
CITY OF TIGARD
BUILDING DIVISION PERMIT #: Et 02008.00079
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/27/2008
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 1.11.
INSPECTION WORKSHEET FOR DATE: 7/22/2008 TIME: 7:01AM PAGE: 70
SITE ADDRESS: 11462 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: AMERICAS TIRE COMPANY LOT #: 003 TYPE OF USE:
PROJECT NAME: DISCOUNT FIRE COMPANY
DESCRIPTION: (4) SIGN LIGHTING
OWNER: DISCOUNT TIRE, PHONE #: 602- 272 -9356
CONTRACTOR: ES & A SIGN & AWNING t/ , MoN PHONE #: 541 - 465 -5516
Inspection Request Scheduled For: Date: 7/22/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 072971 -01 541- 868.1752 - Y
Corrections/Comments/Instructions:
•
V
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 v 66 Date: —] , 11- t Phone #: (503) 718- 1{