Permit 4' CITY OF TIGARD ELECTRICAL, PERMIT
PERMIT #: ELC2006 -00321
DEVELOPMENT SERVICES DATE ISSUED: 6/5/2006
° I II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1 S136DA -00800
SITE ADDRESS: 11540 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: FRUITLAND ACRES LOT : 001 JURISDICTION: TIG
Project Description: 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: 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:
GOODWILL IND. SECURITY SIGNS INC
1943 SE 6TH AVE. 2424 SE HOLGATE BLVD
PORTLAND, OR 97214 PORTLAND, OR 97214 •
Phone: Contact #: PRI 503 - 232 -4172
FAX 503 - 230 -1861
FEES
Description Date Amount Reg #: ELE 26- 560CLS
[ELPRMT] ELC Permit 6/5/2006 $106.80 LIC 122809
[TAX] 8% State Surcharge 6/5/2006 $8.54
Total $115.34 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 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: Permittee 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 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 Applicati EGElvF . FOR OFFICI HSI:ONLY
City of Tigard ' Received,/..., U k r don Permit No LC }.0047 4503
11111 II ° 13125 SW Hall Blvd., Tigard, OR 97223 - AA p Pl an Review 1
Phone: 503.639.4171 Fax: 503.598.1960 R ZOO ' 6 D�By Other Permtt: N .1006 -.. e i:
- rI GAItD •
Inspection Line: 503.639.4175 Date Ready/By.. runs: See Page 2 for „
Internet: www.tigard- or.gov cur of., j'1(J
Ajl otified/Method is Supplemental Information < if
TYPE °T1PIDING r)T ISTO.I\ PLAN REVIEW
El New construction El Addition /allteration/replacement l Please check all that apply:
❑ Demolition 0 Other: ❑Service over 225 amps, comm'l ❑Hazardous location
❑Service over 320 amps – rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of I- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building 0 System over 600 volts nominal units in one structure
El Multi - family ❑Building over three stories El Feeders, 400 amps or more
❑ Master builder 0 ❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting RV park
Job no.: I Job site address: C �� p ❑Health - care facility ❑der:
I � 1 A-�F I c- 1( Submit 2 sets of plans with any of the above.
City/State/ZIP: The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: 1 Project name: /... FEE* SCHEDULE
V{. / I t... 4 . — Description I Qty. I Fee. I Total I ••
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map/parcel no.:
Limited energy, non - residential 75.00 2
DESCRIPTION Each manufactured or modular
• dwelling, service and/or feeder 90.90 . 2
Services or feeders installation, alteration, and/or relocation •
_ 200 amps or less 80.30 2
t 201 amps to 400 amps 106.85 2
0 PROPERTY 401 amps to 600 amps 160.60 2
/ / 601 amps to 1,000 amps 240.60 2
I Over 1,000 amps or volts 454.65 2
�' Reconnect only 66.85 2
lP rak Temporary services or feeders installation, alteration, and/or
relocation
200 amps or less 66.85 1
installation ' on property that I own which is not 201 amps to 400 amps 100.30 2
for or , _ to • ' t and 701. 401 amps to 600 amps 133.75 2
r ' -
Branch circuits — new, alteration, or extension, per panel
❑ APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
Address: first branch circuit
Each add'I branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax: : ( )
Sign or outline lighting Z 53.40 2
E - mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
c — extension. Describe: Page 2 2
Business name: ` - „.)6a L —( -t csx.. u S 1
..-el.' �� �+ /'1 Each additional inspection over allowable in any of the above
Address: 3
- �rt�_.fs=
t,Art vi I Per inspection 62.50
City/ State/ZIP: t4) Investigation per hour (I hr min) 62.50
Phone: CrONT3t L( ("'1 Z I Fax: G67 )'?30 &Sec. 1 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: v72 &' Electrical Lic.: Z656::c.(,`. Suprv. Lic.: 3 8 1c,t. Subtotal: f 0(v . g0
Suprv. Electrician signature, required: — Plan review (25% of permit fee):
Print name: . A A Date: {' - State surcharge (8% of permit fee): O . 5
V'� l a,fL C L .-•- .Li C i7t h S":7 , 4 ' c cA '�p TOTAL PERMIT FEE ' 1 C .
Authorized signature: ***--- --- -- This permit application expires if a permit is not obtained within 18
days after it has been accepted as complete
Print name: tf7r.,4 a -c o Date: ( , 1 p , Fee methodology set by Tri-County Building Industry Service Board .
es Number of inspections per permit allowed
I:\ Building \Pamits\ELC- PnmitApp,doc 03/23/06 440- 4615T(11/05/COM/WEB -3- 39-
2
•
Electrical Permit Application - City of Tigard • • •
J.
Pagel - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
•
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener* • .. -
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
•
❑ Other.
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system : 1 .
(SEE OAR 918 -260 -260) •
Check Type of Work Involved: •
.
❑ Audio and Stereo Systems • ,
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical •
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling .
❑ Other , ti : ..
Total number of commercial systems: d
*No licenses are required. Licenses are required
for all other installations
I: Building\Pamib\ELC- PamitApp.doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION - PERMIT #: ELC2006 -00321
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/5/2006
Phone: (503) 639 -4171 L �'�I
Inspection Requests (24 Hrs.): (503) 639 -4175 - - - ---i F__..
INSPECTION WORKSHEET FOR DATE: 7/5/2006 TIME: 7:00AM PAGE: 23
11540 SW PACIFIC HWY
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: FRUITLAND ACRES LOT #: 001 TYPE OF USE:
PROJECT NAME: GOODWILL DRIVETHRU DONATION
DESCRIPTION: Sign lighting.
OWNER: SECURITY SIGNS INC PHONE #: 503- 232 -4172
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 7/5/2006 Pour Time: '
- o•e • Inspection Description Confirm # Contact # Message
199 Electrical final 032657 -01 503-232 -4172 N
Corrections /Comments/ Instructions:
A DASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: KGB `—C Date: r l 1 01j Phone #: (503) 718- /VA