Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT ISSUED: E 3/2008 00007
COMMUNITY DEVELOPMENT
DATE ISSUED: 1/3/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S 136DB -00201
SITE ADDRESS: 11581 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: FRED MEYER LOT : JURISDICTION: TIG
PROJECT: LES SCHWAB
Project Description: Sign lighting for (1) relocated wall sign.
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:
WILMINGTON TRUST CO, TRUSTEE VANCOUVER SIGN COMPANY, INC
BY FRED MEYER, INC 6615 SW HWY 99
3800 SE 22ND AVE VANCOUVER, WA 98665
PORTLAND, OR 97242
Phone: Contact #: PRI 360 - 693 -4773
FAX 360 - 693 -2747
FEES
Description Date Amount Reg #: ELE 37 -46CLS
[ELPRMT] ELC Permit 1/3/2008 $53.40 LIC 63951
[TAX] 8% State Surcharge 1/3/2008 $6.41 SUP 525SIG
Total $59.81 REQUIRED ITEMS AND REPORTS
•
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for
more than 180 . - . ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 -P .1 -0010 th • • h ' 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6. •9 or 1.800.332.2344.
Issued =y: j Permittee Signature: L. ` 111t1L∎
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
v •
Electrical Permit Application roll t,rrlcl.: usi; om.v
City of Tigard Date / : / ,$ ' S( g.,
Date : G Permit No.:
li
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C Phone: 503.639.4171 Fax: 503.598.1960 Date/B : Other Permit:
1.1 n It D Inspection Line: 503.639.4175 Date Ready/By: WA VI See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
Please check all that apply (submit sets of plans wfitems checked below):
❑ New construction ❑ Addition/alteration/replacement
Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition
519n 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 10 Other: 5; trl ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system' larger separately derived system.
❑ Addition of new motor load of 13"A", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: I I$ 8/ 61,3 P4,c 1 c i C. 1-1 w Six or more re s. occupancy.
❑ Six or mo ote esidential units. ❑ Recreational vehicle parks.
City /State /ZIP: -v , d, 0 IQ 912. z 3 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: /AS , 5 ci'LL,Jab ❑ 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.
// .5 R1 5 W r p a.c f- i C. y Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
1 , Limited energy, multi - family 75.00 2
10
re CQ.ti'V .Q t 1_W1,
1. YIA teA s Igfl residential (with above sq. ft.)
J �+ Services or feeders Instalation, alteration, and/or relocation
200 amps or less 80.30 2
Er PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: Les ScliLwa10 401 amps to 600 amps 160.60 2
/� 601 amps to 1,000 amps 240.60 2
Address: / / S / s' tit] Pa-6A i G Nt.) y Over 1,000 amps or volts 454.65 2
City/State /ZIP: T p n Temporary services or feeders installation, alteration, and/or
t q J ,ra to 4 /7.Z. 3 relocation
Phone: (603 ) (0 3 t 7 LI 20 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 10030 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
A. Fee for branch circuits with
/ APPLICANT _ I 51 CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: VQY ,e o U,e'I` is V1 Co B. Fee for branch circuits
without service or feeder fee,
Contact name: A c , 'tor nn first branch circuit 46.85 2
Address: 6 ( I S N E Hwy 99 Each add'I branch circuit 6.65 2
`1 n Miscellaneous (service or feeder not included)
City/State/ZIP: 7 (gACA 0 R 9 7 2. 2 3 Each manufactured or modular 90.90 2
�J1 dwelling, service and/or feeder
Phone: (360) 643 9173 I Fax: : ( 360 )104 3 2.141 Reconnect only 66.85 2
E -mail: ce;d,s Q udn,Sig n co. c0 al Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting (i / 53.40 6- o 2
Business name: Van. co t. v et' $ i cr Q Co
1
1 Signal circuit(s) or limited- /
energy panel, alteration, or
Address: 6 15 N C g wY extension. Describe: Page 2 2
City/State /ZIP: ; ar rk. O R I q '�' � / Z.:S Each additional inspection over allowable In an of the above
Phone: (3 (,0 64 77 I (360) Per inspection 62.50
Fax: 693 Z? 4 � Investigation per hour (1 hr min) 62.50
CCB Lic.: 4, 39 s I Electrical Lic.: 31 ( (1.51 Suprv. Lic.: 5 I'; . SI 6 Industrial plant per hour 73.75
Suprv. Electrician signature, required: ELECTRICAL PERMIT FEES `'
S 53 . T
Print name: k ate:
Plan review (25% of permit fee): ..
n m a i'r' >D State surcharge (8% of permit fee): 6 , /
Authorized signature: / !�_= TOTAL PERMIT FEE: 59 . ( 1
� This permit application expires If a permit is not obta within 180
Print name: R 8i d 5'tt7 r ryl I Date: days after It has been accepted as complete.
• Number of inspections allowed per permit.
1:\ Building \Permits\E1.C- PermitApp.doc 05/23/06 440- 4615T(II /05 /COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC200B•00007
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/3I2Q0
Phone: (503) 639 -4171 Mi
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1/28/2008 TIME: 7 :80AM PAGE: 30
SITE ADDRESS: 11681 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: FRED MEYER LOT #: TYPE OF USE:
PROJECT NAME: LES SCHWAB
DESCRIPTION: Sign lighting for (1) relocated wall sign.
OWNER: WILMINGTON TRUST CO, TRUSTEE, PHONE #:
CONTRACTOR: VANCOUVER SIGN COMPANY, INC PHONE #: 360. 6934773
11 a-q t O'
Inspection Request Scheduled For: Dat . 1/08 Pour Time:
Code # Inspection Description Co firm_ Contact # Message
199 Elect.iical final 043-01 360.772 -6301 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: y N3 Le" Date: 1' v t (5 1 ) Phone #: (503) 718- 1416f