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Permit
A .. CITY OF TIGARD ELECTRICAL PERMIT CITY PERMIT #: ELC2002 -00573 DEVELOPMENT SERVICES DATE ISSUED: 10/25/02 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 - 4171 PARCEL: 1S136DB-02500 SITE ADDRESS: 11636 SW PACIFIC HWY SUBDIVISION: ZONING: C -G BLOCK: LOT : JURISDICTION: TIG Project Description: Connect new pole sign cabinet to existing circuit. 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: NICOLE KELSO TUBEART SIGNS 6345 CAUFIELD ST 4243 -A SE INTERNATIONAL WAY WEST LINN, OR 97068 MILWAUKIE, OR 97222 Phone: Phone: 503 - 653 - 1133 Reg #: ELE 37- 554CLS FEES Description Date Amount Required Inspections [ELPRMT] ELC Permit 10/25/02 $53.40 [TAX] 8% State Tax 10/25/02 $4 Rough -in Elect'l Final Total $57.67 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 d ct questions to OUNC at (503) 246-6699 or 1- 800 - 332 -2344. Issued By: 64/tA-e- Permit Signature: =/ ` • OWNER INSTALLATION ONLY ( I 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: 2\ CAPpid DATE: LICENSE NO: 10. �Q 1 Cs Call 639 -4175 by 7:00pm for an inspection the next business day f Sr�t..2.00 D ©o�.v • A ` ElectricalPermitApplication Datereceived: /O e l 6 -��- Permit no.g2X.- a.pa57 _ ; 1 : ".) . City of Tigard v.,:., ii r Project/appl.no.: 'Expiredate: City of Tigard Address: 13125 SW H all Blvd, rl'i( Q78�3 iii L- ' Date issued: i Receipt no.: Phone: (503) 639 -417 Fax: (503). 598-1960 OCT 2 K 2002 • Case file no.: •- .. ._ Payment type: .. , . . Land use approval: (,t M t _ ?�.t i `v.. --- ., A • , a T . . �. ' TYPE OF PERMIT 0 1 & 2 family dwelling or accessory 0 Comtnercial/industrial • 0 Multi- family 0 Tenant improvement 0 New construction . 0 Addition/alteration/replacement . . 0 Other. . . 0 Partial JOB SITE INFORMATION . . Job address: )/ , , 5 "-e,, AC.' • t „.) Bldg. no.: - Suite no.: . Tax map/tax lot/account no.: . ' Lot: Block: (Subdivision: 4 • • Project name: 4r( il J Description and location of work on premises: _o ' C ` A /42,4 ' Estimated date of completion/inspection: • • _ � 0 �'�:��4W l CONTRACTOR APPLICATION FEE SCIIEDU.E Job no: .322 Fee , Business name: , '7j4.?- Description Qty. (ea) Tota no. insp New residential - single or amid-family per Address: . • --d7 ,� � / . , - - dwelling unit. Includes attached garage. • . City: _ , /__ State: agJ ZIP: Air Serviceioduded. _ Phone: ! C /ty�123?'l'f E -mail: 7000 sq. ft. or Less 4 CCB no.: r ' to Elec. bus. lie. no: 3l �S Each additional 500 sq. ft or portion thereof Limited energy, residential 2 • i t/' • u ' • n..: / _ Limited energy, non- residential 2 ■� - ,, .II ��i 4 / r ,f Each manufactured home or modular dwelling Signature of supervising el: uired) Dat Service and/or feeder 2 Sup. elect name (print): License n • • _ Services orfeeders Installation, • - alteration or relocation: PROPERTY OWNER 200 amps or less 2 Name (print): 201 amps to 400 amps 2 Mailing address: 401 amps to 600 amps 2 601 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: 401to600am.s . 2 ENGINEER 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 2 City: I State: I ZIP: B. Fee for branch circuits without purchase Phone: Fax E-mail: of service or feeder fee, first branch circuit: 2 Each additional branch circuit PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included): 0. Service over 225 amps-cot unercial 0 Health-carefacility Each pump or irrigation circle 2 0 Service over 320 amps- rating of 149.2 CI Hazardous location Each sign or outline lighting / 2 family dwellings . 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, 0 System over 600 volts nominal more residential units in one structure alteration, or extension* - 2 0 Building over three stories 0 Feeders, 400 amps or more *Description: O Occupant load over 99 persons O Manufactured structures or RV patio Each additional inspection over the allowable In any of the above: 0 Egress/lightingplan 0 Other Per inspection 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 $ Na all jurisdictions accept petit cards, please call jurisdiction for more infarmatioa Notice: This permit application (at Plan review 0 Visa CI MasterCard expires if a permit is not obtained' ( %) $ Credit card number l / within 180 days after it has been State surcharge (8%) .... $ E1Q1ea accepted as complete. TOTAL $ 57.l0 7 Name of cardholder as shown on credit card ' $ Cardholder signature Amount 440 -4615 (6/00/COM) Electrical Permit Fees: Limited Energy Fees: - .� m lete Fee Schedule Below:. T YPE OF WORK INVOLVED - RESIDENTIAL ONLY Complete Restricted Energy Fee $75.00 " Number of Inspections per permit allowed • (FOR ALL SYSTEMS) • Servce i included:- - - ...; Items -- Cost ': Total Check Type of Work Involved: Residential - per unit - 1000 sq. R or less N $145.15 - 4 ❑ Audio and Stereo Systems Each additional 500 sq. ft. or • - . - -- .... . portion thereof $33.40 .. 1 Burglar Alarm . . Limited Energy - $75.00 a Each Manuf'd Home or Modular. .... V Garage Door Opener' Dwelling Service or Feeder ' `° $90.90 2 El . , . ' Services or Feeders „ . - rt.' Heatin Ventilation and Air Conditionin 9 System* Installation, alteration' or _ , N _ 9 ' `'200 amps orless •' '- $80.30 v 2 m 2 01 amps to 400 amps r'' ' ' _ 1 $106.85 2 � W Vacuum Systems' _ 401 amps to 600 amps $160.60 2 601 amps to 1000 amps - $240.60 .. .. - - 2 ❑ -Other Over 1000 amps or volts - $454.65 .- 2 _. -. .. - _ ... ' Reconnect only . . . $66.85 2 - . • ' . ' Temporary Services or Feeders - . ." - • ' TYPE OF WORK INVOLVED - COMMERCIAL ONLY Installation, alteration, or relocation ' Fee for each system' $75.00 -200 amps or less V . $66.85 2 • - (SEE OAR 918-260 -260) _ V 201' amps to 400 amps + $100.30 . 2 . 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, - see "b" above. ❑ - Audio and Stereo Systems . Branch Circuits • [:1 Boiler Controls New, alteration or extension per panel • a) The fee for branch circuits with purchase of service or - - • ❑ . • Clock Systems feeder fee. _ _ Each branch circuit - $6.65 • 2 ❑ _Data Telecommunication Installation b) The fee for branch circuits without purchase of service ❑ Fire Alarm Installation or feeder fee. ' First branch circuit $46.85 - • • Each additional branch circuit $6.65 El HVAC - Miscellaneous . , • Instrumentation (Service or feeder not included) . Each pump or irrigation circle $53.40 Intercom and Paging Systems _Each sign or outline lightir g - • $53.40 i9ft 1 ' Signal circuit(s) or a limited energy • panel, alteration or extension $75.00 ❑ Landscape Irrigation Control* Minor Labels (10) $125.00 . Each additional inspection over • ❑ Medical the allowable in any of the above Calls • Per inspection $62.50 ❑ Per hour $62.50 In Plant $73.75 ❑ Outdoor Landscape Lighting* Fees: ❑ . Protective Signaling Enter total of above fees • $ El - Other 8% State Surcharge $ - 4.€):1 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. . _... Fees: Total Balance Due $ C7.6 7 - Enter total of above fees - $ 0 Trust Account # • 8% State Surcharge $ • Total Balance Due $ i :Wsts\fomzcklc- fees.doc 10 /09/00 - • CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested I ( ( / AM PM BUP Location I) ( 3 4 Suite MEC Contact Person K •— Ph ( ) GA 33 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ..[ ELC a - 05/3 Footing ELC ' " S ' Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT 7 1 3 %'l Post & Beam d Cl+ ✓►', 'vivo Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In ( UG/Slab 1 ,04 u Low Voltage Fir: Alarm 4101, i PART FAIL 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SI ' Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date /h I/. I � OR Inspector 1 _ o. Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL