Permit CITY OF TIGARD PERMIT
PERMIT #: ELC2000 -00577
n DEVELOPMENT SERVICES
4 l 4 D ATE ISSUED: 10/4/00
s `�' j 13125 SW Hall Blvd.. Tigard. OR 97223 (503)' 639 -4171
PARCEL: 1S136CD-00100
SITE ADDRESS: 11705 SW PACIFIC HWY Y
SUBDIVISION: ZONING: C -G
BLOCK: LOT : 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: 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:
MEYER SIGN CO OF OREGON
7340 SW LANDMARK LN
• TIGARD, OR 97223
Phone: Phone: 620 -8200
Reg #: LIC 00064014
SUP 569SIG
ELE 20 -190CL
FEES Required Inspections
Type By Date Amount Receipt Elect'I Final
PRMT CTR 10/4/00 $53.40 2720000000( ,
5PCT CTR 10/4/00 •$4.27 2720000000(
Total $57.67
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Spedalty 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. ATTENTIO : Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 throw, OA ;'• 2- 001 -0080. You may obtain copies of these rules ord irect questions to OUNC at (503)
246 -1987. / /
PERMITTEE'S SIGNATURE j_� ISSUED BY: L Air !
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 639 -4175 by 7:00pm for an inspection the next business day
10/03/00 TUE 14:08 FAX 503 598 1960 CITY OF TIGARD X1 002
• Electrical Permit Application
Date received: Permitno.: Ems' 2000 --/ • /
._,.,, i .: ' p City of Tigard Project/appLno.: Expire date
Ciry ofTlgarcf address: 13125 SW Hall Blvd, Tigard,'OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639.4171
Fax: (503) 598 - 1960 Case file no.; Payment type:
Land use approval: SGT - 0 - 60 /4 ..5
'FI'i'E OF PERMIT
O 1 & 2 family dwelling or accessory 26 CommerciaUintiuetrial 0 Multi - family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other. ❑ Partial
Jolt S i 1,E EN 1•Olt;%l; \'1'I ON
Job address: 1 ) ■J 1 1 1MA w ■ Bldg. no.: Suite no.: Tax m:. tax lot/account no.:
Lot: Block: Subdivision:
Project name: 'Description and location of work on premises:
Estimated date of com .letion/ins . flow' o llZ u / o o
i OiN I I(A(: FUIt AI'I'LI(.AI 1ON" 1'l;I SC!IE1)(1;1; ,
Job no: FM Mat
Business name: lie { / s1 . Cp Qty. (ea) Total co. heap
i c Address: `13'.10 SW ttor, &h k (t , dwelling hew per _ dwe ]QognaiLlnclodesattat�edgan®e. •
City: 1 Z State: ote I ZIP: Ctin 3 Senicchcindeib
Phone: (s o -:1no 1yl Fax: ( C? o 104 E-mail: 1000K. ft. or less 4
CCB no.: - I Elec. bus. lic. no: , 0 — /90 e 1...
Each additional Soo sq. ft or portion thereof
L i m i ted energy, res 2
City /metro lie. no.: /0///0 / Limited energy. non- residential 2
Each manufactured home or modular dwelling
Signature of supervising electrician (required) Data Service and/or feeder 2
Sup. elect name (print): License no: Services or feeders IosmQatlo0.
alterationta Macedon:
/r PROPER I1" OWNER 200 amps crless 2
Name (print): ha et 4. L I.IOSSroe - eg
41 am • a to 900 am. a 1
Mailing address: Z0et 5,,, - Sll'S- 601 amps ro600amps , 2
0 Suu y�le
601 amps to 1(100 amps 2
City: ( 4-14 !State: ore I ZIP: 6 /7 701 Over 1000 amps or volts 2
Phone: (j, jely_ ojwl Fax: 12,,7.. t5or) I E-mail: Reconrectonly 1
Owner insta`lation 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 les 00. r + orretocatl®: ,
ORS 447, 455, 479, 670, 701. 200 amps or less 2
20I amps to 400 amps 2
Owner's signature: __- _ Date: 401 to600amps - 2
I ?N(: Lv f: F:It Branch drealta - new, alterutlon,
or extension per panel;
Name' A. Fee for branch circuits with purchase of
Addres service or feeder fee, each branch circuit 2
City: IState: IZIP: B. Fee for branch circuits without purchase
Phone: IFax: E -mail: of service or feeder fee, first branch circuit: 2 .
Each additional branch circuit
PLAN RI. 1 11,11 1 I'Ir :rse cheer, :111 that :Apply) Muse .(Servkmor feeder mot included):
O Service over 225 amps- conuner 0 Health- care facihy Each pump or irrigation circle 2
O Service over 320 amps - rating of l&2 0 Hazardouslocation Each signor outline lighting / 2
fly dwellings 0 Building over 10,000 square feet four or Signal citatit(s) or a limited energy panel,
0 System over 600 volts nominal more residential caffein one atructme alteration, orextension* 2,
O Building over three stories O Feeders, 400 amps or more "Description:
O Occupant load over 99 petsom O Manufaetraed structures or RV park Fads additional inspection overthe allowable Its
O ER= O Other any (Cite above:
ms
Perirrspec6on 1-1-1--T--
Submit _ gets of plats with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other C
•
Not all jurisdictions accept credit cards, ptease call jutlydirdco for m n ore informed Notice: This permit application Pettit fee $ s ).3. W)
O Pisa O MasterCard expires if a permit is not obtained Plan review (at _ To) $
Qedit card number: / / within 180 days after it has been State surcharge (8%) .... $ ��
Expires accepted as complete. TOTAL $ . 7 !0 7
Nome of cardholder as shoo,: on credit card
$
Cardliolckx signature Amount
440.4615 (blOrYCUM)
eR
# 4 7
•
10/03/00 TUE 14:09 FAX 503 598 1960 CITY OF TIGARD ?j003
Electrical Permit Fees: Limited Energy Permit Fees: -
•
Number of Inspections • - permit allowed TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Service Included: Items Cost Total _
4a. Residential - parunit Restricted Energy Fee._._ - .._.__. $16.00
Icon sq. ft or fess 6147.15 4 (FOR ALL SYSTEMS) •
Each additional 600 sq. R or '
portion thereof $33.40 1 Check Type of Work Invoked:
Limited Energy $76.00 ❑
Each Manufd Horne or Modular Akudio and Stereo Systems
Mating Danko or Feeder 680.60 2
❑ Burglar Alarm
4h. Stxvkes Or Feeders
Installation. atteration, or relocation Garage Door Opener'
2C6 amps or lase $60.30 2 ❑
201 amps to 400 amps 8108es 2
4Cl amps to600amps $160.80 2 ID Fieagn Ventilation and Air Cond tlo ling System' 8
601 amps to 1000 amps 6240.60 2
Over MO amps er yens 5434.65 2 ❑ Vacuum Systems'
Reconned oNy 568.85 2
4a Temporary Services or Feeders ❑ Other
Installation, alteration, or relocation •
200 amps or less 564.85 2 TYPE OF WORK INVOLVED - COMMERCIAL ONLY
201 amps to 400 amps 5100.30 2 -
401 amps to 600 amps 8133.75 2 Fee for each eyalmn..._ ..... ........:__...._....._......... $75.00
Over 600 amps to 1000 voila , (SEE OAR 918. 260.260)
see "b^ above.
ad. Branch Circuits Check Type of Work Involved:
New, aheraton or extension per paned ❑ Aadlo and Stereo Systerrla
a) The fee for branch dreu itc
' with purchase of service or Boller Centtols
feeder fee. ❑
Each branch &rah 68.655 2
b) The fee for branch dreu t ❑ Clock Systems
% hkoa! purchase of service
or feeder fee. ❑ Data Telecommunication Installation
First branch ercu;t Telecommunication
Roth additional branch chtuit $6.65 ❑ Fire Alarm Installation
4e. MiscmUanewa .
(Service or feeder not hdaded) • ❑ HVAC
Each pump or Irttgation dr le 653.40 •
Each sign or okaerro aghtltg • 653.40 I ❑ indrumentellon
Signal drasdlsl or a limited erergy .
panel. attennon or extension $16.00 ll^^ Intercom and Paging Systems
Minor Labels (101 5125.00 LJ,
41. Each additional Inspection over ' ❑ Landscape Irrigation Contror
the allowable M any of the above
Per inspection 652.50 ❑ Medical '
Per hour . 652.60
In Plant - $73.76 _ ❑ Nurse Cans •• _
5. Fees: • El Outdoor Landscape Lighting*
6s. Enter total of abuts fees
8% Surdmrpe (.08 X trial fees) s ❑ Protective Signaling •
Subtofar •
Ib. Enter 25%of fine 8a roc 6 ❑ Olhet
Plan Review If rewired (Sac. 3)
Subtotal S Number of Systems
❑ Trust Account di _ • No Ikons are required Lianas are rewired for all ether r.abil •
Total balance are . s �_
ENTER FEES $
• 8% SURCHARGE (.08 X TOTAL ABOVE) 6
. TOTAL . $
•
CITY OF TIGARD Electrical Permit Application Plan Check #
131 SW HALL BLVD. Rec'd By
•
TIGARD OR 97223 Date Recd
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print or Type Permit #
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of business) Service included: Items Cost Sum
I
Address 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
City /State /Zip Each additional 500 sq. ft. or
Commercial 1:1 Residential El Limited thereof $25.00 1
Limited Energy $25.00
Each Manuf d Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all current licenses) 4b. Services or Feeders
Electrical Contractor Installation, alteration, or relocation
200 amps or less $60.00 2
Address 201 amps to 400 amps $80.00 2
City State Zip 401 amps to 600 amps $120.00 2
Phone No. 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. 20 -1qc, CIS' Exp.Date
OR State CCB Reg. No. G 4O f y Exp.Date 4c. Temporary Services or Feeders
COT Business Tax or Metro No. t Rq I Exp.Date Installation, alteration, or relocation
200 amps or less $50.00 2
201 amps to 400 amps $75.00
Signature of Supr. Elec'n 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No.S(o g 1 S L Cr Exp.Date t 0 / / /0 see "b" above.
Phone No. 4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address Each branch circuit $5.00 2
City State Zip b) The fee for branch circuits
tY p without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 2
The installation is being made on property I own which is not Each additional branch circ $s.00 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle $40.00 _ 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required): * Signal circuit(s) or a limited energy
panel, alteration or extension $40.00 2
Minor Labels (10) $100.00
Please check appropriate item and enter fee in section 5B.
4 or more residential units in one structure 4f. Each additional inspection over
Service and feeder 225 amps or more the allowable in any of the above
System over 600 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00
as described in N.E.C. Chapter 5 In Plant $55.00
* Submit 2 sets of plans with application where any of the above apply. 5. Fees:
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $
NOTICE Subtotal $
5b. Enter 25% of line Sa for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account #
Total balance Due $
I: \DSTS\ELC96.APP Rev 9/96
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
I l BUP
Date Requested /f) Z / AM PM BLD
Location // 1,0C 5 w Pk C 1 tet G Suite MEC
Contact Person Ph 5 3r ,3- 3 74 PLM _
Contractor Ph SWR
BUILDING Tenant/Owner ELC — ' ' • 7
Retaining Wall E
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN AC —6 ° /4..)
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm ------ I L.
Susp'd Ceiling < < v Ye__
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
S d- 4 5
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
Sery C
Rough In
UG /Slab 5/ 4.
Low Voltage
Fire Al
ASS PART FAIL
SIT
ackfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required befor- ext inspection y at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ nable to inspect - no access
ADAr (0 -- ). - 7 7 9 P iii O th e oach /Sidewalk Date Ins eCtO Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.