Permit CITY OF TIGARD ELECTRICAL PERMIT
TIGARD PERMIT #: ELC2005 -00379
rTA ' ■-" DEVELOPMENT SERVICES DATE ISSUED: 6/6/2005
' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S136CD
SITE ADDRESS: 11705 SW PACIFIC HWY J ZONING: C -
SUBDIVISION: PACIFIC CROSSROADS 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:
PACIFIC CROSSROADS PROPERTIES, I SIGNCRAFT LLC
BY WYSE INVESTMENT SERVICES CO 9033 SW BURNHAM
200 SW MARKET ST STE 345 TIGARD, OR 97223
PORTLAND, OR 97201
Phone: Phone: 503 - 639 - 4910
FEES Reg #: LIC 155420
ELE 34- 674CLS
Description Date Amount SUP 75SIG
[TAX] 8% State Surcharge 6/6/2005 $4.27
[ELPRMT] ELC Permit 6/6/2005 $53.40 REQUIRED ITEMS AND REPORTS
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. 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 1-811! 32 -2 •4.
Issued By: .r - 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.
• ' id . - r i • -
Elect ti. Permit Appl FOR OFFICE USE ONLY
t uEIVE
City of Tigard Received PermitNo.: q
13125 SW Hall Blvd., Ti ard, OR 97223 Date/By: VA/ e ,�'� G G DS - 3.7 /
g Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 JUN I N / R 20 j - , Date/By: Other Permit:
Inspection Line: 503.639.4175 � V „ ^ •_I �� Date ReadyBy: s: H See Page 2 for
r.0 CITY OF TIGAF�y
Internet: www.ci.tigard.os N otified/Method: 37 ' ( � Supplemental Information
• •_;t . . T . ,.. I li 6 iviSIO ,; • . ` ' °'PLAN ••.REVIEW - .
❑ New constriction '
❑ Addition/alteration/replacement Please check all that apply:
stri
['Service over 225 amps, comm'l ['Hazardous location
❑ Demolition 2 S I& N
❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft., • . ' , , C ATEG ORY` OF CONSTRUCTION . '•. , of 1- and 2- family dwellings 4 or more new residential •
❑ 1- and 2- family dwelling (ommercial/industrial ❑ Accessory building 0 System over 600 volts nominal units in one structure
❑Building over three stories ['Feeders, 400 amps or more
❑ Multi- family 0 Master builder ❑Other:
['Occupant load over 99 persons ['Manufactured structures or
JOB. SITE INFORMATIOP,N, AND LOCATION - ❑Egress/lighting plan RV park
Job no.: Job site address: I rlo5 5. W• PG(GIc f Hwy. ❑Health -care facility ❑Other:
1IV fl f7
-�• Y ' Submit 2 sets of plans with any of the above.
City/Stale /ZIP: l i 9 a rd, C R 9722. The above are not applicable to temporary construction service.
f SUSHI HANA FEE* SCI I Qt y E l
Suite/bldg./apt. no.: Project na .
Descri I Qty. Fee. I Total ••
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'l 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
t "" -"` ' :`DESCRII?TION, OF R'ORIC "�`'
`� " � .•.••' Each manufactured or modular
Hookup +0 tee► eX i s+i n9 p0W e r -6r Wa I I s i h S erv ic es service and/or installation, 90.90 2
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
PROPERTY OWNER , 0' TENANT 201 amps to 400 amps 106.85 2
' "` "" 401 amps to 600 amps 160.60 2
Name: Westwood v ` elo fwlent Corp'. — 601 amps to 1,000 amps 240.60 2
Address: 5030 C,.w, Moody soi4eo 240 Over 1,000 amps or volts 454.65 2
OR Reconnect only 66.85 2
City /State /ZIP: 9 r- i•Iand, OR g720 I Temporary services or feeders installation, alteration, and/or
(503)2,2g'3030 (503 )213 °02!
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 exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
k. • • [3', APPLICANT. YEIJA (J.T , ❑• CONTACT PERSON - e , A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: SusH I HANG branch circuit
B. Fee for branch circuits
Contact name: 1C .0 C 110 I without service or feeder fee, 46.85 2
1 1705 S.W. l'ac' ^G 1+L t . SoI S
each branch branch
circuit 6.65 2
Address: 11705 W T7 �TW
/] Each add'1 branch cir
City /State /ZIP: . 11 ... 0 a r ct 4OR "{722, Miscellaneous (service or feeder not included)
" Pump or irrigation circle 53.40 2
Phone: (503) 984 . 4455 Fax:: (5b3)37 2 • 1 p 495 Sign or outline lighting i 53.40 53.40 2
E -mail: ' / A Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
SI6NCRAFy ELF- GTRICA L ADV. LLG extension. Describe: Paget 2
Business name:
Address:903?) SW Burnham Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State /ZIP: "Ma M OR 87223 Investigation per hour (1 hr min) 62.50
Phone: (Ea )034'. 4910 Fax: (503) 63R' 4cQ Industrial plant per hour 73.75
ELECTRICAL ,EERMTI FEES" • '` ,a.
CCB Lic.: 155420 Electrical Lie.: 3qq -474.4 15 5l &> Subtotal 6..
Suprv. Lie.: 1 ::.
� � v- v
Suprv. Electrician signature, required: �� ( / , J � L � Plan review (25% of permit fee)
QVjd L. . Wilkinson i Date: 6-‘2.•
State surcharge (8% of permit fee) ,9,1 Print name: D
Authorized signature. /
V C / ^ / � / � � / � TOTAL PERMIT FEE 5 -7t by
This permit application expires if a permit is not obtained within f 80
Print name: She after it has been accepted as complete
'le" ��� Date: � •� � S * Fee methodology set by Tri -County Building Industry Service Board
** Number of inspections per permit allowed.
i:\Building \Permits \ELC- PermitApp.doc 12/03 440- 4615T(10 /02/COM/WEB
CITY OF
BUILDING DIVISION PERMIT #: ELC2005.00379
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/6/2006
Phone: (503) 639 -4171 uiulpypi�il f�l .
Inspection Requests (24 Hrs.): (503) 639 -4175 .. ' ''__-
INSPECTION WORKSHEET FOR DATE: 7/7/2005 TIME: 7:10AM PAGE: 15
SITE ADDRESS: 11705 SW PACIFIC HWY J CLASS OF WORK:
SUBDIVISION: PACIFIC CROSSROADS LOT #: TYPE OF USE:
PROJECT NAME: SUSHI HANA
DESCRIPTION: Sign lighting.
OWNER: PACIFIC CROSSROADS PROPERTIES, I, PHONE #:
CONTRACTOR: SIGNCRAFTLLC PHONE #: 503 - 6394910
Inspection Request Scheduled For: Date: 7/7/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
1.9 Electrical final 010946-01 . i . )3-964- -
10946 -01 03 -91 1 -6655 V
Corrections /Comments/ Instructions:
I. _ 1 \ - 6 ( . ,1 ) - -) 9 P\v\N .
C C
) v'
PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
,/
Inspector: 44 Lt Date: -. 4) �� Phone #: (503) 718-
0