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Permit • CITY OF TIGARD ELECTRICAL PERMIT OS" , PERMIT #: ELC2002 -00559 - DEVELOPMENT SERVICES DATE ISSUED: 10/21/02 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S101 BB -00301 SITE ADDRESS: 11834 SW PACIFIC HWY ZONING: C -G SUBDIVISION: BLOCK: , LOT : 001 JURISDICTION: TIG Project Description: Electrical to 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: 5 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: SHELL OIL CO /EQUIVA MEYER SIGN CO OF OREGON PO BOX 4935 7340 SW LANDMARK LN TIGARD, OR 97223 Phone: not available Phone: 620 -8200 Reg #: ELE 20 -190CL FEES Description Date Amount Required Inspections [ELPRMT] ELC Permit 10/21/02 $267.00 [TAX] 8% State Tax 10/21/02 $21.36 Elect'I Final Total $288.36 • 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: ��.( /�- Permit Signature: Gc Z Tlt -�G� 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: 57o E/6 Call 639 -4175 by 7:00pm for an inspection the next business day Electrical Permit Application Date received: 10 _ I -off Permit no.:ELL rp o 5 y .l,�. ;.� � i City of Tigard Project/appl. no.: • Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: e I Receipt no.: Phone: (503) 639 - 4171 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory 'Y Commercial/industrial ❑ Multi- family ❑ Tenant improvement ❑ New construction ❑ • ddition/alteration/replacement ❑ Other: ❑ Partial JOB SITE INFORMATION Job address: 118 ` tu ,/q a e f , Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: Block: ISubdivisi• : Project name: 0 5 e ) I S - , I Description and location of work on premises: '[per , ,in ‘ ,4. 14 60 4, Estimated date of completion/inspection: I I CONTRACTOR APPLICATION FEE SCIIEDU,E Job no: Fee Max Business name: At/y( Sl6A) a, , & Description Qty. (ea.) Total no. insp J , - _ New resident - s or multi- family per Address: 7 7 f Q 5W /r1G✓Y�fot c� (+Cl dwellingunit .Includesattachedgarage. City: 7—f c ,4_ 7 Z D I State: p /LI ZIP: 9 7 2. Z. 3 . Serviceincluded: Phone: A 2e, -g2o0 I Fax: l0 20-7074E-mail: 1000 sq. ft. or less 4 CCB no.: 1, t./ p / t./ I Elec. bus. lic. no: 7� _ ( 9 t)C ES Each additional 500 sq. ft. or portion thereof to Limited energy, residential 2 City/ tr0 tic. 1 6 9q _ / 0 Limited energy, non- residential 2 l 0,-2.1,-0'2_, E ach manufactured home or modular dwelling Signal e o pervi ing le r c ire Date S(,1, s1(a. _ Service and/or feeder 2 �� Services or feeders – installation, Sup. elect. n a (print): ' u License no: - -- alteration or relocation: PROPERTY OWNER 200 amps or less 2 Name (print): 6 L2 i I t C L A- V A 201 amps to 400 amps 2 p 401 amps to 600 amps 2 Mailing address: pp A4, 4 l 601 amps to 1000 amps 2 City: .5 IState--XjZIP: 772 I a 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, or relocation: ORS 447, 455, 479, 670, 701. 200 amps or less 2 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600 amps 2 ENGINEER Branch circuits - new, alteration, or extension per panel: Name: 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): O Service over 225 amps - commercial ❑ Health -care facility Each pump or irrigation circle 2 ❑ Service over 320 amps -rating of 1&2 ❑ Hazardous location Each sign or outline lighting $ — 2 family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, ❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2 ❑ Building over three stories ❑ Feeders, 400 amps or more *Description: O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional Inspection over the allowable In any of the above: ❑ Egress/lighting plan ❑ Other. Per inspection I I I I Submit _ sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ i7 .cx, ❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $ Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ o'z I. 3 Expires accepted as complete. TOTAL $ . 3 Name of cardholder as shown on credit card $ Cardholder signature Amount 440 -4615 (600/COM) ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES;; . ; - -, Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total si, Check Type of Work Involved: Residential - per unit 1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems Each additional 500 sq. ft. or portion thereof $33.40 1 ❑ Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular ❑ Garage Door Opener Dwelling Service or Feeder $90.90 2 Services or Feeders ❑ Heating, Ventilation and Air Conditioning System' Installation, alteration, or relocation 200 amps or less $80.30 2 ❑ Vacuum Systems 201 amps to 400 amps $106.85 2 401 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 $66.85 2 (SEE OAR 918-260 -260) 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 ❑ 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 ❑ HVAC Miscellaneous ❑ Instrumentation (Service or feeder not included) Each pump or irrigation circle $53.40 Each sign or outline lighting S $53.40 ❑ Intercom and Paging Systems 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 Per inspection $62.50 El Nurse Calls Per hour $62.50 In Plant $73.75 ❑ Outdoor Landscape Lighting Fees: ❑ Protective Signaling Enter total of above fees $ ❑ Other 8% State Surcharge . $ _ 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 $ Enter total of above fees $ ❑ Trust Account # 8% State Surcharge $ Total Balance Due $ All New Commercial Buildings require 2 sets of plans. i:\dsts\forms\elc- fees.doc 08/30/01 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested L7` -.027 AM PM BUP Location I g L Suite MEC Contact Pers•' ; Ph ( ) 20 - gZdO PLM Contractor Ph BUILDING 111 i I/Owner c ELC SS - 9' Footing v Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam 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 Low Voltage Fire Alarm Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. tItIl PART FAIL SITE El Please call for reinspection RE: El Unable to inspect — no access Fire Supply Line ADA a te C o ��oL Inspector c Approach/Sidewalk D / 0 Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 - 4171 MST A BUP Received Date Requested 1 / AM PM BUP Location PA) 3 el Suite MEC Contact Person Ph ( ) as D - $Zo PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC CZ 6 Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Fi rewal l 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 Low Voltage Fire Alarm 4I I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL SITE ❑ Please call for reinspection RE: fl Unable to inspect — no access Fire Supply Line ADA ` Approach/Sidewalk Date ) 'ice m % (23 Inspector / � JJ Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL