Permit • CITY OF TIGARD ELECTRICAL PERMIT
Eril- PERMIT #: ELC2006 -00656
COMMUNITY DEVELOPMENT DATE ISSUED: 11/14/2006
TIGARD 1 31 25 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135DD-05106
SITE ADDRESS: 11995 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: LOT : JURISDICTION: TIG
Project Description: (1) sign lighting
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
' 1000 SPOR 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:
WEIR EX CO INC HIGHLIGHT SIGN CORP
CCC PROPERTY MANAGEMENT PO BOX 23667
14001 WILLAMINA CREEK RD TIGARD, OR 97281 -3667
WILLAMINA, OR 97369
Phone: Contact #: PRI 503- 620 -8205
' FAX 503 - 624 -3725
FEES
Description Date Amount Reg #: ELE 37 - 660CLS
[ELPRMT] ELC Permit 11/14/200( $53.40 LIC 104599
[TAX] 8% State Surcharge 11/14/200( $4.27 SUP 517SIG
Total $57.67 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 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those rule - - - forth in OAR 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain copies of the e rules or d' -: questio• - to OUNC at
503.2 • :.669 9 or 1.8 1 " . 33 . '.
r Issu: d By: = jf p44/ Permittee Signature: / z e ` _, �, /'
!S!.
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 503.639A175 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.
• Electrical Permit Application li lication - ro orrlcl: I'si ()Nix
' City of Tigard Ve d // /c4 o , . FG - 004547
Permit No.: 7
a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
' II Phone: 503.639.4171 Fax: 503.598.1960 Date/13 . Other Permit:
TI G A It D d a, Inspection Line: 503.639.4175 Date Ready/By: rte' e Page 2 for
Internet: www.tigard- or.gov Notified/Method Supplemental Information
TYPE OF WORK PLAN REVIEW
' ❑ New construction ❑ Addition / alteration /replacement Please check all that apply (submit a sets of plans w/items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: 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 ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A°, "E , "1 -2 ", "I -3 ",
Job no.: Job site address: Oh-. Or HO 06 I56,04 PliFii1 Six or more residential a or more. occupancy.
❑ Six or units. 0 Recreational vehide parks.
City /State/ZIP: � � Ct g s s cy ,Ic Fs t Nil. '. 'j /'1 � Nl C.� . O Health-care
Hazardo locations. ❑ Supply 0 volts voltage for more than
' 600 volts nominal.
Suite/bldg. /apt no.: Project name: oft ,f/A j O l J a ❑ Service or feeder 600 amps or more.
/� , FEE SCHEDULE
Cross street/directions to job site: %Al, qA *b' b -t' su..' /9 , 4tow t Description I Qty. I Fee. I Total I •
11 New residential single - or multi- family dwelling unit.
Peer % AM(y ID 0411X *Al 64 t Includes attached garage.
Subdi vision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
75.00 2
• DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi- family 75.00 2
0 14 '�0p V t /t / a -M) 4I (� f ' jeA ..&00,00404 residential (with above sq. ft.)
/� Services or feeders installation, alteration, and/or relocation
Q 9.14 • 200 amps or less 80.30 2
❑ PROPERTY OWNER I ada 201 amps to 400 amps 106.85 2
. Name: � i �A 6101 t>) 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
• Address: I' 9 oil Ito . peel P1 G f . Over 1,000 amps or volts 454.65 2
City/State/ZIP: p 1 + A `` Temporary services or feeders installation, alteration, and/or
a' 3 relocation
Phone: (sfl3) (0 S?,. 409 00
I Fax: ( f0 3) (4 & (u-- S (4,7 200 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 599 amps 133.75 2
• Branch circuits - new, alteration, or extension, per panel
Owner signature: Date:
A Fee for branch circuits with
FPLICANT I [3'CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: 1.( 1 1 4 `f 41 $104) �Rp. B. Fee for branch circuits
Contact name: 7 without service or feeder fee, 46.85 2
11 .1/ L/ //9Fy� 0 first branch circuit
Address: g. p Au. /I/JZ j 1 Poi, Each add'l branch circuit 6.65 _ 2
• Miscellaneous (service or feeder not included)
City/State/ZIP: fAR 0p, Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: (3;03) 6 943.-4 ar Fax: : (SO) 4, aer Reconnect only 66.85 2
E -mail: 'Nli•. 0 41 'i1(/ titl 140 , Comyj i Pump or irrigation circle 53.40 2
• C NTRAC OR Sign or outline lighting 4/ 53.40 2
•
Signal circuit(s) or limited -
Business name: /�pf�(i)GffT 9/bp ,J �t energy panel, alteration, or
Address: 8 90 t L ��� /<ii,,q f�• extension. Describe: Page 2 2
City /State/ZIP: '1"1t'v/1JRn 0 A, 976142.'3 Each additional inspection over allowable in any of the above
n ,,T Per inspection 62.50
. Phone: ( ) (i ap g� p r- I Fax: (1)3) OiP 4 t - • 3 70,T Investigation per hour (1 hr min) 62.50
CCB Lic.: I Oirs7'/ I Electrical Lic.: fib 3-11 I Suprv. Lic.: 4.7 •(, CLS Industrial plant per hour _ 73.75 ELECTRICAL PERMIT -
Suprv. Electrician signature, required: / .P / S b ta ,
Print name: ,,A v --Da '` Plan review (25% of permit fee):
Ir11 �)' , ' � / 1/ /T 0(o State surcharge (8% of permit fee): 4/. 2- - 7
• Authorized signatu • TOTAL PERMIT FEE: 6- , (s 7
• Print name /r. A4�o� Date: n f/ t . r This permit application expires if a permit is not obtained within 180
Q& days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\ Building \Permits\ELC- PnmitApp.doc 05/23/06 4404615T(I1/05 /COM/WEB
Electrical Permit Application - City of Tigard .„
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
• Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
• ❑ Audio and Stereo Systems*
•
El Burglar Alarm
❑ Garage Door Opener*
. ❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
. Fee for each commercial $75.00
system
(SEE OAR 918 -260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
•
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
El Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
• *No licenses are required. Licenses are required
for all other installations
I:\Building\Pamit ELC- PamitApp.doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC200G-OUE66
13125 SW Hall Blvd., Tigard, OR 97223 A _ DATE ISSUED: 11/14/2006
Phone: (503) 639 -4171 1241j_ I�It
Inspection Requests (24 Hrs.): (503) 639 -4175 °`__
INSPECTION WORKSHEET FOR DATE: 1/11/2007 TIME: 7:03AM PAGE: 20
SITE ADDRESS: 11995 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: DR BRUNO DA COSTA DENTIS
DESCRIPTION: ( sign lighting
OWNER: WEIREX CO INC, PHONE #:
CONTRACTOR: HIGHLIGHT SIGN CORP PHONE #: 503-620.82Q5
- Inspection Request Scheduled For: Date: 1/11/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 Electrical service 042014 -01 503 - 620-8205 N
Corrections/Comments/Instructions:
•
0 IVO e 4cc.-,' e ed cLq Vc Y a,)
Loki 1-c e s 1 (Jec 4 f-11, (DO /l/Ee)
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
AL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: //42111'd Date: I `"/) —(o 7 Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC700 &00f 6
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/14/2006
Phone: (503) 639 -4171 i f Il
Inspection Requests (24 Hrs.): (503) 639 -4175 'Id—
,
INSPECTION WORKSHEET FOR DATE: 1/18/2007 TIME: 7 :06AM PAGE: 15
SITE ADDRESS: 11995 SW PACIFIC I CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: DR BRUNO DA COSTA DENTIS
DESCRIPTION: (1) sign lighting
OWNER: WEIREX CO INC, PHONE #:
CONTRACTOR: HIGHLIGHT SIGN CORP PHONE #: 503-620-8205
Inspection Request Scheduled For: Date: 1/18/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 Electrical service 042255-01 503-620.8205 N
Corrections /Comments/ Instructions:
V; t AL .OQ p 1x, 6.6 csa pit 1 ele \-Aed- bN
5I AN Wink bKaPi b5 - :O1J10 Q
`1 t. C---
b
•
1p PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CD u f LV)L--1' Date: t l l tko r i Phone #: (503) 718 -2-�