Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2002 -00511
DEVELOPMENT SERVICES DATE ISSUED: 10/14/02
m � I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171
PARCEL: 2 S 103 D D -00400
SITE ADDRESS: 13727 SW PACIFIC HWY 100
SUBDIVISION: ZONING. C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: Electrical to 2 signs.
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: 2
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HMI 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:
ES & A SIGN & AWNING
1210 OAK PATCH RD
EUGENE, OR 97042
Phone: Phone: 541 -485 -5546
Reg #: ELE 20 -255CL
FEES
Description Date Amount Required Inspections
[ELPRMT] ELC Permit 10/3/02 $106.80
[TAX] 8% State Tax 10/3/02 $8.54 Rough -in
Elect'I Final
Total $115.34
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
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
S6',t1 Opt 7c( `Y— 60 175 -
• ' 1 A Electrical Permit Application
Date received:) 3 O 2- Permit no.: o� —0p.5'j /
_, .` City of Tigard iii Project/appl. no.: Expire date:
City ofTigard Address: 13125 SW Hall Blv r 2 Date issued: By: l Receipt no:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 OCT
- 3 2002 Case file no.: Payment type: ,
Land use approval: x L I. 1 0 4: "" ___ . F ' A r. •
TYPE OF PERMIT
❑ I & 2 family dwelling or accessory O Commercial/industrial ❑ Multi- family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement O Other. ❑ Partial
JOB SITE INFORiIATION
Job address: l ?z-Tal Sly PPi l H KPh' Bldg. no.: Suite no.: /tit, Tax map /tax lot/account no.:
Lot Block: 'Subdivision: .
Project name: 0k • FEetreCDS PUQ, 'Description and location of work on premises: NISI-AU- WA IA. j j f`S (z)
Estimated date of completion/inspection:
CONTRACTOR APPLICATION ., FEE SCHEDULE
Job no: Fee Max
Business name: ES 4 A StGIJ 4 Aw (N � Descri . don Qty. (ea) Total no. insp
Address: 10213 IJ>✓ MP 4(
New a t.Incl per
rmit. Includes attached garage.
City: 'Fbl? -TIA IU ' State:024 ZIP: 'fl2-2j Service included:
Phone:503- 542-210O I Fax: 2- 21 O6 1E-mail: 1000 sq. ft. or less 4
CCB no.: Iii--15 Elec. bus. lic. no: 2O -2J T CLS Each additional5oosq.ft orportianthereof __
Limited energy, residential 2
City/metro lic. no.: 2A-2.S /6 - I —BY Limited energy, non- residential ■■ 2
e Each manufactured home or modular dwelling
Signature of supervising electrician (required) Date p _ i _
Service and/or feeder 2
Sup. elect name (print): i� . /91` u �, 71J License no: (p Service r feeders — installalion,
alterat or relocation:
PROPERTY OWNER 200 amps or less 2
Name (print): W I I,SON'S 116 t) gerAIL C , l-1C) 201 amps to 400 amps 2
Mailing address: )�j J J SIA) 5-n4 m I TE 200 401 amps to 600 amps 2
601 amps to 1000 amps 2
City: PO K-T LAW D ' State:OR ZIP: cl 2O 1 Over 1000 amps or volts ,I 2
Phone:5O3 -2.21• MOO I Fax: 1E-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, alteratlon,ornelocahon:
ORS 447, 455, 479, 670, 701. 200 amps or less
11
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 am .s 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: 'State: '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 O Health -care facility Each pump or irrigation circle • 2
O Service over 320 amps- rating of 18t2 0 Hazardous location Each sign or outline lighting 2- 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
O System over 600 volts nominal more residential units in one structure alteration, or extension* - 2
O Building over three stories O Feeders. 400 amps or more *Description:
O Occupant load over 99 persons 0 Manufactured structures or 1W park Each additional inspection over the allowable in any of the above:
O Egress/lightingplan O 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 $
O Visa O MasterCard expires if a permit is not obtained' Plan review (at _ %) $
Credit card number - / / within 180 days after it has been State surcharge (8 %) .... $
Expires accepted as complete. TOTAL $
Name of cardholder as shown on credit card
Cardholder signature Amount 440 -4615 ((IOWCOM)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received Date Requested / " AM PM BUP
Location �_ _ Suite MEC
i
Contact Person Ph ( $6v) Z g S 3 S '17 PLM
Contractor 1(} ,� Ph ( ) SWR
4)
BUILDING Tenant/Owner L D ELC - c C 5/
Footing
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 O/j}57
Rough -In
UG /Slab 6 40), Low Voltage
Fire Alarm
PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
S Please call for reinspection RE: 111 Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date bg 3 qraP , Inspector c2 Ext V
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL