Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00523
� DEVELOPMENT SERVICES DATE ISSUED: 9/19/2006
4 4 II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2 S 103 D D -00800
SITE ADDRESS: 13815 SW PACIFIC HWY 100 ZONING: C -G
SUBDIVISION: 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:
D.W. SIVERS COMPANY BIGFOOT SIGNS LLC
4730 SW MACADAM AVE 2413 LITTLE KALAMA RIVER RD.
#101 WOODLAND, WA 98674
PORTLAND„ OR 97201
Phone: Contact #: PRI 360 - 255 -9011
FAX 360- 225 -6125
FEES
Description Date Amount Reg #: ELE 37 990CLS
[ELPRMT] ELC Permit 9/19/2006 $53.40 LIC 155744
[TAX] 8% State Surcharge 9/19/2006 $4.27 SUP 604S1G
Total $57.67 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other a! . . ble laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or i - o is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Cente . T .se rules are set
forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct estions to OUNC . 0 46 -6699 or
1- 800 -332 -2344.
Issued By: _37, -- 7 ?f_e_7i 1 Permittee Signature:
" � J OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, o ent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503- 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
. Electrical Permit' FOR OFFICE USE ONLY t(15€_tiNig'
City of Tigard y Receive. Permit
13125 SW Hal Blvd., Tigard, OR 972 l A 20 6 Date/By: �/ 11 � 6;4,06 ....a$
��� Plan Revi
Phone: 503.639.4171 Fax: 503.598. 0 i !' n I `\ Other Permit:
1G ,I Date/By:
Inspection Line: 503.639.4175 �F ``''� `0 _„_a_ L+l- F'1 Date Ready/By: ® See Page 2 for
Internet: www.ci.tigard.or.us C \I w` �Q \v - Notified/Method: r / / S Information
' A , oF WORK .. ,'. , ., - -. PLAN.REVIEW,..
❑ New construction ❑ Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑ Other: ❑Service over 225 amps, comm'I ['Hazardous location
['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
. . CATEGORY OF CONSTRUCTION -. - - ... . r` of I- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Multi - family ❑ Master builder ❑ Other: ❑Building over three stories ['Feeders, 400 amps or more
['Occupant load over 99 persons ❑Manufactured structures or
- JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
Job no.: Job site address: 13 $ISM 6 h. 111,1 ❑Health -care facility ❑Other:
``^^'' Submit 2 sets of plans with any of the above.
City/ State/ZIP: ► 7 7At -, O g- g 7 9 a 3 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: 100 Project name: . )nil gk U FEE* SCHEDULE .
Description I Qty. I Fee. I Total I '•
Cross street/directions to job site: # t Me' Or /�,1� New residential single -or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I 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
. DESCRIPTION OF WORK Each manufactured or modular
•
, ' � l EIS! �l 519 I dwelling, service and /or feeder 90.90 2
(4� Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER . , ig, TENANT. _ . 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: m id t I I 601 amps to 1,000 amps 240.60 2
Address: l 3 $ l5 - S (A) 19Auk` tom, Over 1,000 amps or volts 454.65 2
I Reconnect only 66.85 2
City/State/ZIP: 'T 7 ACd OR q z 9-3 Temporary services or feeders installation, alteration, and/or
Phone: (5 b3) 5 011— y4 g (o 2000 0 a amps I Fax: ( ) 2 m p s
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
I. APPLICANT . I ❑ CONTACT PERSON A. Fee for branch circuits with
Q service or feeder fee, each 6.65 2
Business name: V J9 &. S /y, ) L C. branch circuit
J B. Fee for branch circuits
Contact name: m 6 `, A, pi without service or feeder fee,
0 7111
I/ each branch circuit 46.85 2
Address: 3 A 1 A414 R,„, 2d Each add'l branch circuit 6.65 2
City/ State/ZIP: GJtevj(AAd C. A 9$40 71f Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: (36 p) 8.25" I Fax:: ( 3 & c ) . 2 9 5 - - - - ( o 1 . 9 5 Sign or outline lighting I 53.40 2
E - mail: _ Signal circuit(s) or limited-
CONTRACTOR energy panel, alteration, or
` extension. Describe: Page 2 2
/
Business name: BF 76 6/1NS 4 L. c C�
�/ ' /_ ( /
Address: n O Each additional inspection over allowable in any of the above
Or 413 l � I4 / e— J 4 'Jk i'r A ' 't`— � , 1 1 Per inspection 62.50
City/State • (A)A 'it ',' ff ( Investigation per hour (1 hr min) 62.50
Pho : (34Q0) 895-- a ! QI ( ) . Fax: ( 365) s .A 9%—_6, / a Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES* - ; .:, .
CCB Lic.: 15s7yif i,,di► Electrical Lic.:3�7 • 0, S Suprv. Lic.: (0y a Subtotal 53. ` t
- Suprv. ElectricianYgnature, required: � r Plan review (25% of permit fee)
-17;11 /� State surcharge (8% of permit fee) a
Print name: rty Date: 9 • /D,6 TOTAL PERMIT FEE C t/1
Authorized signature: ' /'f This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: -7 1 3 ci../... Ai.J Date: S if 0 & • Fee methodology set by Tri -County Building Industry Service Board
•• Number of inspections per permit allowed.
iABui1d nglPemuts'.ELC- PennitApp.doe 12/03 440 4613T(10 /02/COM/WEB - '. ....e../c........- T ,
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*
❑ Burglar Alarm
El Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
El Vacuum Systems*
El Other:
I. COMMERCIAL WORK ONLY: — _— - -�
Fee for each commercial system $75.00
(SEE OAR 918 - 260 -260)
Check Type of Work Involved:
El Audio and Stereo Systems
• ❑ Boiler Controls
❑ Clock Systems
El Data Telecommunication Installation
El Fire Alarm Installation
El HVAC
El Instrumentation
El Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
El Outdoor Landscape Lighting*
El Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
i: BuildingWermits \ELC•PertnitApp.doc 04/03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006 -00523
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9 /19/2006
Phone: (503) 639 -4171 � � li
Inspection Requests (24 Hrs.): (503) 639 -4175 . ' 1.1.
INSPECTION WORKSHEET FOR DATE: 11/3/2006 TIME: 7:01AM PAGE: 26
SITE ADDRESS: 13815 SW PACIFIC HWY 100 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: WINDFALL ZtL∎
DESCRIPTION: ign igi
OWNER: SIVERS COMPANY, D.W. PHONE #:
CONTRACTOR: BIGFOOT SIGNS LLG PHONE #: 360
Inspection Request Scheduled For: Date: 11/3/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
1 * —_ • - ,Ilation 039272 -01 360-225-8110 Y
Corrections /Comments /Inst• ctions: cOO • \35
- A ,
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1" 6t3 " " Date: l' l' 1 ' 640 Phone #: (503) 718- 2 -41'4