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Permit CITY O T I G A R D ELECTRICAL PERMIT . 4 4 ; P ERMIT #: ELC1999 -00302 AL41 DEVELOPMENT SERVICES DATE ISSUED: 5/21/99 � 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S 110AA -00700 SITE ADDRESS: 14030 SW PACIFIC HWY SUBDIVISION: '7 6, S ZONING: C -G BLOCK: LOT : JUR TIG Project Description: Sign or outline 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: RAMSAY SIGNS 9160 SE 74TH AVE PORTLAND, OR 97206 ORIGINAL Phone: Phone: 777 -4555 Reg #: SUP 157SIG LIC 00063422 • ELE 26 -106c1 FEES Required Inspections Type By Date Amount Receipt Elect'I Final PRMT GEO 5/21/99 $40.00 99- 315562 5PCT GEO 5/21/99 $2.00 99- 315562 Total $42.00 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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -1987. Permit Signature: Issued By: i 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: 'v //9 DATE: of LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day CITY OF TIGARD Electrical Permit Application Plan Check # 13125 SW HALL BLVD. Rey d By TIGARD OR 97223 Date Recd Date to P.E. Phone (503) 639 -4171, x304 Print or Type Date to DST G Inspection (503) 639 -4175 Incomplete or illegible will not be accepted Permit # d /f - de 34 Fax (503) 684 -7297 Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Number of Inspections per permit allowed Name (or name of business) 6tA0KF A 4 . 7& ,SrstTI a,J Service included: Items Cost Sum I Address V4 4) f RC_,I F ic- d ir∎tr 4a. Residential - per unit 1000 sq. ft. or less $110.00 4 City /State /Zip . l 7 t Ae. viz-- Each additional 500 sq. ft. or Commercial Residential ❑ Limited thereof $25.00 1 Limited Energy $25.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $68.00 2 2a. Contractor installation only: (Attach copy of all current licenses) 4b. Services or Feeders Electrical Contractor " - �L 6/4 S Installation, alteration, or relocation Address ° (i (0 se , -/ t-' A ` t/z 20 amps to or less $60.00 2 201 amps to 400 amps $80.00 2 Cityq: State o 2 --- Zip 172 0t, 401 amps to 600 amps $120.00 2 Phone No. `717 £4 - 601 amps to 1000 amps $180.00 2 Job No. 2--6 2- a Over 1000 amps or volts $340.00 2 Reconnect only $50.00 2 Elec. Cont. Lice. No. Z s IO6 CL Exp.Date / o • .99 OR State CCB Reg. No. (oA L/ 2.2- Exp.Date/_/Z-r/ 4c. Temporary Services or Feeders COT Business Tax or M . o No. Exp.Date Installation, alteration, or relocation _ 200 amps or less $50.00 2 201 amps to 400 amps Signature of Supr. Elec' �'`�" ' 401 amps to 600 amps $100.00 2 3S Over 600 amps to 1000 volts, ( License No. U Exp.Date Ib -11 see "b" above. Phone No. rr4-- - 4d. Branch Circuits New, alteration or extension per panel 2b. For owner installations: a) The fee for branch circuits with purchase of service or Print Owner's Name feeder fee. Address Each branch circuit $5.00 2 - b) The fee for branch circuits City State Zip without purchase of Phone No. service or feeder fee. First branch circuit $35.00 2 The installation is being made on property I own which is not Each additional branch circui $5.00 2 intended for sale, lease or rent. 4e. Miscellaneous (Service or feeder not included) Owner's Signature Each pump or irrigation circle $40.00 2 Each sign or outline lighting - TT $40.00 aC. 2 3. Plan Review section (if required):* Signal circuit(s) or a limited energy panel, alteration or extension $40.00 2 Minor Labels (10) $100.00 Please check appropriate item and enter fee in section 5B. 4 or more residential units in one structure 4f. Each additional inspection over Service and feeder 225 amps or more the allowable in any of the above System over 600 volts nominal Per inspection $35.00 Classified area or structure containing special occupancy Per hour $55.00 as described in N.E.C. Chapter 5 In Plant $55.00 * Submit 2 sets of plans with application where any of the above apply. 5. Fees: 40 i- Not required for temporary construction services. 5a. Enter total of above fees $ 5% Surcharge (.05 X total fees) $ - NOTICE Subtotal $ 5b. Enter 25% of line 5a for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $ NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $ IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY e TIME AFTER WORK IS COMMENCED. ❑ Trust Account # $ Total balance Due I: \DSTS \ELC96.APP Rev 9/96 7/19/99 Activities for Case #: ELC1999 -00302 . 9:23:48 AM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes ELCC001 Application received 5/20/99 GEO RECD No Hold GEO 5/21/99 ELCC003 Permit created 5/21/99 GEO • DONE No Hold GEO 5/21/99 ELCC799 Electl Final 5/21/99 5/21/99 6/23/99 CD PASS No Hold AKJ 6/23/99 ELCC500 (F)Issue permit 5/21/99 GEO DONE No Hold GEO 5/21/99 ELCC800 Case Finaled 6/23/99 AKJ DONE No Hold AKJ 6/23/99 • • • • • • • • Page 1 of 1 • . 1 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 Gj BUP Date Requested ll II ��e q J AM X PM BLD Location I ( -ICS() pat F'f0J Suite q� MEC Contact Person Ph ? q '� �D PLM Contractor A/714 S' Ph SWR �] BUILDING Tenant/Owner ,(�,�r! ELC ir -60—, Retaining Wall ELR Footing Access: Foundation 5), >`' J FPS Ftg Drain SGN Crawl Drain Inspection Notes:61 „ �/� Slab llGt el SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing C1) S S1.4 t O V Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: //t/19 66 Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL C ELECIN Service Rough In UG /Slab Low Voltage Fire • larm i kigik PART FAIL Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk . Date //-- Other l/ 7.3 !f , Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.