Permit CITY O F T I G A R D ELECTRICAL PERMIT
P ERMIT #: ELC2000 -00452
J '��I� DEVELOPMENT H BMEN SO RVICiES 639 -4171 DATE ISSUED: 8/7/00
PARCEL: 2S 110AA -00700
SITE ADDRESS: 14030 SW PACIFIC HWY
SUBDIVISION: ZONING: C -G
BLOCK: 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:
TOSCO CORPORATION RAMSAY SIGNS
PO BOX 52085 9160 SE 74TH AVE
PHOENIX, AZ 85072 PORTLAND, OR 97206
Phone: Phone: 777 -4555
Reg #: SUP 157SIG
• LIC 00063422
ELE 26 -106cI
FEES Required Inspections
Type By Date Amount Receipt Elect'I Final
PRMT BLD 8/7/00 $42.75 0004304
5PCT BLD 8/7/00 $3.42 0004304
Total $46.17
This Permit is issued subject to the regulations contained ' the Tigard Munidpal Code, State of OR. Spedalty Codes and all other applicable laws.
All work will be done in accordance wi h approved p - s. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days A ENTIO• . Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 -00 -0011 thr• •gh OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE A • • / M._ SUED BY:
OWNER INSTA ION ONLY
The installation is being ma ' e on property I own which is not int • d 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
•
CITY OF TIGARD Electrical Permit Application Plan Check #
.- 13125 SW HALL BLVD. Rec'd By
TIGARD OR 97223 Date Recd
Date to P.E.
Phone (503) 639 -4171, x304 11,-VV.
Cam" Date to DST
Inspection (503) 639 -4175 Print of Type Permit # fiet. 71,W5 z.
Fax (503) 598 -1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below: •
Name of Development Number of Inspections per permit allowed
Name (or name of business) l.(. lf\ () C L- 1 Service included: Items Cost Sum 4 '
Address l go 30 S,VU 1 PPAC.I.FIA 4 4a. Residential - per unit
1000 sq. ft. or less $ 117.75 4
City /State /Zip - 1 - 1 c .D - OR- Each additional 500 sq. ft. or
portion thereof $ 26.25 1
Commercial 0 Residential ❑ Limited Energy $ 60.00
Each Manut'd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2
(Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders
information for COT data base). Installation, alteration, or relocation
Electrical Contractor pp.YY\5Qq d r 200 amps or less $ 64.25 2
Address gaol) SIC, 7I4? /, {-�, Pev`e 201 amps to 400 amps $ 85.50 2
City 2XL.f'cts State OR_ Zip Ci 7 o'1Gf/
401 amps to 600 amps $ 128.50 2
N 1
601 amps to 1000 amps $ 192.50 2
Phone No. 503 - '7 7 - 1 -Li 5 5 5 Over 1000 amps or volts $ 363.75 2
Job No. 5- 2{ -(1C7 Reconnect only $ 53.50 2
Elec. Cont. Lice. No. Exp.Date 4c. Temporary Services or Feeders
OR State CCB Reg. No.rp3cf2.52- Exp.Date 1 - b I Installation, alteration, or relocation
COT Business Tax or Metro No. Exp.Date 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
0 , / A 401 amps to 600 amps $ 107.00 2
Signature of Supr. Elec� • Over 600 amps to 1000 volts,
License No. 35 f Exp.Date see "b" above.
Phone No. q� -1 55 4d. Branch Circuits
New, alteration or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name Each branch circuit $ 5.35 2
Address b) The fee for branch circuits
without purchase of service
City State Zip or feeder fee.
Phone No. First branch circuit $ 37.50
Each additional branch circuit $ 5.35
The installation is being made on property I own which is not 4e. Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or irrigation circle $ 42.75
Owner's Signature Each sign or outline lighting i $ 42.75 ya , 7
Signal circuit(s) or a limited energy
(if required):* panL alteration or extension $ 60.00
3. Plan Review section
( Minor Labels (10) $ 107.00
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over
4 or more residential units in one structure the allowable in any of the above
Service and feeder 225 amps or more Per inspection $ 50.00
Per hour $ 50.00
System over 600 volts nominal In Plant $ 59.00
Classified area or structure containing special occupancy as
described in N.E.C. Chapter 5 5. Fees:
5a. En .stotal of above fees $ a , 75
* Submit 2 sets of plans with application where any of the above apply. g,er, Surcharge (.05 X total fees) $ ,
Not required for temporary construction services. Subtotal $
5b. Enter 25% of line 5a for
NOTICE Plan Review if required (Sec. 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account # U
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ / 1p , /7
is \dsts \forms \electric.doc
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
,y BUP
Date Requested - 1 AM PM BLD
Location / c/0 3 540 , Suite MEC
Contact Person Ph 77 7 - Y SS r _ PLM
Contractor Ph S
BUILDING Tenant/Owner 75c , CBypg LC , v -ev Y
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing •-
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
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
eC€CTRJ
Se' (dl S
Rough In
UG /Slab
Low Voltage
F'
e Alarm
_► 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 Vi Approach /Sidewalk
Other Date 9/15 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.