Permit CITY OF TIGARD _ ELECTRICAL PERMIT
°' PERMIT #: ELC2007 - 00360
' COMMUNITY DEVELOPMENT DATE ISSUED 5/24/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S1 10AA -02000
SITE ADDRESS: 14255 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: FURNITURE OUTLET
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:
WEC97H- OREGON -2 INVESTMENT TRUST MARTIN BROS SIGN INC
7 PENN PLAZA, STE 618 3165 COMMERCIAL ST SE
NEW YORK, NY 10001 SALEM, OR 97302
Phone: Contact #: PRI 364 -2211
•
FAX 503 - 364 -4315
FEES
Description Date Amount Reg #: ELE 24 -23CLS
[ELPRMT] ELC Permit 5/24/2007 $53.40 LIC 64761
[ELPLCK] ELC PIn Rev 5/24/2007 $4.27 SUP 399SIG
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 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: , ).Li Permittee 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 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.
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Electrical Permit Application
Date receive tf P ermit no�.PG�1�7�[X��
�l a l! ' City of Tigard E sc, j i Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall li '= Date issued: By: I Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 MAY 2 4 2007 Case file no.: Payment type:
Land use approval: 1-
t
F ii 1 4.J 'r l t'Jt1 s _
TYFE 3 r:7:�1M91T
❑ 1 & 2 family dwelling or accessory [ rCommercialindustrial ❑ Multi - family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration /replacement ❑ Other: , ❑ Partial
JOB SITE INFORMATION
Job address: /4/ a SS , k) 9.g h/ Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: 'Block: 'Subdivision: , 44,1
Project name: ft r -)'tu.o. Dsc & & I Description and location of work on premises: 6 i r' _ £a.a 't,¢ii.J .
Estimated date of completion/inspection:
CONTRACTOR APPLICATION FEE SCHEDULE
Job no: Fee Max
Business name: II / _ ' , S . h_C— Description Qty. (ea) Total no. insp
�/ New residential - single or multi -family per
Address:3 ( „Jo, u_•, 0.1,Q__. S. dwelling Wt. includes attachedgarage.
. City:`S, • State: (f ZIP: f 730,a Serviceincluded:
Phone;�j -34,y -a a // I Fax: 364 43 /S I E -mail: _ n tL. , u .s-.4. J 1000 sq. ft. or less 4
'
CCB no.: 417 ( I Elec. bus. lic. no: �7 ilia r47..„ 4 �o . Each additional 500 sq. ft. or portion thereof
l LL S Limited energy, residential ___ 2
City/metro lie. no.: G 7 9 / a Limited energy, non- residential 2
- ------_
.57a /07 Each manufactured home or modular dwelling
Signa ure o supervising electrician (required) Date Service and/or feeder 2
L icense no: Services or feeders — installation,
Sup. elect. name (print): ib .S 399 5/ 6
alteration or relocation:
PROPERTY OWNER 200 amps or less 2
Name (print): ceie ;,-. #1) 70 201 amps to 400 amps 2
401 amps to 600 amps ___ 2
Mailing address: P, 0. Box /0 601 amps to 1000 amps ___ 2
City: 7 h off,- J I State: � I ZIP: Over 1000 amps or volts ■■. 2
Phone: 9p - 7001 !Fax: I E -mail: Reconnect only t
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, alteration, or relocation:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
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: I State: • I 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 apple) Misc. (Service or feeder not included):
❑ Service over 225 amps - commercial Cl Health -care facility Each pump or irrigation circle 2
O Service over 320 amps - rating of 1&2 ❑ Hazardous location Each sign or outline lighting / . 6'3, ' 2
family dwellings ❑ 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 ❑ Feeders, 400 amps or more 'Description: c :5 / (cA)
O Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lightingplan O Other. Per inspection I
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Permit fee $ 53
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application
0 Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number / / within 180 days after it has been State surcharge (8 %) .... $ 4- a 7
Expires accepted as complete. TOTAL $ 57- 6 ' 7
- Name of cardholder as shown on credit card
Cardholder signature Amount 440 -4615 (6100fCOM)
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Electrical Permit Fees: • .•'' Limited Energy Fees:
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
/� Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total Check Type of Work Involved:
Residential - per unit
1000 sq. ft or less _ $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40 1 ❑ Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular .
G arage Door Opener'
Dwelling Service or Feeder $90.90 2 Ej
Services or Feeders ❑ Heating, Ventilation and Air Conditioning System*
Installation, alteration, or relocation
200 amps or less $80.30 2 Vacuum Systems
201 amps to 400 amps _ $106.85 2 El
401 amps to 600 amps $160.60 2
601 amps to 1000 amps $240.60 2 ril
Over 1000 amps or volts $454.65 2
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each system $75.00
200 amps or less $66.85 2 (SEE OAR 918 -260 -260)
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75 2 Check Type of Work Involved: •
Over 600 amps to 1000 volts. ❑
see "b" above. Audio and Stereo Systems
Branch Circuits ❑ Boiler Controls
New, alteration or extension per panel
a) The fee for branch circuits
with purchase of service or n Clock Systems
feeder fee.
Each branch circuit $6.65 2 ❑ . Data Telecommunication Installation
b) The fee for branch circuits
without purchase of service ❑ Fire Alarm Installation
or feeder fee.
First branch circuit $46.85 HVAC
Each additional branch circuit $6.65
Miscellaneous ❑ Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40 ❑ Intercom and Paging Systems
Each sign or outline lighting / $53.40 S3, yd
Signal circuit(s) or a limited energy El panel, alteration or extension $75.00 Landscape Irrigation Control'
Minor Labels (10) $125.00 ❑
Medical
Each additional inspection over
the allowable In any of the above
Per inspection $62.50 ❑ Nurse Calls
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Per hour _ $62.50
In Plant $73.75 ❑ Outdoor Landscape Lighting
Fees: ❑ . Protective Signaling
Enter total of above fees $ r Other
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8% State Surcharge $ Number of Systems
25% Plan Review Fee
See "Plan Review" section on $ No licenses are required. Licenses are required for all other installations
front of application.
Fees:
Total Balance Due $
Enter total of above fees $ _
❑ Trust Account # 8% State Surcharge $
Total Balance Due $
i:\dsts\forms\elc- fees.doc 10/09/00
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007-00360
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/24/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/15/2007 TIME: 7:00AM PAGE: 50
SITE ADDRESS: 14255 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: Ft ITU:2E GU ;11 1-
DESCRIPTION: ;3ito ' p
OWNER: W i• )t EG,ON -2 INVESTMENT TRUST, PHONE #:
CONTRACTOR: F" 1' x r' ) r, PJ INC PHONE #: 364 -27.11
Inspection Request Scheduled For: Date: 0/15/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 054002 -01 503 -364 -2211 N
Corrections/Comments/Instructions:
`Tt4 o w rm>—q
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G NO6 Le"' Date: 1 45% 01 Phone #: (503) 718 - )4 f