Permit i' a ELECTRICAL PERMIT
CITY OF TIGARD
PERMIT #: ELC2005 -00160
„.. iA DEVELOPMENT SERVICES DATE ISSUED: 3/18/2005
'r 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2 S 110A B -00200
SITE ADDRESS: 14405 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: CANTERBURY PLACE LOT : 1 -3 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:
KOLVE, G C SIGNCRAFT LLC
14389 SW PACIFIC HWY 9033 SW BURNHAM
TIGARD, OR 97224 TIGARD, OR 97223
Phone: Phone: 503 - 639 - 4910
FEES Reg #: LIC 155420
ELE 34- 674CLS
Description Date Amount SUP 75SIG
[ELPRMT] ELC Permit 3/18/2005 $53.40
[TAX] 8% State Surcharge 3/18/2005 $4.27 REQUIRED ITEMS AND REPORTS
Total $57.67
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 0 R 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 0 -332 -2 :4.
Issued By: vti ____ _ Permittee SignatuK5
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.
RECEIVE!: sc,n► De-2 — ass
Electric ]Permit Application FOR OFFICE USE ONLY
City Of Tigard MAR 18 A Datee e y 3 J J ? PermitNo.:Ei „�,o0 / 6,o
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review / / ; Phone: 503.639.4171 Fax: 503.598.1960 CITY O _" a�� ,�,,,, i ;' Date/By: Other Permit:
Inspection Line: 503.639.4175 BUILDING 7 � T 7 ��T I• !�. n ' �y'- Date Ready/By: 3t ' ® See Page 2 for
Internet: www.ci.tigard.or.us B ILDING V i Notified/Method: I I Lk Supplemental Information
i ...;,y i r t ti;4 i s r : r 'ti y .' 2 V . .,' f'�`r.'?S\ d i ti J .- S e r . •r .
i . 'YPE O F � i V,7 :7,174,:i.',-"4,,%1.t 4 �,, a .,'1p " . f J` .S, ,gi - .,]!?� _.
?. �% ; - ri. .. k�4 t E- �7. "': .. .... i .. _ - ,�. �. - �_'l'e .. :. ,_xi� �t �- u'VLra'<�41_.a� .c !it „'1�` yY_ � � ., .- .
❑ New construction ❑ Addition/alteration/replacement Please check all that apply:
❑ Demolition Other 5 6N
OService over 225 amps, comm'l ❑Hazardous location
a r ; i . , . ❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
CATE`GO.RY' OF ;CONSTRUC'TION r i5zz r • J , f •.; u' of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2 family dwelling R ommercial/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
'' ;; n'i JOB'SITE ifl�FFOINNIiON A1ND LOGA'ETION:' 1:i a ❑Eg tm plan RV park
Job no.: Job site address: 14405 _ ..., ... ress/li gh gPlTy � t wall 9
5 5 W . ;Pacific i H h ey: sign
Hwy. ❑Health -care facility
2 sets of plans with any of the above.
City/State/ZIP: "t Bard , OR 61/223 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: Ca5hC0 rouni ial S ervices - . :. v - '.1-;,,•-•:='-- '° - r F F ` • ; :S - i- - IIT L ` , ,': a� ':+ .
/�' J Description I Qty. I Fee. I Total
Cross street/directions to job site: R j c fluty / Gaa role St New residential single - or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
v: j
.±
' Limited energy, non - residential 75.00 2
,-'. L ' ,,,, �F n?,- DESCR('PTIQN OF -' 'ORIC: ' " :'� •_ ', Each manufactured or modular
1-took- op 4z, ext 5�' c 1 e c�- ri c i bi ?>D r
- dwelling, Services or feeders installation, and/or feeder 90.90 2
r ervces llation, alteration, and/or relocation
i lluwiinafcd Was St1 200 amps or less 80.30 2
['PROP JtT'Y ' ;OWNER `4 `., s , ❑ TENANT 201 amps to 400 amps 106.85 2
•a . . _ .. . '-i'' _ . - . - . _,1,_ -' .' 'v k a: 401 amps to 600 amps 160.60 2
Name: v' .C, • (-Collie. Co. ' L 601 amps to 1,000 amps 240.60 2
Address: 7438q 5.w. Pac -f j ^ . 1-TW y Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State /ZIP: 1 iard , OR. 8722.3 Temporary services or feeders installation, alteration, and/or
Phone: ( 503) (926 •3001 Fax: ( 603 664 -5611 200 a tion
ca
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
' 1 [y 'Xft3ICANT , ' r ' k; A. Fee for branch circuits with
�i . ..y + .., ° .. . . „ C � .. .ON`IAC� PEItS0
S 1 JCR JFT ElECT2i cA L A DVERT151 N G LLC branch circuit
feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: S E4Eu_ey CABA without service or feeder fee,
46.85 2
each branch circuit
Address: 9033 SU.) BURN HAM Each add'l branch circuit 6.65 2
City/State/ZIP: T1GP►RQ OR 41122.3 Miscellaneous (service or feeder not included)
Phone: (6-03) b39 • 46110 Fax: : 5613 63 9 .4441
Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 ,53.4el 2
E - mail: Signal circuit(s) or limited-
;` i.,?y' • , ` ' -- `CON , k A r ~'` " 1 :a , energy panel, alteration, or
.� �� extension. Describe: Page 2 2
Business name: 54 Wle 4 a1ooveo •
Address: Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: - Investigation per hour (1 hr min) 62.50
Phone: ( ) Fax: ( ) Industrial plant per hour 73.75
FTT CTUCA PERIV.IT-.:F, FS * , i `'i z r
CCB Lic.: 15642.0 Electrical Lic.:9 Suprv. Lic.: Subtotal
. 5 3.10
Suprv. Electrician signature, required: Si - r ;Q .. 2 1i Plan review (25% of permit fee) y.;
Print name: DA In D W ILK 1 MSo�J Date: State surcharge (8% of p ermit fee)
b 5
/Of Authorized signature: TOTAL PERMIT FEE S
ature:
gn � T his permit application expires if a permit is not obtained within 1 0
q days after it has been accepted as complete
Print name: sw (b Date 5. 1 .45' • Fee methodology set by Tri-County Building Industry Service Board
•• Number of inspections per pemtit allowed.
i:\ Building \Pemtits\ELC- PemitApp.doc 12/03 440- 4615r(10/02/COM/WEB
Electrical Permit Application - City of Tigard ' 4 .
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
O011itVI CYAL AMI ONI"Y`' , > ,f`
Fee for each commercial system $75.00
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
is\ Building \Pcrmits\ELC- PermitApp.doc 04/03
CITY .
BUILDING DIVISION PERMIT #: ELC2005 -00160
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/18/2005
Phone: (503) 639 -4171 /Aoiiiiil �;`
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 3/25/2005 TIME: 7:07AM PAGE: 121
SITE ADDRESS: 14405 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: CANTERBURY SQUARE LOT #: 1 -3 TYPE OF USE:
PROJECT NAME: CASHCO FINANCIAL
DESCRIPTION: Sign lighting.
OWNER: KOLVE, 0 C, PHONE #:
CONTRACTOR: SIGNCRAFT LLC PHONE #: 503 - 639 -4910
Inspection Request Scheduled For: Date: 3/25/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 002693 -02 503 - 639 4910 N
Corrections /Comments/ Instructions:
, (.:,__.
.te'V
PASS Ill PARTIAL APPROVAL ❑ CANCEL ' ii" NO ACCESS
,1 i_ �
r,,< ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: iN-ai�tx --Q_ Date: i� l5 Phone #: (503) 718-