Permit CITY OF TIGARD
DEVELOPMENT SERVICES PERMIRI #ALELC96I�766
13125 SW Hall Blvd.,
9 ,
DATE ISSUED: 12/06/96
PARCEL: 2S11OAB -00200
SITE ADDRESS...: 14385 SW PACIFIC HWY
SUBDIVISION • CANTERBUURY PLACE ZONING:C —G
BLOCK • LOT -1-3
Project Description: Installing a permanent 216 sq. ft. wall sign
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS : 0 0 — 200 amp • 0 PUMP /IRRIGATION 0
EACH ADD'L 5O0SF...: 0 201 — 400 amp • 0 SIGN /OUT LINE LTG..: 1
LIMITED ENERGY • 0 401 — 600 amp • 0 SIGNAL /PANEL • 0
MANF. HM/ SVC /FDR..: 0 601+amps-1000 volts.: 0 MINOR LABEL (10)...: 0
- - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS - --
0 — 200 amp • 0 W /SERVICE OR FEEDER: 0 PER INSPECTION ° 0
201 — 400 amp • 0 1st W/O SRVC OR FDR.: 0 PER HOUR • 0
401 — 600 amp • 0 EA. ADD' L BRNCH CIRC: 0 IN PLANT • 0
601 — 1000 amp • 0 PLAN REVIEW SECTION
1000+ amp /volt • 0 > =4 RES UNITS > 600 VOLT NOMINAL..:
Reconnect only • 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: FEES
JERRY KOLVE type amount by date recpt
14385 SW PACIFIC HWY PRMT $ 40.00 JD 12/03/96 96- 287176
5PCT $ 2.00 JD 12/03/96 96- 287176
TIGARD OR 97224
Phone #:
Contract or:
MULTI LIGHT SIGN CO. $ 42.00 TOTAL
3255 NE BROADWAY
REQUIRED INSPECTIONS
PORTLAND OR 97213 Elect' 1 Service
Phone #: 503 - 281 -3083 Elect'1 Final
Reg #..: 64107
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee Signature
applicable laws. All work will be done in accordance with
approved plans. This per.it will expire if work is not started
within 188 days of issuance, or if work is suspended for lore
than 180 days. Issued B y
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 for inspection — 639 -4175
Community Development ELECTRICAL PERMIT APPLICATION
I AA ,
13125 SW Hall Blvd. 1.
Tigard, OR 97223 Permit # Ll -C/R'b - 6 - nde
^ / 1 , Date Issued 17r 6 Ala
� I� Phone (503) 639 -4171
CITY OF TIGARD FAX (503) 684 -7297
TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development 1.)e.111M 40 Number of Inspections per permit allowed
Address I �0 8‘c .(� . . P( iC. K 1 W I Service included: Items Cost(ea) Sum
City /State /Zip if 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
Name (or name of business) csAYiNQ. Each additional 500 sq. ft. or
portion thereof $25.00
Commercial IP Residential ❑ Limited Energy $25.00 1
Each Maned Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
T' c r, 4b. Services or Feeders
f 1l ( L.c 1 `PLC) Installation, alteration, or relocation
Electrical Contractor �^ `LA
�� 0 201 amps to 400 amps $80.00 2
CI
Addr�$s ,32 5 1) •P• Ge u t o 7 A (-� / 4 ip Z 401 amps to 600 amps $120.00 2
City d1C 1 � State Z
� �3 $180.00 2
g t` Over a mps to amps amps
Phone No. I O - z... Over 1000 amps or volts $340.00 2
Job NO. Reconnect only $50.00 2
contractor's license NO. R /4- 9 QC.- 4c. Temporary Services or Feeders
Contractor's Board Reg. No. . • Installation, alteration, or relocation
Signature of Supr. Elec'n gi A A.,_ _IIMPIl� 200 amps or less 2
License No.34a &I Ph" No. _: 201 amps to 400 amps $50.00 -
401 amps to 600 amps $75.00 2
Over 600 amps to 1000 volts $100.00
2b. For owner installations: see "b" above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane
Address a) The fee for branch circuits with
City State Zip purchase of service or feeder fee. 2
Each branch circuit $5.00
Phone No. b) The fee for branch circuits withou
The installation is being made on property I own which is purchase of service or feeder fee. 2
First additional circuit br $35.00
not intended for sale, lease or rent.
Each additional branch circuit $5.00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40.00
4 or more residential units in one structure Minor Labels (10) $100.00
Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.C. Chap 5 Per inspection $35.00
Per hour $55.00
In Plant $55.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
5a. Enter total of above fees $
NOTICE 5% Surcharge (.05 X total fees) $ -
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. w°rdIcumdeNeko- ❑ Trust Account #
prm.epp $
Balance Due $
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /FIr /Slab Plbg. Top Out Insulation'
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other:
Date: 7 7/ 7 A.M. .M. Entry: r /4
Address: / Z 3 g5 c
Tenant: Ste: MST:
�y BUP:
/Own: d — �3 MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
t
� s 472 5 C ,-,
/ t�57i2aqv t�,o-, � ,e5 fi
/
Inspector/U/ : ^��
r: c / —0" — ` � /. Date:
APPROVED DISAPPROVED /CALL FOR REINSP. 4 CO