Permit CITY OF TIGARD EL ECTRICAL PERMIT
-��, ,� i ��� ; DEVELOPMENT SERVICES UATE ISSUEDLCP�i1lO� /�7 Hall Blvd., Tigard,
PARCEL: 2S 11 v DB -00 700
SITE ADDRESS...: 15520 SW PACIFIC HWY #D
SUBDIVISION : WILLOW BROOK /TIGARD PROMENADE ZONING:C -G
BLOCK • LOT • 10
Proje-ct Description: 'f SIGN CIRCUITS, 3 TO DIRECTIONAL. SIGNS, 1 TO MENU BOARD
- -- -RESIDENTIAL UNIT- - - -- -- -TEMP SRVC /FEEDERS- - - --- ------ MISCELLANEOUS - - - --
1000 SF OR LESS • 0 0 -- 200 amp • 0 PUMP /IRRIGATION • 0
EACH ADD'L 500SF...: 0 201 - 400 amp • 0 SIGN /OUT LINE LTG..: 4
LIMITED ENERGY • 0 401 - 600 amp • 0 SIGNAL /PANEL . 0
MAN! HM/ SVC /FDR..: 0 601 +amps -1000 volts.: 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 SpVC OR FOR.: 0 PER HOUR • 0
401 - 60O 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 - - --
CARL_ KARCHER ENTERPRISES type amount by dat recpt
8O0 MELLON AVENUE PRMT $ 160.00 .T *H 01/1.5/97 97- 288480
SPCT $ 8.00 J *H 01/15/97 97- 288480
MANTECA CA 95337
Phone #: 823 -9251
Contractor: - --- .- -- - -------------- ------------------
ES & A INC $ 168.O0 TOTAL
1210 OAK PATCH RD
-- REQUIRED INSPECTIONS --- - - - ---
EUGENE OR 97042 Wall Cover Elect'1 Service
Phone #: 541 -485 -5546 Underground Cove _
Reg #..: 111286
/ A
'
This permit is issued subject to the regulations contained in the 6 Q `� -
K. Tigard Municipal Code, State of Ore. Specialty Codes and all other Perm i t t e i gnat ure
applicable laws. All work will be done in accordance with ,
approved plans. This permit will expire if work is not started / f ift / within 188 days of issuance, or if work is suspended for more -_ !.� A .Ld _.
than 188 days. sued Sy
------------------- -- -OWNER INSTALLATION ONLY------- -------- - - - - -- ------ - - - - --
The installation is being made on property I own which is not intended for
sale, lease, or rent.
- OWNE.R' S SIGNATURE: __ DATE DATE:
--------------CONTRACTOR INSTALLATION ONLY--------------------------
SIGNATURE OF SUPR. EL.E:C' N : DATE
LICENSE NO:
Ca].1 for inspection -- 639 -4175
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. #
Permit # T�,C,-/
M11'' Phone (503) 639 -4171 Date Issued / -/5-`�
�'`
71 FAX (503) 684 -7297 deivn . 5C,Z-
CITY OF TIGARD TDD No. (503) 684 -2772 Issued by
Inspection (503) 639 -4175
1. Job Address: T( ,iz I � 114 1A- 4. Complete Fee Schedule Below:
Name of Development �' S \I v1.- Number of Inspections per permit allowed
Address `' '2 sW F -'L; r(,L Service included: Items Cost(ea) Sum
City /State/Zip T. &' ARO , 072- ‘':// 4a. Residential - per unit 4
1000 sq. ft. or less $110.00
Name (or name of business) A -J - Each additional 500 sq. ft. or
portion thereof $25.00 1
-
Commercial ❑ Residential ❑ Limned Energy $25.00 - Each Manufd Home or Modular 2
Dwelling Service or Feeder $68.00
2a. Contractor installation only:
4b. Services or Feeders
Installation, alteration, or relocation 2
Electrical Contractor 200 amps or less $60.00 2
-
A d d r e s s 1 - o pp- v.°grct:1 i 201 amps to 400 amps $80.00 2
City ev 6 [i State &Y1_- &Y1_- Zip �'? 2 401 amp to 600 amps $120.00 2 -
•� �T p r C-1-t7 P (7 601 amps to 1000 amps $180.00 2 - Phone No. ` /20 - 2f. - � Over 1000 amps or volts $340.00 2
-
Contractor's License No. E. 20 -- ZS'''- C(--- Reconnect only $50.00 -
Contractor's Board Reg. No. ii IVY.; 4c. Temporary Services or Feeders
/ Installation, alteration, or relocation 2
Signature of Supr. Elec'n ' 4._ , .'_ 200 amps or less $50.00 2
License No. 1433- Phone No�`!iarlikri, 201 amps to 400 amps $75.00
401 amps to 600 amps $100.00
Over 600 amps to 1000 volts
2b. For owner installations: see 'b• above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per panel
Address a) The fee for branch circuits with
City State Zip purchase a of circuit or feeder fee. $s.00 2
Phone No. b) The fee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder fee. 2
E
not intended for sale, lease or rent.
First branch circuit $35.00 2
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 / (� r -
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. Chapter 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:
NOTICE 5a. Enter total of above fees $ /10,
5% Surcharge (.05 X total fees) $ ?).
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF Sb. 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. ❑ Trust Account # $
Balance Due $ /1.430v
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3/4 In WHITE BORDER a ' f "s4 w 3 , %tp w
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2 /. a ? q '.; s . s 'kti,4 � i
6 a4 f4< S" /
3'0" 0 03„ DRIVE 4 ` ;I, 4 =~r�4 f4
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TH R U a4 R; 4�
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;4 lip . , a3 5,.,q 4“ ';
4 PAINT CABINET 4 4x4 t � s
;' 4 PMS COOL GREY #4 , 4 s ' il '
ikt
(BM #3402 GREY) 4 £ 4f 4 ,
3 In DIA. STEEL PIPE ► t . ?
PAINTED PMS COOL GREY #4
(BM #3402 GREY) 4 ';: 4 , ': SIDE VIEW
PIPE DIRECT BURIAL
INTO GROUND 36 In
TYPICAL INTERNALLY ILLUMINATED . 36 n DEEPIAUGERED CABINET= ALUMINUM FABRICATED WITH 800 MA. FLUORESCENT LAMPS
FACE = WHITE LEXAN WITH TRANSLUCENT VINYL DECORATION
D/F DIRECTIONAL SIGNS . ' FOOTING W/ CONCRETE BACKGROUND= #3630-73 RED PSV
1 1 LETTERS = WHITE
1 HAPPY STAR= #230 -015 YELLOW WITH 1 /2 In RED OUTLINE AND
� 1/2 In WHITE OUTER OUTUNE
' ' FACE DETAIL= RED
i
AMOUNT OF SIGNS & COPY TO BE DETERMINED
•
Page No. 1 CASE HISTORY FOR CASE NO.: ELC97 -0022
CARL KARCHER ENTERPRISES
15520 SW PACIFIC HWY Unit: D
09/16/97
Action Description Reg/ Schd/ End/ Action Notee Disp By Update Upd
Code Sent Done Done Date By
•
•
•
ELCC001 Application received / / / / 01/06/97 RECD .]NH 01/15/97 J *H
ELCC003 Permit created 01/15/97 / / 01/15/97 01/15/97 J *H
ELCC500 (F)Iseue permit / / / / 01/15/97 PAID JMH 01/15/97 J *H
ELCC799 Elect'l Final / / / / 02/11/97 PASS MJR 02/12/97 MJR
ELCC800 Case Finaled / / / / 02/11/97 PASS MJR 02/12/97 MJR
•
•