Permit %h, CITY OFTIGARD
,,, , DEVELOPMENT SERVICES ELECTRICAL PERMIT
„ ' * �� i� PERMIT #: ELC96-0698
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/29/96
saett3 PARCEL: 2S110DB -00700
SITE ADDRESS...: 15532 SW PACIFIC HWY
SUBDIVISION • WILLOW BROOK /TIGARD PROMENADE ZONING:C -G
BLOCK • LOT •10
Project Description: FOR SUPERCUTS SIGN
- -- 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..: 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/0 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
SUPERCUTS type amount by date recpt
15532 SW PACIFIC HWY PRMT $ 40.00 TAT 10/29/96 96- 285176
STE 3 SPCT $ 2.00 TAT 10/29/96 96- 285176
TIGARD OR 97224
Phone #:
Contractor:
BLAZE SIGNS OF OREGON $ 42.00 TOTAL
PO BOX 23910
REQUIRED INSPECTIONS
PORTLAND OR 97281 -3910 Elect'1 Service
Phone #: 503- 639 -3262 Elect' 1 Final
Reg #..: 64325
/ ..
This permit is issued subject to the regulations contained in the 140 '
Tigard Municipal Code, State of Ore. Specialty Codes and all other . er' ` ' t Signature
applicable laws. All work will be done in accordance with /
a
7
pproved plans. This permit will expire if work is not started
within 180 days of issuance, or if work is suspended for more 1?".e
than 180 days. I ued By
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
, A 13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. #
^I'"' (.0, Permit # et_e eo -069'
�Ai' f I II
'` Phone (503) 639 -4171 Date Issued /0 29
FAX (503) 684 -7297 / / /
CITY OF TIGARD TDD No. (503) 684 -2772 Issue by ,
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
r
Name of Development /, 0
a .�`/0a�AANDE' Number of Inspections per permit allowed
Address /$-$32 -d ..Sw �e it Ay/ Service included: Items Cost(ea) Sum
// /
City /State/Zip GA/d ae. 97) a P 4a. Residential - per unit 4
1000 sq. ft. or less $110.00
Name (or name of business) ., SuPE�Pc UrS
Each additional 500 sq. " or
portion thereof $25.00 1
Commerciaj Residential ❑ Limited Energy $25.0
Each Maned Home or Modular 2
Dwelling Service or Feeder $68.00
2a. Contractor installation only: 4b. Services or Feeders
5 Installation, alteration, or relocation 2
Electrical Contractor LI,4ZE .q 200 amps or less $60.00 2
Address �AX .2 3,vo 201 amps to 400 amps $90.00 2
401 amps to 600 amps $120.00 2
City ,Q TLAtf/O State_ Zip_ 9 7 601 amps to 1000 amps $180.00 2
-
Phone No. (1e6> Goy 336. Over 1000 amps or volts $340.00 2
Contractor's License No. 24 -380 f*_' I 5 Reconned only $50.00
Contractor's Board Reg. No. / , . 2 S' 4c. Temporary Services or Feeders
� Installation, alteration, or relocation 2
Signature of Supr. Elec j' / , 200 amps or less $50.00 2
License No. /3S /P Phone No. d..1, 32Z2.- 401 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
purchase of service or feeder fee. 2
City State Zip 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 branch circuit $35.00 2
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 u D. U(/
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 58. 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 $ i Do
5% Surcharge (.05 X total fees) $ , / i
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 1
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. ❑ Trust Account # $
Balance Due $ 3.2.l)
rpds.. dW.6. - m.a{y
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Page No. 1 CASE HISTORY FOR CASE NO.: ELC96 -0698
SUPERCUTS
15532 SW PACIFIC HWY
09/15/97
Action Description Reg/ Scbd/ End/ Action Notes Diep By Update Upd
Code Sent Done Done Date By
ELCC001 Application received / / / / 10/29/96 PASS TAT 10/29/96 TAT
ELCC003 Permit created / / / / 10/29/96 PASS TAT 10/29/96 TAT
ELCC500 (F)Issue permit / / / / 10/29/96 PASS TAT 10/29/96 TAT
ELCC800 Case Finaled / / / / 11/08/96 PASS MIR 11/08/96 MJR
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