Permit A. CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00735
� TrN DEVELOPMENT SERVICES DATE ISSUED: 12/22/03
, - I- ' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171
PARCEL: 1 S 134 BC -00300
SITE ADDRESS: 12282 SW SCHOLLS FERRY RD
SUBDIVISION: GREENWAY TOWN CENTER ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: Sign lighting for (2) signs.
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: 2
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:
BPP RETAIL LLC CUSTOM SIGN CO INC
BY BURNHAM PACIFIC PROPERTIES TODD PHILLIS INC
ATTN: JOHN WATERS 9316 SW 12TH DR
SAN DIEGO, CA 92101 PORTLAND, OR 97219 -4204
Phone: Phone: 246 - 8324
Reg #: ELE 26- 750CLS
LIC 72764
FEES SUP 423SIG
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 12/22/03 $106.80
[TAX] 8% State Surcharge 12/22/03 $8.55 Rough - •
Elect'I Final
Total $115.35
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: Permit Signature: ' ', T V Ilriv'
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 639 -4175 by 7:00pm for an inspection the next business day
Electrical Permit Application Received FOR OFFICE USE ONLY
Electrical
Date/By: Permit No..LC 03 —t'ia 73 55
Cit of Ti and Planning Approval Sign ^ yJ 3 0O 3i
y g 1 Date/By: Permit No.: - /
13125 SW Hall Blvd. `��‘ J Plan Review Other
Oregon 9
g
Tigard, Ore 7 11 ( Date/By: Permit No.: Phone: 503 - 639- 41%Fax: 503 -598 960 ,' Post- Review Land Use
° � ;, � ' 'IP 1 0T l i � 1' � • r Date/By: Case No.:
Internet: w ww.ci.tigard `t pz'.ps 4, • Cs i
� �� � � _ -� Contact Juris.: El See Page 2 for
24 -hour Inspection Regl \ t' 503 - 639 -�5 Name/Method: Supplemental Information.
0 -r c O 0\1,
C.\OR
: °,K'Y11 .1-+' WORK .' . •- . _ , _ - PLAN . • 1 W (Please check all that apply) . •
[S] New construction ❑ Demolition ❑ Service over 225 amps- ❑ Health -care facility
commercial 0 Hazardous location
❑ Addition/alteration/replacement C • tiler: ❑ Service over 320 amps -rating of ❑ Building over 10,000 square feet,
CATEGORY OF CONSTRIJ ' TIOI _ - 1 & 2 family dwellings four or more residential units in
❑ I & 2- Family dwelling ❑ Commercial/Industrial ❑ System over 600 volts nominal one structure
❑ Building over three stories ❑ Feeders, 400 amps or more
El Accessory Building ❑ Multi- Family
❑ Occupant load over 99 persons 0 structures or RV park
❑ Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Oth
' :.;TOE SITE INFORMATION and LOCATION Submit _ sets of plans with any of the above.
The above are not ap?licable to temporary construction service.
-
Job site address: 11.1- 3 HI gui Pear y
Suite #: ZZSr I Bldg. /Apt. #: Number of inspections per permit allowed
Project Name: ?; s.A S4'.-A- Description Qty Fee (ea.) Total
New residential -single or multi- family per 1
Cross street/Directions to job site: dwelling unit. includes attached garage.
Service included:
l ► 1000 sq. ft. or less 145.15 4
1
Each additional 500 sq. ft. or portion thereof 33.40 1
Subdivision: Lot #: Limited energy, residential 75.00 2
Limited energy, non residential 75.00 2
Tax map /parcel #: Each manufactured home or modular dwelling
• DESCRIPTION OF -WORK ` - service and/or feeder 90.90 2
Services or feeders - installation,
I C NI -kV l CJ1( S.`V1 h alteration or relocation:
I � . 200 amps or less 80.30 2
U ✓►G�C J CG V� �CCJIn �' GI k t1� 201 amps to 400 amps I06.8s 2
J 401 amps to 600 amps 160.60 2
❑ PROPERTY OWNER' I D TENANT .- ' " , ... , `' 601 amps to 1000 amps 240.60 2
Over 1000 amps or volts 454.65 2
Name: Kr „1 -ors Lo v e r1 Reconnect only 66.85 2
Address: I 01 1 3 - 14) & v ta i2,id y Rd Temporary services or feeders - installation,
City/State /Zip: -- -� 0' ; N o" alteration, 00 am s o le ss relocation:
� ��� r � � 200 amps or less 66.85 I
Phone: 3 for - - 53 in Fax: 1-4 4 - U 32 1r 201 amps to 400 amps 100.30 2
401 to 600 amps 133.75 2
APPLICANT ' ❑ CONVICT, PERSON Branch circuits - new, alteration, or
Name: extension per panel:
Address: A . Fee for branch circuits with purchase of
service or feeder fee, each branch circuit 6.65 2
City/State /Zip: B. Fee for branch circuits without purchase of
service or feeder fee, first branch circuit 46.85 2
Phone: I Fax: Each additional branch circuit 6.65 2
E -mail: Misc.(Service or feeder not included):
CONTRACTOR ` . " , - Each pump or irrigation circle 53.40 2
Each sign or outline lighting Z, 53.40 2
Job No: 12ci Signal circuit(s) or a limited energy panel,
it.r S: c . 1 o1 Oesi n Description:
or extension Page 2 2
Business Name: CA/ -)
Description:
Address: inspection 5 w/ 1/-4'' 0' -
City/State /Zip: 'par 1 lct..d O'Y p ►� Ea h additional inspection over the allowable in any of the above: Per spection per hour (min 1 hour) 62.50
Phone: Fax: "Z Investigation fee:
CCB Lic. #: °7 27 (v 4 Lic. #: 7 C.A.5 er:
Supervising electrician _ I p -/ -O
Subtotal $ Electrical "Perritit l ees* .'
Su
P g ! /C) i -s0
signature required: � // Plan Review (25% of Permit Fee) $
Print Name: Tod& Pt ll t3 Li - #: k Z3 51 Ca State Surcharge (8% of Permit Fee) $ -SS
' TOTAL PERMIT FEE $ // 5. 3
Authorized � Notice: This permit application expires if a permit is not obtained within
Signature: Date: I z 1 180 days after it has been accepted as complete.
*Fee methodology set,by Tri -County Building Industry Service Board.
'roast Pc,: t,l_
(Please print name)
i:\Dsts\Permit Forms\ElcPermitApp.doc 01/03
•
Electrical Permit Application - City of Tigard , G
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all systems $75.00
•
Check Type of Work Involved:
El Audio and Stereo Systems
Li Burglar Alarm
El Garage Door Opener*
E] Heating, Ventilation and Air Conditioning System
•
E] Vacuum Systems
LI Other — - -
-
COMMERCIAL WORK ONLY:
Fee for each system $75.00
(SEE OAR 918 - 260 -260)
Check Type of Work Involved:
Ej Audio and Stereo Systems
•
Boiler Controls
Clock Systems
Data Telecommunication Installation
El Fire Alarm Installation
HVAC
Instrumentation _
Intercom and Paging Systems
El Landscape Irrigation Control
El Medical
•
Nurse Calls
Outdoor Landscape Lighting
El Protective Signaling
n Other
Number of Systems
* No licenses are required. Licenses are required for all
other installations -- .
i:\Dsts\Pemvt Forms\ElcPemvtAppPg2.doc 01/03
CITY OF TIGA RD 24 -Hour
BUILDING - ' Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received 13 iv:01 Date Requested l tted l 0 AM PM BUP
Location /21 1 Z _Sa Suite MEC
Contact Person 73r1 Ges II t. e,01 Ph (S7 ;) 2_0 ) - - /(o j PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner .0_, iiYl/l . PP 3 O' 7.3 S
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: n SIT
Post & Beam 01e/L,/ !✓!. X.l 44A r rl
Shear Anchors • _ / -
Ext Sheath/Shear �'� d '� ���� ^/L. �'lQ -UI�-
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm • . 4.9v-0790
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL l 1
PLUMBING LP
Post & Beam -L 3 9 - D n o
Under Slab `�
Rough -In
Water Service
Sanitary Sewer Icy — Lt r„ 11-})
Rain Drains �l/
Catch Basin / Manhole I
Storm Drain /-147
Shower Pan
Other:
Final
PASS PART FAIL 9 l / MECHANICAL / 5 (NlI/P' `-
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PART FAIL
EL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SI fl Please call for reinspection RE: LI Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date - % a Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record fr m the job Site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested AM PM BUP
Location `ZZ G o - 2 , _. 4. RAI rAes., ite MEC
Contact Person Ve Ph ( 4q s7 r I ? (I-- PLM
Contractor Ph ( ) - 4� N 3 —003/7
BUILDING Tenant/Owner 4-1y4 - 3- 3 0
Footing
Foundation ELC
Ftg Drain Access: _ 0 Q I
Crawl Drain
Slab Inspection Notes: SIT C L't" �/
Post & Beam Nj , l A lA.: �Q
Shear Anchors //
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof C ...
Other:
Final
PASS PART FAIL
-2/ ..„.7
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
e PART FAIL •
\LECTTh AL
Service
Rough -In
UG/Slab
Low Voltage
Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
• PART FAIL
SIT Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA n
Approach/Sidewalk Date 9 — C . Inspector 4'l �---- / Ext
Other: •
Final DO NOT REMOVE this Inspection record fr th e site.
PASS PART FAIL