Permit CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2000 -00535
DATE ISSUED: 09/11/2000
VI
DEVELOPMENT H O B S ER 97223 CES 3-4171
PARCEL: 1S134BC-00300
SITE ADDRESS: 12286 SW SCHOLLS FERRY RD
SUBDIVISION: ZONING: C -G
BLOCK: LOT : 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:
CMR SIGN SYSTEMS
1820 E BURNSIDE
PORTLAND, OR 97214
Phone: Phone: 285 -7918
Reg #: LIC 104219
SUP 319SIG
ELE 26- 695CLS
FEES Required Inspections
Type By Date Amount Receipt Elect'I Final
PRMT CTR 09/11/200C $42.75 2720000000(
5PCT CTR 09/11/200C $3.42 2720000000(
Total $46.17
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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE f4.04,e4_776,A) ISSUED BY: .19:91./
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
CITY OF TIGARD Electrical Permit Application Plan Check #
131?�5 SW HALL BLVD. Rec'd By /L1/9/ C_
\v� Date Rec'd r /viert)
• TIGARD OR 97223 RE Date to P.E.
Phone (503) 639-4171, x304 3 Z00 Date to DST
Inspection (503) 639 -4175 Print of Type 11 VG QME p7 Permit # EC.0 Zoaa -00525
Fax (503) 598 -1960 Incomplete or illegible will nott andiiiVa Called
1. Job Address: 4. Complete Fee Schedule Below: .
Name of Development BAJA FRESH Number of Inspections per permit allowed
Name (or name of business) RAJA FRESH Service included: Items Cost Sum I
Address 12286 SW SCOLLS FERRY RD. 4a. Residential - per unit
City /State /Zip TIGARD, 0 R . 1000 sq. ft. or less $ 117.75 4
Each additional 500 sq. ft. or
a portion thereof $ 26.75 1
Commerci
f'rJ Residential ❑ Limited Energy $ 60.00
Each Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2
(Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders
information for COT data base). Installation, alteration, or relocation
Electrical Contractor CAR/ COI I JMR T A T NC _ 200 amps or less $ 64.25 2
Address 1820 F. RIIRNS T DF 201 amps to 400 amps $ 85.50 2
PIIRTI AND State OR Zip 9 7� 401 amps to 600 amps $ 128.50 2
City P 14 601 amps to 1000 amps $ 192.50 2
Phone No. 939 -8753 Over 1000 amps or volts $ 363.75 2
Job No. Reconnect only $ 53.50 2
Elec. Cont. Lice. No. 96 -6g5C1 S Exp.Date 10 -1 -00 4c. Temporary Services or Feeders
OR State CCB Reg. No. 1n4219 Exp.Date 1-21-02 Installation, alteration, or relocation
COT Business Tax or Metro No Exp.Date 8-01 200 amps or less $ 53.50 2
//A 201 amps to 400 amps $ 80.25 2
Signature of Supr. Elec'n 401 amps to 600 amps $ 100.00 2
Over 600 amps to 1000 volts,
319S I G 11 -01 see "b" above.
License No. Exp.Date
4d. Branch Circuits
Phone No. 239 -8153 New, alteration or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name Each branch circuit $ 5.35 2
Address b) The fee for branch circuits
without purchase of service
City State Zip or feeder fee.
Phone No. First branch circuit $ 37.50
Each additional branch circuit $ 5.35
The installation is being made on property I own which is not 4e. Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or irrigation circle $ 42.75 r
Owners Signature Each sign or outline lighting ( $ 42.75
Signal circuit(s) or a limited energy
(if required):* panL alteration or extension $ 60.00
3. Plan Review section
( Minor Labels (10) $ 100.00
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over
4 or more residential units in one structure the allowable in any of the above
Service and feeder 225 amps or more Per inspection $ 50.00
Per hour $ 50.00
System over 600 volts nominal In Plant $ 59.00
Classified area or structure containing special occupancy as '
described in N.E.C. Chapter 5 5. Fees:
5a. Enter total of above fees $ 2-
* Submit 2 sets of plans with application where any of the above apply. 8% Surcharge (.08 X total fees) $ - Not required for temporary construction services. Subtotal $
5b. Enter 25% of line 5a for
NOTICE Plan Review if required (Sec. 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account # `/
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ / '7
/
i:\dsts\forms\clectric.doc
9/12/00 Activities for Case #: ELC2000 -00535
10:57:17 AM '
Assigned Hold Updated r
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCC001 Application received 8/31/00 MAIL RECD No Hold DLH 9/11/00
ELCC003 Permit created 9/11/00 DLH DONE No Hold DLH 9/11/00
ELCC799 Elect'I Final No Hold DLH 9/11/00
ELCC500 (F)Issue permit 9/11/00 DLH DONE No Hold DLH 9/11/00
ELCA510 (F) Reprint permit 9/11/00 ZZZ DONE No Hold ZZZ 9/11/00
•
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Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 Hour Inspection Line: 639 -4175 Business Line: 63 -4171
BUP
Date Requested 1/ - AM PM BLD
Location /2,2- 54) SGh /ls Cevb -7 /Zd Suite MEC
Contact Person Dove• Ph 3 b3-7P - 6470 PLM
Contractor C / ✓ � l �� / Ph SWR •
BUILDING Tenant/Owner ELC •au - 0053
Retaining Wall ELR
Footing
Access: FPS
Foundation h "' / i , ,As/ c/,,
/�
Ftg Drain SGN
Crawl Drain Inspection 'Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire wall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof /v
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS__PART FAIL
ELECTRICAL
Service
Rough In �
UG /Slab I (f
Low Voltage �(
F• - Al .. (J
ART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for rei • pection RE: Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk
Other Date i Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.