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Permit CITY OF T I GA R D ELECTRICAL PERMIT PERMIT #: ELC2001 -00470 �,�; DEVELOPMENT SERVICES • DATE ISSUED: 9/24/01 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S102AA -03100 SITE ADDRESS: 08635 SW SCOFFINS ST SUBDIVISION: TIGARD HIGHWAY TRACTS ZONING: CBD BLOCK: LOT : 016 JURISDICTION: TIG Project Description: Sign lighting for one sign. 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: SVCIFDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: AMERICAN LEGION POST #158 LUMINITE SIGN CRAFT INC. 8635 SW SCOFFINS 9033 SW BURNHAM TIGARD, OR 97223 TIGARD, OR 97223 Phone: Phone: 503 - 639 -4991 Reg #: LIC 116449 ELE 34- 530CLS SUP 159SIG • FEES Required Inspections Type By Date Amount Receipt Wall Cover PRMT CTR 9/24/01 $53.40 2720010000( Elect'I Final 5PCT CTR 9/24/01 $4.27 2720010000( • Total $57.67 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 • • ow ru es .: • • ted by the Oregon Utility Notification Center. Those rules are set forth in PAR 952 -101 -0010 through OAR 952-001-Of s 0 . You may obtain co 'es of these rules or direct questions to Permit Signature: �� /�/J �ki�yi�� I ued By: �/ P / A ' . ,,/ 1 1 1 , � 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 '4 Community Development • ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. Tigard, OR 97223 Planck/Rec. # �� ;� M L . i Permit # . � �I Phone (503) 639 -4171 Date Issued ) CITY OF TIGARD FAX (503) 684 -7297 Issued by TDD No. (503) 684 -2772 Inspection (503) 639 -4175 1. Job Address: 4. Complete Fee Schedule Below: Name of Development American Leo ion ua 1 1 Number of Inspections per permit allowed Address 8635 S .W. Scoff ins Service included: Items Cost(ea) Sum City /State/Zip Ti g a r s Or , 97223 4a Residential - per unit 4 1000 sq. ft. or less $110.00 Name (or name of business) Same Each additional 500 sq. ft or 1 portion thereof $25.00 - Commercial ❑ Residential ❑ Limited Energy 525.00 Each Maned 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 Luminite SignCraft, Inc 200 amps or less $60.00 2 Address An - 4" S w Rtirnham 201 amps to 400 amps $80.00 2 - 401 amps to 600 amps $120.00 2 - City T i Ci a r d State n r Zip 97 2 7 '3 601 amps to 1000 amps $160.00 2 - Phone No. 639-<910 Over 1000 amps or volts $340.00 2 - Contractor's License No. 5 Reconnect only $50.00 - Contractor's Board Reg. No. rR *l 1 6449 4c. Temporary Services or Feeders Installation, alteration, or relocation 2 Signature of Supr. Elec'n,_ , ,. A iv, ,i 200 amps or less $50.00 2 - License No./' p ." � Phi e No. '639-4991 201 amps to 400 amps - 401 amps „sooamps $75.00 $100.00 2 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 of service or feeder lee. 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 lee. 2 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 4 n . n 0 - 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 $ 4n 0 R 5% Surcharge (.05 X total fees) $ 2.00 PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ 42 ft 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 $ 42 .0O wacnconWnMMppmapp i Electrical Permit Application Date received: '?,W p/ Permit no.: ez.4 4:2 T lj, :.i ll _ City of Tigard Project/appI.no.: Expire date: CirynjTigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: I Receiptno.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: TYPE OF PERMIT ❑ I & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement ❑ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial JOB SITE INFORMATION J ob address' et 4 5 . • ■ A/ Bldg. no.: Suite no.: Tax map /tax lot/account no.: Block: I Subdivision: Project name:j�Q(CA11..)y0) Description and location of work on premises f W S]GNI Estimated date of completion/inspection: 3 •7 - 2-S '() I CONTRACTOR APPLICATION FEE SCHEDULE Job no: Fee Max Business name: (.(J/yl e-2 1 G Description Qty. (en.) Total no. insp 1 New residential - single or mall - family per Addres Q S 0,6 \ dwelling mat. Includes attached garage. City: iv I State:Q I ZIPer? 2 3 ' Service included: Phone:/ a IFaxb3 9pi'-X -mall: to00 sq. ft. or less 4 CCB no.: ( 14, 4(( I Elec. bus. lie. no: Each additional 500 sq. ft. or portion thereof _ Limited energy, residential 2 City /metro lic. no.: Lj L( r� L C( Limited energy, non- residential 2 Each manufactured home or modular dwelling Signature of supervising electrician (required) Date Service and/or feeder 2 Sup. elect. name (print): License no: Services or feeders — installation, alteration or relocation: PROPER OWNER 200 amps or less 2 Name (print): 201 amps to 400 amps 2 Mailing address: 401 amps to 600 amps 2 g 601 amps to 1000 amps 2 City: I State: I ZIP: Over 1000 amps or volts 2 Phone: I Fax: I E -mail: Reconnect only 1 Owner installation: The installation is being made on property I own Temporary services or feeders - which is not intended for sale, lease, rent, or exchange according to llation, alteration, orrelocatton: 20 amps or less 2 20 ORS 447, 455, 479, 670, 701. 201 1 amps to 400 amps 2 Owner's signature: Date: 401 to 600 am's 2 ENGINEER Branch circuits - new, alteration, Name: or extension per panel: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 City: I State: I ZIP: B. Fee for branch circuits without purchase of service or feeder fee, first branch circuit: 2 Phone: Fax: E -mail: Each additional branch circuit: PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included): Cl Service over 225 amps- commercial 0 Health -care facility Each pump or irrigation circle 2 ❑ Service over 320 amps -rating of 1&2 ❑ Hazardous location Each signor outline lighting 2 family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, O System over 600 volts nominal more residential units in one structure alteration, or extension* 2 0 Building over three stories ❑ Feeders, 400 amps or more *Description: ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above: ❑ Egress/lightingplan 0 Other. Per inspection 1 1 1 1 Submit _ sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Permit fee $ Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application $ ❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) credit card number: I / within 180 days after it has been State surcharge (8 %) .... $ Expires accepted as complete. TOTAL $ Name of cardholder as shown on credit card $ Cardholder signature Amount 440-4615 (6/00/COM) • ELECTRICAL PERMIT FEES: ., LIMITED ENERGY PERMIT FEEL: Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY p Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total 4, Check Type of Work Involved: Residential - per unit 1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems Each additional 500 sq. ft. or • portion thereof $33.40 1 ❑ Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular Dwelling Service or Feeder $90.90 _ 2 ❑ Garage Door Opener Services or Feeders ❑ Heating, Ventilation and Air Conditioning System' Installation, alteration, or relocation 200 amps or less $80.30 2 201 amps to 400 amps $106.85 2 F7 • Vacuum Systems` 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 2 ❑ Other _ . Over 1000 amps or volts $454.65 2 Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY Installation, alteration, or relocation Fee for each system $75.00 200 amps or less $66.85 _ 2 (SEE OAR 918-260 -260) 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved: - Over 600 amps to 1000 volts, see "b" above. • ❑ Audio and Stereo Systems Branch Circuits El New, alteration or extension per panel Boiler Controls a) The fee for branch circuits with purchase of service or ❑ Clock Systems feeder fee. • Each branch circuit $6.65 2 ❑ Data Telecommunication Installation b) The fee for branch circuits •without purchase of service ❑ or feeder fee. Fire Alarm Installation First branch circuit $46.85 ❑ Each additional branch circuit $6.65 HVAC Miscellaneous ❑ Instrumentation (Service or feeder not included) Each pump or irrigation circle $53.40 Each sign or outline lighting • $53.40 53. OD ❑ Intercom and Paging Systems Signal circuit(s) or a limited energy panel, alteration or extension $75.00 ❑ Landscape Irrigation Control • Minor Labels (10) $125.00 Each additional inspection over ❑ Medical the allowable in any of the above Per inspection $62.50 El Nurse Calls Per hour $62.50 In Plant $73.75 ❑ Outdoor Landscape Lighting Fees: 2 ii Protective Signaling Enter total of above fees $ �1 e/o n Other G 3 8% State Surcharge $ / • 8 7 Number of Systems 25% Plan Review Fee See "Plan Review" section on $ * No licenses are required. Licenses are required for all other installations front of application. Fees: Total Balance Due $ b 7 c 7 Enter total of above fees $ ❑ Trust Account # 8% State Surcharge $ • Total Balance Due $ All New Commercial Buildings require 2 sets of plans. • • i:\dsts \forms \elc- fees.doc 08/30/01 QITY OF TIGARD BUILDING INSPECTION DIVISION . MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP • Date Requested AM PM BLD Location ( -e 3 S -4--c-W„) Suite MEC Contact Person Ph 6 oZ / — 7-3 zZ PLM Contractor Ph SWR BUILDING Tenant/Owner ELC X00/ 00 q7 Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm ? Susp'd Ceiling s7511- C q fpro I/Q-4 Roof �/ Y 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 cP Final PASS PART FAIL ELECTRICAL Service Rough In Low Voltage b Low V Fire Alarm PASS 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 Fire Supply Line [ ] Please call for reinspection RE: / ] Unable to inspect - no access ADA Approach /Sidewalk D Other at / Insp �� �i� kts, _ Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.