Permit CITY OF TIGARD ELECTRICAL PERMIT
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PERMIT ISSUED: ELC2007
COMMUNITY DEVELOPMENT
DATE ISSUED: 11/28/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S112DA
SITE ADDRESS: 15333 SW SEQUOIA PKWY ZONING: I -P
SUBDIVISION: PACIFIC CORPORATE CENTER LOT : JURISDICTION: TIG
PROJECT: SAIF CORPORATION
Project Description: (1) 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: SIGNAUPANEL:
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:
PACIFIC REALTY ASSOCIATES MARTIN BROS SIGN INC
15350 SW SEQUOIA PKWY #300 -WMI 3165 COMMERCIAL ST SE
PORTLAND, OR 97224 SALEM, OR 97302
Phone: Contact #: PRI 503- 364 -2211
FAX 503 - 364 -4315
FEES
Description Date Amount Reg #: ELE 24 -23CLS
FELPRMT] ELC Permit 1 1/28/200' $53.40 LIC 64761
[TAX] 8% State Surcharge I 1/28/200' $4.27 SUP 399S1G
Total $57.67 REQUIRED ITEMS AND REPORTS
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: 4fizd4zt, Permittee Signature: �► ��� � �
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 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
sC u 62o opa- ) 1
Electrical Permit Applicati FOR OFFICE
USE ONLY
City of Tigard 4 i r' E 1 V' . 1 ' 1 ' / /
1111 a 13125 SW Hall Blvd., Tigard, OR an Review
0 Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
TI G A It D Inspection Line: 503.639.4175 NOV 2 8 2007 Date Ready/By: Juris: es See Page 2 for
Internet: www.tigard - or.gov '� /� ® Notified/Method: / Supplemental Information
TYPE O)� �i I,f � Ur 1 JuA PLAN REVIEW
11 New construction ❑ Addit8 1 i►e t�t IISjO Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition %Other: 5 /b A) where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1 - and 2- family dwelling Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "1 -3 ",
Job no.: Job site address: � l � Six or or more. occupancy.
/et) (f aJ ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: -- 77 () - 4 4.0 ) q 7 as ( '' J ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 1 Project name: C',Rp ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site 14 ) �,.�f� Description I Qty. I Fee. I Tow I •
/ �' New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK • (with above sq. ft.) 75.00 2
Limited energy, multi - family 75.00 2
• ✓l,Q j'Y/OIL, A1.137 ) (44, /)1if79.1.( &IPI`t .SI . residential (with above sq. ft.)
G Services or feeders installation, alteration, and/or relocation
t..41.sfaLt J1.4c,t) 14157.( ifta s i py, _ 200 amps or less 80.30 2
❑ PROPERTY OWNER Di TENANT 201 amps to 400 amps 106.85 2
Name: / CD /e p 401 amps to 600 amps 160.60 2
/ 601 amps to 1,000 amps 240.60 2
Address: .9,0Z iy/� - c•••6_ Over 1,000 amps or volts 454.65 . 2
City/State /ZIP: vJ 67 / Temporary services or feeders installation, alteration, and/or
/!-t relocation
Phone: ( a 73 _ 7.? -7 Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits•= new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
iz tj e tti without service or feeder fee, • 46.85 2
Contact name: /Q�Q first branch circuit
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: - Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: (` ? B651. a Q / , Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle • 53.40 2
CONTRACTOR Sign or outline lighting / 53.40 S$ ¥d 2
Business name: //� `I �.1� Signal p a nel t(s) or limited -
Q JI"�t7 �(J j�S . i4 L energy panel, alteration, or
Address: zi 63-e Qom/ �i S. extension. Describe: Page 2 2
City/State /ZIPS A /n g7�3o Each additional inspection over allowable in any of the above
/ Per inspection 62.50
Phone:
( a3 ) 7 ,2c311 Fax: (503) 36 y .sv Investigation per hour 0 hr min) 62.50
CCB Lic.: 61/74 / I Electrical Lic.: 0 2f.. Q3 CLS Supry . Lic.: ..9 6 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, requir . f g Subtotal: S3. 40
Plan
Print name: � an review (25% permit fee):
�� -u S Date: lQ /o ( State surcharge (8% of permit fee): q_ al
Authorized signature: TOTAL PERMIT FEE: .5 41
Print name: Date: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
• -Number of inspections allowed per permit.
I:\ Building 'Permits\ELC- PermitApp.doc 05/23/06 440-4615T(11/05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information •
LIMITED ENERGY PERMIT FEES: - 4.0
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined ... $75.00 •
f►.;'
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
• Garage Door Opener* '•' ' • , -
❑ , i S.a
Heating, Ventilation and Air Conditioning System* i r, •
❑ Vacuum Systems* Z • - .. ^, s --
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system • .. �il• ` 1. rV :l% '�� : a�'. \ q,: :•� `�' ` '�,
(SEE OAR 918 -260 -260)
Check Type of Work Involved:
• L V 1% v . ' ,
F
❑ Audio and Stereo Systems • .
❑ Boiler Controls • ..� �� �. ` +` .1 t : • .,
❑ Clock Systems � c.7.\-",2. - . , •
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
• Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control* �, F, • �'• ^.i�'
•' \ID. Medical •
•
❑ Nurse Calls • ''�;'. .. e'. r"a ,•, t • r ‘1...
...
Outdoor Landscape Lighting*
❑ Protective Signaling .. : = ,� • r • . ,
•
Other
•
•
Total number of commercial systems:
lId licenses are required. Licenses are required
for •all's tther installations
I: \BuildingWermits\ELC- PermitApp.doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION - PERMIT #: ELC2007 -00801
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11l2Q/2007
Phone: (503) 639 -4171 ���.�� �� ��
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1/18/2008 TIME: 7:02AM PAGE: 72
SITE ADDRESS: 15333 SW SEQUOIA PKWY CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: SAIF CORPORATION
DESCRIPTION: (1) &ign lighting.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: MARTIN BROS SIGN INC PHONE #: 503 - 364 - 2211
Inspection Request Scheduled For: Date: 1/18/2008 Pour Time:
Code # Inspection Description onfirm # Contact # Message
199 Electrical final . 063459 -01 i 503 - 364 -2211 N
Corrections /Comments /Instructions:
'p 1•I S i i N Gi(Z,CV 1'T .
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V U4.1-_ Date: I -1 I Phone #: (503) 718- f ilf i tl i o
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