Permit A CITY OF T I G A R D PERMIT #: ELC2002 -00453
44:- AJIA DEVELOPMENT r o
SERVICES (503) 639 -4171 DATE ISSUED: 9/9/02
- 13125 SW Hall
PARCEL: 1S135BD-01200
SITE ADDRESS: 09800 SW SHADY LN
SUBDIVISION: ZONING: C -G
BLOCK: LOT : 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: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
EQUITY ONE ' ARTICO LITE LLC
9800 SW SHADY LANE . 8621 SE POWELL BLVD
TIGARD, OR 97223 PORTLAND, OR 97266
Phone: Phone: 503 - 253 -9406
Reg #: LIC 141398
ELE 26- 1128CLS
FEES Required Inspections
Type By Date Amount Receipt Rough -in
5PCT CTR 9/9/02 $4.27 2720020000( Elect! Final
PRMT CTR 9/9/02 $53.40 2720020000(
•
Total $57.67
This Permit is issued subject to the regulations contained in the Tigard Mu niapal 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 ' work_is_nostarted within 180 days of issuance, or if
work is suspended for more than 180 days. A i o NTION: Oregon law require'you to follow rules adopted by the Oregon Utility Notification
Center. Those rules are set forth in OAR 95 1 1 -0010 through OAR 952 - 01 -0080. You may obtain copies of these rules or direct questions to
TIP .4040444,tdr
Permit Signature: / Issued By:
:, ,�
�i�� ,
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
•
• E1,aoa? - c- ) 453
.: f'' Electrical Permit Application
Date received: Permit no.:
m..�ty. {t / I � ,n
�j,L :._ City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: I Receipt no.:
Phone: (503) 639 - 4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
0 New construction 0 Addition/alteration /replacement 0 Other: 0 Partial
JOB SITE INFORMATION
Job address: 9 $00 ,/ SH 4.P y L M , Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: I Block: I Subdivision:
Project name: E(3,42 try eke I Description and location of work on premises: .
Estimated date of completion/inspection:
CONTRACTOR APPLICATION FEE SCIIEDU.E
Job no: Fee Max
•
Business name: A -R- L (rE' L L C Description Qty. (ea.) Total no. insp
Address: gap Z I S E pbv/ r�C et V (' New residential tiIl cl -single tt or ched garage.
multi-family per
dwelling unit. Includes attached garage.
\0 City: potormw,t d.. I State:era I ZIP: 9744. Si' Service included:
Phoneme S'J v 9gO(0, I Fax• I E -mail: 1000 sq. ft. or less 4
Q ILA Set l ec. bus. Z� ��Z�C� Each Limited additional 500
residenti sq. ft. al or portion thereof
CCB no.: lic. no:
City /metro lie. no.: (p0 /(,p ,
R(s'N�� � ` � Li mited ener ener non- residential 2 2
. Each manufactured home or modular dwelling
Signature of supervising electrician (required) Date 9 -9-o . Service and/or feeder 2
Sup. elect. name (print): / B - / License no: Services or feeders — installation,
alteration or relocation:
PROPERTY OWNER 200 amps or less 2
Name (print): 201 amps to 400 amps - 2
401 amps to 600 amps 2
Mailing address: 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 installation, alteration,or
200 amps or less 2
ORS 447, 455, 479, 670, 701.
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
• ENGINEER Branch circuits - new, alteration,
or extension per panel:
Name: 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 . (Serviceorfeedernotincluded):
O 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 sign or 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
❑ Building over three stories ❑ Feeders, 400 amps or more *Description:
❑ Occupant load over 99 persons 0 Manufactured structures or RV park Each additional Inspection over the allowable in any of the above:
O Egress/lightingplan ❑ Other. Per inspection I I I
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other ' /
Permit fee $ 5 9 ) �Y'n
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application
O Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number / / within 180 days after it has been State surcharge (8 %) .... $ c -c- ' 7
Expires TOTAL $
accepted as complete. •
Name of cardholder as shown on credit card
$
Cardholder signature Amount 440-4615 (6100 /COM)
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: ,,,
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 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
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 ❑ Fire Alarm Installation
or feeder fee.
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 ❑ 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 Nurse Calls
Per hour $62.50
In Plant $73.75 ❑ Outdoor Landscape Lighting
Fees: ❑ Protective Signaling
Enter total of above fees $ El Other
8% State Surcharge $ 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 $
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
CITY OF TIGARD 24 -Hour
n s ection Line: (503) 639 -4175 S
BUILDII I
\ . p ( ) MST
INSPECTION DIVISION ' 1 Business Line: (503) 639 -4171
j BUP
•
Received Date Requested I l ' - AM PM BUP
Location ( 80. 4 e'' �"'�d LN11 Q Suite MEC
Contact Person T om') V Ph ( 3 ) c f y % _ 1 f 5b PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner c ) ,j Qn� ELC ) p 6., 00 43
Footing //
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam f 0 00 / a � nnrt
Shear Anchors D, ; 7 5
Ext Sheath/Shear L/C ) y
/)
Int Sheath/Shear V
Framing
Insulation 1 . c) 3
Drywall Nailing
Firewall ( NA c' (,p
Fire Sprinkler ti v'
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
• 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
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
• ow Volta et,
Fire Alarm
- Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
d1= PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date Abti. a�� jam Inspector / 2 o <f � 6 L' jc , Ext
Other: �f
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL