Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00757
DEVELOPMENT SERVICES DATE ISSUED: 12/1/2004
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S135BA-00102
SITE ADDRESS: 10230 SW WASHINGTON SQUARE RD
SUBDIVISION: GA RBURG ZONING. C -G
BLOCK: LOT : 001 JURISDICTION: TIG
Project Description: (1) wall 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:
MEYER SIGN CO OF OREGON
15205 SW 74TH AVE
TIGARD, OR 97223
Phone: Phone: 620 - 8200
Reg #: LIC 64014
SUP 566S1G
FEES ELE 20- 190CLS
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 12/1/2004 $53.40
[TAX] 8% State Surcharge 12/1/2004 $4 Elect'l Final
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 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: ' _ • 'IOW
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
s w -z.,, L - 003(49
Electrical Permit Application / FOR OFFICE USE ONLY
t Received
- / �'QY r Electrical Permit No.: �A 7— • ,�J
L." i !N / 7 /
City of Tigard Planning Approval Sign
Date/B Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/B : Permit No.:
Phone: 503 -639 -4171 Fax: 503 -598 -1960 0 Post - Review Land Use
i' �
Internet: www.ci.tigard.or.us c•i I � Date/B : Case No :
Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name/Method: Su .. lemental Information.
,,, '`,Y* = : TYPE OF WORK' ` • - - .- , . - • - 'PLAN REVIEW (Please that a iiib •_ : ,;:
❑ New construction I ❑ Demolition ❑ Service over 225 amps- ❑ Health -care facility
commercial ❑ Hazardous location
❑ Addition/alteration/replacement Other: �.�t-'�A/ ❑ Service over 320 amps - rating of ❑ Building over 10,000 square feet,
' .. : :'t; / '!CATEGORY: DECONSTRUCTION :. ".: '- . . 1 & 2 family dwellings four or more residential units in
❑ 1 & 2- Family dwelling - Commercial/Industrial ❑ System over 600 volts nominal one structure _
❑ Building over three stories ❑ Feeders, 400 amps or more
❑ Accessory Building ❑ Multi- Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
❑ Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other:
r
. • JO &SITE INFORMATION and LOCATION', :,= ' '•'•• Submit _ sets of plans with any of the above.
rn,r The above are not applicable to temporary construction service.
Job site address: /DZ3O ,2u Wdgilbo t0N , ,, KAi� . . ; . .- , h: FEE* SCHEDULE''•``_ ., 3 :i_ ;; -' .
Suite #: C DIX I Bldg. /Apt. #: Number of inspections per permit allowed
Project Name: ,..50..07/72A--/) E D I Qty Fee (ea.) Total
New residential- single or multi - family per 1
Cross street/Directio s to job site: dwelling unit. Includes attached garage.
i3 WP•1 S 1 - .t rio 4 Welk Service Included:
1000 sq. ft. or less 145.15 4
IP4-5, / N� o Th N 6V)1111-10- - Each additional 500 sq. ft. or portion thereof I 33.40 I
� + Limited energy, 75.00 2
#
Lot : gy, residential
Subdivision: Limited energy, non residential 75.00 2
Tax map /parcel #: Each manufactured home or modular dwelling
..!: :,C . - _`4DESCRIPTION OF WORK•; . • :_ :,?' service and/or feeder 90.90 2
� � '�� /� / / Services or feeders - installation,
r S , (-J G(f'+ -_ ‘ , 6A) alteration or relocation: -
200 amps or less 80.30 2
201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
—
r'B 'Ilk(6 j ` 601 amps to 1000 amps 240.60 2
'PROPERTY OWNE u E ANT -` p p
Over 1000 amps or volts 454.65 2
Name: /J{ / (! p_. ` Co . Reconnect only 66.85 2
Address: go/ iv,7 LG12Q e! r �� , ?00 Temporary services or feeders - installation,
/ �/ - alteration, or relocation:
City/State /Zip: e47a / »ejni / C Y
, 9D D/ 200 amps or less 66.85 I
Phone: 310) 39L1 -6/)00 Fax: ( io 395' 27 9 201 amps to 400 amps 100.30 2
R 401 to 600 amps 133.75 2
❑ APPLICANT- ` :': , • ® CONTACT PERSON - - Branch circuits - new, alteration, or
Name: � T � UL ak2.p extension per panel:
/� A. Fee for branch circuits with purchase of
Address: /w/uQ 0 S CCY) Ut a ( 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 I 6.65 2
E -mail: Misc.(Service or feeder not included):
CONTRACTOR Each pump or irrigation circle 53.40 2
Each sign or outline light / 53.40 2
Job No: Signal circuit(s) or a limited energy panel,
• alteration, or extension Page 2 2
Business Name: kt& YL L .:,16,0 6. e8 OR, Description.
Address: /SZDS 4to 7 / )f' ,
(1722, Each additional inspection over the allowable in any of the above:
City /State /Zip: T! g o oR • I/ Per inspection per hour (min. 1 hour) 62.50
Phone: C�4 6 2 o --g Zoo Fax 5' ) 2o- 7o7t -/ nvestigation fee:
,/ c. Zo -Igo CC-S Other:
CCB Lic. #: 4 �D `1 Electrical Permit Fees* . -. .
Supervising electrician, Subtotal $ II' y 6 .
signature required: y) Plan Review (25% of Permit Fee) $
Print Name: ii 0 fil e ,- -) 4S1 Lic. #: 6/6 -5 6 State Surcharge (8% of Permit Fee) $ y..27
TOTAL PERMIT FEE $ X ( - I -
Authorized 1 - ` /N Notice: This permit application expires if a permit is not obtained within
Signature: l V� Date: I F .ad- 180 days after It has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
(Please print name)
i:\Dsts\Permit Forms\ElcPermitApp.doc 01/03
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
• L
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all systems $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems
- -
❑ Burglar Alarm • •
• Garage Door Opener
n Heating, Ventilation and Air Conditioning System
❑ Vacuum Systems • •
• ❑ Other •
•
COMMERCIAL WORK ONLY: •
Fee for each system $75.00
(SEE OAR 918 - 260 -260)
Check Type of Work Involved:
•
❑ Audio and Stereo Systems
❑ Boiler Controls
n Clock Systems
• Data Telecommunication Installation
n Fire Alarm Installation
HVAC
n Instrumentation
n Intercom and Paging Systems
❑ Landscape Irrigation Control
❑ Medical
❑ Nurse Calls
n Outdoor Landscape Lighting
❑ Protective Signaling
n Other
Number of Systems
* No licenses are required. Licenses are required for all
other installations
i:\Dsts\Permit Forms\ElcPermitAppPg2.doc 01/03
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: ELC2004 -00757
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/1/2004
Phone: (503) 639 - 4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 3/31/2005 TIME: 7:05AM PAGE: 50
SITE ADDRESS: 10230 SW WASHINGTON SQUARE RD C-12 CLASS OF WORK:
SUBDIVISION: OAKBURG LOT #: 001 TYPE OF USE:
PROJECT NAME: SCOTTRADE
DESCRIPTION: (1) wall sign.
OWNER: PHONE #:
CONTRACTOR: MEYER SIGN CO OF OREGON PHONE #: 620-8200
Inspection Request Scheduled For: Date: 3/31/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 003361 -01 503- 620-8200 N
Corrections /Comments /Instructions:
P7
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
"--
Inspector: :� e
, ... �i , r Dat / 0 3 Phone #: (503) 718-
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business,Line:" (503) 639 -4171 MST
BUP
Received Date Requested ",=.1 � 3 AM PM BUP
Location l 6 3a (e) S Suite MEC
Contact Person Hatc-;'.Ph ( ) z 3 9 -94.64 PLM
Contractor Ph ( ) SWR S C
BUILDING Tenant/Owner ELC �� �r 7 Vg
nn
Footing ELC g.d O � 0 0 '7
Foundation Access: S ) `p
Cr l Drain 6 / eo ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
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 *1 / / ,�'
Post
h -Beam ! C J `� N �'� s �1�' (1 . I 1 G d c V L‘ v%
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL L - h(
Service V�
Rough -In �`V�,` � D \N St r1 ��
UG/Slab
Low Voltage
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA D ate l •-�G�
Approach/Sidewalk Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the J site.
PASS PART FAIL