10900 SW 121ST AVENUE ADDRESS:
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CITY OF TI RD FILECTRIC',AL PERMIT
PI:-RMI
T #: El_(-9505�2'2
DATE ISSUED: '11./03/95
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW He I Blvd.Tigard,Oregon 97223s8199 (503)639-4171 PARCEL: I G I 3413D-0*7200
SITE ADDRESS. . . ; !Q000 SW 11:::AGT AV(-':_
3UBDIVICSION. . . . .- ZONING.-R-4. 5
BLOCK. . . . . . .. . . . : LOT. . . . . . . . . .. . s :
Plr-oject Desct-iotiOn - f0t- sign or sign C)Utlininq
-----RESIDENTIAL UNIT------- ---TEMP' rRVC/FEEDERS- -------Ml SCEL1_ANEOUS-------
1000 SF CR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . s lb
TACH ADD$ L 5007F. . . : 0 x:0.1 - 400 Amp. . . . . . . : 0 SIGN/OUT LINE LTG. I
LIMITED ENERGY. . . . . : 0 401 -- GOO ramp. . . . . . . : 0 SIGNAL /PANEL. . . . . . . :: V,
MANF. HM/ c33V('/FDR. . . 0 60 14 a M F)5 -.J 000 � of t 5. . 0 MINOR LAe1!L ( 10) . . . : 0
---SE RV I(--[-./FEEDER------ CIF,:LJTTS-------- - ---nDD*IL I1\JSPEC7IO1qS-----
171 200 amp. . . . . . : 0 W/SERVICE OR t:EEDER: 0 PER INSPECTTj1q. . . . . : 0
201 400 amp. . . . . . . 0 Ist W/O SRVC OR FDR. z 0 PFR H17.1 IR. . . . . . . . . . . . V1
401 600 amp. . . . . . : 0 EA A.I)D' L BRNCH CIRC; 0 IN . . . . . . . . . . . 0
2171. 10011) am! . . . . . : 0 REVIEW SECT I Ot4--'---
1000+ amp/volt . . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 JOLT NOMINAL.
Recannec,t onl.v : 0 SVC/FDR 225 AMPS. CLARS AREA/SPEC OCC.
Owner,.
TRINITY EVANGELIGAL CHLJRCH tvpe amof,tv.t t)v nate v-s?r-n
10900 3W 121ST PRMT 40. 00 JDA 11/03/95 95-272511
5P171, 4, 2. 00 JDA 11/03/95 95-272511.
TIGARD OR 9*7222
phone #:
C"ontr-act or-:
OWNER # 42. 00 TOTAL
REQUIRED INSPECTIONS -------
Phonp it: Electric-al Final.
Re rl 000000
This oersit is issued subject to the reSulations contained in the �� �(jt,, �'
Tigard Municioal Code. State of Ore. Soecial'y Codes and all other Permittee Signature
applicable laws. All work will be done in accordance with
aperoyed plans. This De-sit will Mire if work is not started
within 180 days of issuance, cr if oork is susoprided for more
than 180 days, I S S Lied
INSTALLATION ON J_y
rhe installation is beinq made on property I ovin which is not intended fn-
sale. lease, or ),ent .
OWNERIS SIr21\lA7URF1 DATE:
C-1 INSTAL: . '.TION
'ITGNATURE Or SUPR. ELECIN* DATE:
i_ILLNGE NO:
Call for inspection 639--4175
CITY OF TIGARD BUILDIN,; INSPECTION NOTICE
Inspec?ion Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Pibg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sever Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation Mech,
Underilr. Insul. Shear Wail Gyp. Bd. -E=,ect.
Date Requested:` , •i 7 l y-� _Time: __AM PM
Address: / L/
Builder: cf O 3 Z U C Permit #:iQ -5
THE FOLLOWING CORRECTIONS ARE REQUIRED:
w
Inspector C- 4,
J<APPHOVFD —DISAPPROVED _APPROVED SUBJECT TO ABOVE
Call For Reinsp. �i�
1 � � Nil. ca r Ca
C 1 t Y CIF. T t l ARD F�t�'tW I P T 111- F�RYMlw:'.N't RkA,,*1 t `,�• r..I i:..�I
f+li 11�Ih' o f It 1 N C 1 Y I~.*WMI F-L I CAL CAM AMOUNT a 0. 1410
KIDDRLSS r 10900 900 Hw .VA HT OPYMh N T CII f+ o I I RIJN 145
HIAk1 )1v1t-,)I :IN 4
Pt-I 2POSU (IF' PA YMEN I- OMOLIN I' [4411) POW-1.18E 01' PAYMP."M Atrit..)1.IIJ I PA 11)
PF..,RMI I 4111. 00 qt I . StJ1 I, F3 VIE:1t r'« 00
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Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hal( Blvd.
Tigard, OR 97223 Permit #
Phone (503) 639-4171Date Issued ,
CITY OF TIGARD FAX (503) 684-7297 nA
TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development �.� Number of Inspections per permit allowed
Addiess—Z,f ke laz lrService included Iterns Cost(ea) Sum
City/State/Zip f,�sr ,?�_ 4a. Residential -ppr unit
1000 sq. ft. or less $11000 4
Name (or name of business)_g lam, L ;,ISE" _ Fach additional boo sq ft or
/ r l 1, portion thereof $25.00 t
Commercial X1 Residential Limited Enerqy
Each Manufd Home or Modular
Dwelling Service or Feeder $6800
2a. Contractor installation only:
4b. Services or Feeders
Electrical Contractor Installation alteration,or relocation
200 amps or less $6000 2
Address _ 201 amps to 400 amps $8000 2
City State__ Zip_ 401 amps to 600 amp, $120 00 2
601 amps to 1000 amps $18000 2
Phone No._ ______ ____ __ over 1000 amps or volts $34000 2
Job NO. Reconnect only $5000 2
Contractor's license NO. 4c. Temporary Services or Feeders
Contractor's Board Reg. No. _ _._ Installation,alteration,or relocation 2
Signature of Supr. Elec'n 200 it or less 2
-- 201 amps to 400 amps $50 i
l_icensr NO.— Phone No 401 amps to 600 amps 00
2
-- -- $75.
Over 600 amps 10 1000 vans $10000
2b. For owner installations: see'b"above.
4d. Branch Circuits
Print Owner's Name i New,alteration or extension per pane
Address K l a)The lee for branch circuits with
City ( Id�� Statep�r zip purchase of circuits or reader fee.
1
"—��— Each breech service
$500 _
Phone No. �y d - b1 The fee for branch circuits without ^�
The installation is being made on erty I own which is purchase of service or feeder fee. 2
not intenders fns se or re t. Each branch sal bruitanch
$35 00
_ __ Each addttlonet branch circuit $500
setOwner's Signature- _ 4e. Miscellaneous
I IQ (Service or feeder not included)
3. Plan Review section (if required): Each pump or Irrigation circle $4000
Fach sign or outline lighting $4000 Cd
Signal circu8(s)or a limited energy
Please check appropriate Item and enter fee in section 5B panel,anerstinn or extension $4000
4 or more residential units in one structure Minor Labels(1(,) $10000
- 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 cf the above
as described in N.E.C. Chapter 5 Per inspection __ $35 00
Per hour $55.00
.-. In Plant _ US 00
Submit 2 sets of plans with application where any of the above --
apply. Not required for temporary construction services. 5. Fees:
5a. inter total of above fees rCPO
J NOTICE 5% Surchrige (05 X total fees) $ �---
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
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) S
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal 6
COMMENCED. "ffi—dw.4. Trust Account #
Balance Dim $
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (50)939.4171 S I rN PERMIT
PERMIT #: SON95-0096
DATE ISSUE_D. . . . . 05/30/95
EXPIRATION DATE: 08/30/95
PARCEL. . . . . . . . . :
ZONE. . . . . . . . . . . . R--4. 5
BUSINESS NAME. . : TRINITY EVANGELICAL CHURCH
SIGN LOCATION. . 1. 10900 SW 1 c I ST AVE
APPLICANT/AGENT- DALE SL.OAT
BUS I NE..ciS TAX NO. OK
r5im�¢zc:sm�_:cxraa�-�sssx tx=u::�e=�-:asc:mar.si�:aas:cmr..r.:mr:ssan.:.+�:�-:weac:�:sac:r:�_c�.=sass:�=amr..::araar-.
SIGN:
PERMANENT (X) FREESTANDING (.K) FREEWAY ( )
TEMPORARY ( > WALL ! ) ELECTRONIC (X)
OTHER ( BILLBOARD ) BALLOON ( �
'311504 DIMENSIONS. . . . . . 11 4' X E3'
TOTAL... SSIGN AREA. . . . . . : 64 sq, ft.
WALLAREA. . . . . . . . . . . . . sq. ft.
WAL.,L. FACE (DIRECTION) : NA
SIGN HEIGHT.. . . . . . . . . . : E ft.
PROJE.C'TION FROM WALL. a in.
ILLUMINAT'ION. . . . . . . . . c INT
DESCRIPTION CIF SIGN:
Permanent 6' Freest avid ing sign w/2 viewsbie surfaces of 41 x 8' �
MATERIALS. . . . . . . . . . . . : ALUM/LrXGN
EXISTING SIGNS. . . . . . . c 1
ELECTRICAL PERMIT LREQUIRED: YES
BUILDING, PERMIT REQUIRED. . c NO
AUMINISTRAT'IVE: F_XCL-PTION). a N/A
PERMIT F'EE c
APPROVEI:► NYa
DATEiv 1115/30/95
J
C9
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L• _
CITY OF T'IGARD Permit No.
SIGN PERMIT APPLI=ON
M-e a;!placant hereby appLles for a permit fcr the wank indicated or as shown in the
accampanying plaits and specifications.
SIGN LO=.-0N ADDRESS: 10900 SW 121st Avenue, Tigard, OR 7ANING:
NAME OF BLZINFSS: Trinity Evangelical Church
APFLICANr/AGENT: Dale Sloat COMPANY: Trinity EvangelicalPHONE: 590-5683
The City of Tigard inpos'es an animal Business Tax which must be kept gent on all
persons doing business in the City. Do you prr ser-ctly have a current business tax?
YES ( ) NO ( ) U.L. L31---1 f --
PMPC6= SIGN: (Cheat as matey as apply)
PERMAhriNr (X X k SIANDRU (h t) FREEWAY ( )
'i NPORARY ( ) WAIL ( ) ELBO RONIC ( )
aI1•m ( ) sIIdBaAR) ( ) BALLOON ( )
SIGN DIIrfr�NSTONS: _ + x 8 feet EXPIRATION DATE:
T7IAL SIGN AREA (Sq. Ft.) : 32 --
E,AIL AREA (Sq. Ft.) . --
WALL FACM:
HEIGHT (Ft) —
PRCiTEtT1u.V FROM WALL:
IT-11 NINATiON: YES (X X) NO ( ) TYPE: in t e r u a I
ODPY: lriuity Evanveiical Church - message board with announcements
?QLT3RIALS: moi" Extrude aluminum frame with _).exan nanplc
EXISTING SIGNS: _
Woorlen Trinity Evangelical Church (to be removed) —
ECC EMON: N/A ( ) APPROVED ( ) HOW HL" t
AREA ( ) HEIGHT ( )
CCMM1-=:
PIANNTJG DM8HRUW All sign permits mist be aoocnpanied by a sole
Permit Fee: drawing and plat plan. If work aitthorized under
Receipt No: 4S-- L '4' a sign permit has not been cxpleted wit2•ar ninety
days after t'..! issuance of the permit, the permit
v,
Date: shall bercxme null and void.
E7BC'IRIC AL PEId'IIT I Cn=7 THAT I THE RECORDED OWtQR OF THE
RBx)UT RE : YES ( ) NO RMPE91Y (fit AN WARIZED BY 'IME CWNIIR.
7"s
W BUILDING PE RKrr
REQUMM: YE` ( ) No ( ) Applican&'s Si -tore
10900 SW 121st Avenue, Tigard, OR 97223 590-5683
c p/BKMPE1RII' Address Telephone
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