Permit CITY F TIGARD ELECTRICAL PERMIT
T
te is - PERMIT #: ELC2006 -00188
DEVELOPMENT SERVICES DATE ISSUED: 4/11/2006
13125 SW Hall Blvd., Tigard,.OR 97223 503 - 639 -4171
PARCEL: 2S101 BB -00401
SITE ADDRESS: 11880 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: TIGARD ROAD GARDENS LOT : 4 ..5 JURISDICTION: TIC
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: 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:
RUSS CHEVROLET SECURITY SIGNS INC
11880 SW PACIFIC HWY 2424 SE HOLGATE BLVD •
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: Contact #: PRI 503 - 232 - 4172
FAX 503 - 230 -1861
FEES
Description Date Amount Reg #: ELE 26 - 560CLS
[ELPRMT] ELC Permit 4/11/2006 $53.40 LIC 122809
[TAX] 8% State Surcharge , 4/11/2006 $4.27 •
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: ! 2426.e. 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.
Savv 6 - 075
Electrical Permit Application roll ol1 Icr t sE ONI_YY
' 'f;it of Tigard RECEIV Received y t/ lb' Permit No. (app _pO /'
13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie
Phone: 503.639.4171 Fax: 503.598.1960 ''" i Date/B . Other Permit:
Inspection Line: 503.639.4175 A p 1 ,4 1,.. '+ ' _ I _ � „ Date Ready/By: t�'0� RI See Page 2 for
Internet: www.ci.tigard.or.us
APR No .J Supplemental Information
TYPE o11 1P TIGAFi[�
� � � PLAN REVIEW
❑ New construction ❑ Additions gff/ Please check all that apply:
❑ Demolition ❑Other: ❑Service over 225 amps, comm'l ❑Hazardous location
❑Service over 320 amps – rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1 - and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling ❑ Cornmercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi- family ❑Master builder ❑Other; ❑Building over three stories :Weeders, 400 amps or more
DOccupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting RV park
I Health -care facility ❑�+er:
Job no.: I Job site address: \ t88o -.....v." ?A .1 tC l4
F Submit 2 sets of plans with any of the above.
City/State/ZIP: - f ,4 (7 ! name: 0 `Z The above are not applicable to temporary construction service.
I Project S �✓ n FEE* SCHEDULE
Suite/bldg./apt. no.:
Iw�..� "( Description I Qty. I Fee I Total
Cross street/directions to job site: New residential single - or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
• DESCRIPTION OF WORK Each manufactured or modular
dwelling, service and/or feeder 90.90 2
"ti fi t ; \ . / ' L _ ( _ Si &Lk/ Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/ State/ZIP: Temporary services or feeders installation, alteration, and/or
Phone: ( ) I Fax: ( ) relocation
200 amps or less 66.85 I
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 600 amps 133.75 2
Owner signature: Date: Branch circuits – new, alteration, or extension, per panel
❑ APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with
service or Business name: branch circuit
ce feeder fee, each 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
Address: each branch circuit
Each add'I branch circuit 6.65 2
City/ State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) I Fax: : ( ) Pump or irrigation circle j 53.40 2
Sign or outline lighting I 53.40 • 2
E - mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: r 1 CZ u 5
Address: - 4. 1 ( 2 T S ' - (- - A Lt� Each additional inspection over allowable in any of the above
Per inspection 62.50
City/ State/ZIP: f ' .44.k 42 c �f Investigation per hour (1 hr min) 62.50
Phone: ( c') 232 C./ 02_• I Fax: ('3)Z30 /'6U 6,/ Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: to , I Electrical Lic.: 76 , t 1prv. Lic.: 3 83 5 Subtotal YD.
Suprv. Electrician signature, requited: L`L` — Plan review (25% of permit fee)
IP State surcharge (8% of permit fee) 41. ..7
Print name: 144Aciez... e---t4..L — Date. , ((, TOTAL PERMIT FEE 37 � /_
Authorized signature: This permit application expires if a c �
n' t pe pp pi permit is not obtained within 80
�'
days after it has been accepted as complete
Print name: c 1 �J" 4T " // C A 1 c 3 I Date: L.(.. I � . • Fee methodology set by Tri- County Building Industry Service Board
t� Q' n
•• Number of inspections per permit allowed.
i:\Building\PennitELC- PennitApp.doc 12103 440- 4615T(10/02/COM/WEB
Electrical Permit Application - City of Tigard ,
Page 2 - Supplemental Information t,
Page
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined........ $75.00
Check Type of Work Involved:
El Audio and Stereo Systems*
El Burglar Alarm
El Garage Door Opener* ' •
•
El Heating, Ventilation and Air Conditioning J
System* `
El Vacuum Systems*
El Other: •
COMMERCIAL WORK ONLY:
Fee for each commercial system. $75.00
(SEE OAR 918 - 260 - 260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
El Boiler Controls •
❑ Clock Systems
El Data Telecommunication Installation
❑ Fire Alarm Installation ° •
El HVAC
El Instrumentation
El Intercom and Paging Systems
❑ Landscape Irrigation Control*
El Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting* 4
El Protective Signaling
•
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations ,
is\ Building \Pezmits\ELC- PamitApp.doc 04/03
CITY OF TIGARD
BUILDING DIVISION .. . PERMIT #: ELC2006.0016B
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/11/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 `'I l
INSPECTION WORKSHEET FOR DATE: 7/5/2006 TIME: 7:00AM PAGE: 21
SITE ADDRESS: 11880 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: TIGARD ROAD GARDENS LOT #: 4 -5 TYPE OF USE:
PROJECT NAME: RUSS CHEVROLET
DESCRIPTION: (1) sign lighting.
OWNER: RUSS CHEVROLET. PHONE #:
CONTRACTOR: SECURITY SIGNS INC PHONE #: 503.232 -4172
Inspection Request Scheduled For: Date: 71512006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 032659 -02 503 - 232 -4172 N
•
Corrections /Comments / Instructions:
I Nti r,
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: t'6f3 L. Date: 9 0 Phone #: (503) 718- 2U v
CITY OF TIGARD •
BUILDING DIVISION -- PERMIT #: ELC2006 -00188
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/11/2006
Phone: (503) 639 -4171 A it i Inspection Requests (24 Hrs.): (503) 639 -4175 �'�� r: _..
INSPECTION WORKSHEET FOR DATE: 7/5/2006 TIME: 7 :00AM PAGE: 22
SITE ADDRESS: 11880 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: TIGARD ROAD GARDENS LOT #: Q - TYPE OF USE:
PROJECT NAME: RUSS CHEVROLET
DESCRIPTION: (1) sign lighting.
OWNER: RUSS CHEVROLET, PHONE #:
CONTRACTOR: SECURITY SIGNS INC PHONE #: 503232 -4172
Inspection Request Scheduled For: Date: 7/5/2006 Pour Time:
••e # Inspection Description Confirm # Contact # Message
140 Sign installation 032659-01 503-232 -4172 N
Corrections/Comments/Instructions:
!( PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: / b C Phone #: (503) 718- 2jt L/