Permit CITY OF T ELECTRICAL PERMIT
'Ar t' DEVELOPMENT SERVICES PERMIT #: ELC98 -0748
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171 DATE ISSUED: i / i 8 / 98
PARCEL: 25115AB -01900
SITE ADDRESS...:16200 SW PACIFIC HWY #J1
SUBDIVISION ZONING:C —G
BLOCK • LOT • JURISDICTION: TIG
Project Description : Electrical service for installation of 3 perianent wall
signs.
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS • 0 0 — 200 amp • 0 PUMP /IRRIGATION • 0
EACH ADD'L 500SF...: 0 201 — 400 amp • 0 SIGN /OUT LINE LTG..: 3
LIMITED ENERGY • 0 401 — 600 amp • 0 SIGNAL /PANEL • 0
MANF. HM/ SVC /FDR..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (10)...: 0
- - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- -
O — 200 amp : 0 W /SERVICE OR FEEDER: 0 PER INSPECTION • 0
201 — 400 amp ° 0 1st W/O SRVC OR FDR.: 0 PER HOUR ° 0
401 — 600 amp • 0 EA ADD'L BRNCH CIRC: 0 IN PLANT • 0
601 — 1000 amp ° 0 PLAN REVIEW SECTION
1000+ amp /volt • 0 > =4 RES UNITS • > 600 VOLT NOMINAL..:
Reconnect only • 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: FEES
BANK OF THE WEST type amount by date recpt
16200 SW PACIFIC HWY PRMT $ 120.00 DEB 12/18/98 98- 311645
SUITE J -1 5PCT $ 6.00 DEB 12/18/98 98- 311645
TIGARD OR 97223
Phone #:
Contractor:
DWINELLS VISUAL SYSTEMS INC $ 186.00 TOTAL
1112 EAST NOB HILL BLVD
REQUI RED INSPECTIONS
YAKIMA WA 98901 Elect'l Service
Phone #: 509-248-3772 Elect'1 Final
Reg #..: 64411
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 sore than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -001 trough MAR - 'A1 -1987. You lay obtain a copy
of these rules or direct questions to OUNC by call•ng (503)246 -1987.
Permittee Signature: : Issued By: aeam_16
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:
/8 -45
LICENSE NO: gP-(/I S /l0
+ +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+ ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + +4• + + + + ++
" Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # E�9 ? -D 7 y�
, �, Date Issued /a� /P /9�'
��� i Phone (503) 639 -4171
„:).14 V FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development 11/ A ` Z W Ilv SQLNAIZIF Number of Inspections per permit allowed
Address 1 ` 6 bO 9U.) Footc I pi c- WA `( S re Service included: Items Cost(ea) Sum
City /State /Zip 1 &� g� - �� 4a. Residential - per unit
l 1000 sq. ft. or less $110.00 4
Name (or name of business) - g 1K OF (A.3eST Each additional 500 sq. ft. or
portion thereof $25.00 1
Commercial K1 Residential Ill Limited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
J / 4b. Services or Feeders
Electrical Contractor DU)) - t.�. I/' ISMI -SYST Installation, alteration, or relocation $60.00 2
200 amps or less
Address I I t r • /J()8 0-1 -1 4_ BLUa 201 amps to 400 amps $80.00 2
N
City P le-4 wi A- State ().41- Zip 'iJO/ 401 amps to 600 amps $120.00 2
601 amps to 1000 amps $180.00
Phone No. . Ott$ 3'7'7 Over 1000 amps or volts $340.00 2
Job NO. Reconnect only
$50.00 2
contractor's license NO. 3 /DL LS /0/ /� j -4c. Temporary Services or Feeders
Contractor's Board Reg. No. ' A I e2 , j/ Installation, alteration, or relocation 2
Signature of Supr. Elec'n 200 amps or less 2
License No. SI Phone No. SacJ pZ- 3! 4)-- 420011 amps amps to to 600 400 amps amps $50.00 $75.00 2
/ V Over 600 amps to 1000 volts $100.00
. 2b. For owner installations: see "b" above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane
Address a) The fee for branch circuits with
purchase of service or feeder fee. 2
City State Zip Each branch circuit $5.00
Phone No. b) The fee for branch circuits withou
The installation is being made on property I own which is purchase of service or feeder fee. 2
Each additional branch circuit $5.00
not intended for sale, lease or rent. First branch circuit $ $5.00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or Irrigation circle` $40.00 2
Each sign or outline lighting J \ $40.00
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40.00
4 or more residential units in one structure Minor Labels (10) $100.00
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 of the above
a described in N.E.C. Chapter 5 Per inspection $35.00
Per hour $55.00
In Plant $55.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
5a. Enter total of above fees $ /020, rd
NOTICE 5% Surcharge (.05 X total fees) $ l -
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) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. wordkomdeNe,eo- ❑ Trust Account #
prm.epp
Balance Due $ /, 6, .07)
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
/ BUP
Date Requested .I L4 AM PM BLD
Location / (i -.O Q 6 _c<_ Suite fl - ( MEC
Contact Person Ph PLM
ontra or Ph SWR o
BUILDING Tenant/Owner %111r ► AA AA �� _ ��i 371 ' ELC n 0 7 T�
Retaining Wall
Footing Access:
Foundation FPSSZDS
Ftg Drain SGN
Crawl Drain Inspection Notes: r
Slab / F /..41 ' . ' / A l! SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Drywall on
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof Cae) r
Misc:
Final _
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
pgGSS PAK FAIL
(E LECTRICAL
Rough In
UG /Slab
Low Voltage
Fire Alarm
F
k. PART FAIL
Backfill/Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date % ZqlQi Inspector - z Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.