Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC99 -0166
A DEVELOPMENT SERVICES DATE ISSUED: 03/22/99
13125 SW Hall Blvd., Tigard, OR 97223 o
PARCEL: 2S115BA -00101
S I tE ADDRESS...: 16`00 SW PACIFIC HWY #S
SUBDIVISION °PP1994 -028 ZONING:C —G
BLOCK • LOT •001 JURISDICTION: TIG
Project Description: Three signs
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS • 0 0 — 200 amp • 0 PUMP /IRRIGATION • 0
EACH ADD'L 5O0SF...: 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-- -
0 — 200 amp • 0 W /SERVICE OR FEEDER: 0 PER INSPECTION • 0
201 — 400 amp • 0 1st W/0 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
BLOCKBUSTER VIDEO type amount by date recpt
16200 SW PACIFIC HWY #6 PRMT $ 120.00 GEO 03/17/99 99- 313779
TIGAR OR 97224 5PCT $ 6.00 GEO 03/17/99 99- 313779
Phone #:
Contractor:
PORTLAND SIGN & NEON $ 126.00 TOTAL
535 SW 28TH AVE
REQUIRED INSPECTIONS
PORTLAND OR 97232 Ceiling Cover Elect'l Service
Phone #: 238 -2964 Wall Cover Elect'l Final
Reg #..: 001028
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 more 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 952-001-010 through OAR 952- 001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (503)246 -1987.
Permittee Si _
nature: / rP(lCl�7�C�11 B :
9 (�� Y 1
�1
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 : ThA / fP , 1 t Cdr DATE:
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD Electrical Permit Application Plan Check #
13125, SW HALL BLVD. Rec'd By 4
TIGARD OR 97223 Date Rec'd 3 -4"?
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print or Type permit #�L�g9 - DI LPG
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development T 1 n""rowN e c6 () (i RL Number of inspections per permit allowed
Name (or name of business) -L_1 C. t)TE't� Service included: Items Cost Sum
Address I. (6200 C •`A/. F'A{ .. -kAJ 4a. Residential - per unit
City/State/Zip "T" GA-R." 0 . Each additional it or less $110.00 4
ty p Each additional l 500 sq. ft. or
Commercial Residential ❑ portion thereof $25.00 1
Limited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all current licenses) `` 11 4b. Services or Feeders
Electrical Contractor 'Tip R�CLA+JD if f.1Q N Installation, alteration, or relocation
200 amps or less $60.00 2 -
Address 53s kit e" z8 Ail E 201 amps to 400 amps $80.00 2
City f LALo State OR Zip R 72 3 Z 401 amps to 600 amps $120.00 2
Phone No. • 7 fo 4 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. Exp.Date
OR State CCB Reg. No. /0Z fi / Exp.Date /^ 2/250 4c. Temporary Services or Feeders
COT Business Tax or Metro Exp.Date Installation, alteration, or relocation
200 amps or less $50.00 2
Signature of Su r. Elec'n - 201 amps to 400 amps $75.00 2
g p 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. 32q Sf Exp.Date /o -i see "b" above.
Phone No. Z '- z 4,4
4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address Each branch cir $5.00 2
-
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 2
The installation is being made on property I own which is not Each additional branch circui $5.00 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle $40.00 y 2
ach si r outline lighting $40.00 /2.1) m - 2
3. Plan Review section (if required):* Signal circuit(s) or a limited energy
panel, alteration or extension $40.00 2
Minor Labels (10) $100.00
Please check appropriate item and enter fee in section 5B.
4 or more residential units in one structure 4f. Each additional Inspection over
Service and feeder 225 amps or more the allowable in any of the above
System over 600 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00
as described in N.E.C. Chapter 5 In Plant $55.00
-
* Submit 2 sets of plans with application where any of the above apply. 5. Fees: 0
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ / Z r'o ee
NOTICE • Subtotal $
5b. Enter 25% of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account # $ r Z6 °
Total balance Due
1: \DSTS\ELC96.APP Rev 9/96
C OFTIGARD
%
DEVELOPMENT (503)6394171
13125 SW SIGN PERMIT
PERMIT It: SGN99 -0022
DATE ISSUED • 03/22/99
PARCEL : 2S 1 i.5BA— 00101
ZONE • C - -G
JURISDICTION...: TIG
BUSINESS NAME..: BLOCKBUSTER
SIGN LOCATION..: 16200 SW PACIFIC HWY #S
APPLICANT /AGENT: PORTLAND SIGN & NEON CO
BUSINESS TAX NO:
SIGN:
PERMANENT (X) FREESTANDING ( ) FREEWAY ( )
TEMPORARY ( ) WALL (Y) ELECTRONIC ( )
OTHER ( ) BILLBOARD ( ) BALLOON ( )
SIGN DIMENSIONS ^ 2' X 15'
TOTAL SIGN AREA 30 sq.ft.
WALL AREA ° 640 sq.ft.
WALL FACE (DIRECTION): N
SIGN HEIGHT 19 ft.
PROJECTION FROM WALL.: 12 in.
ILLUMINATION • INT
•
DESCRIPTION OF SIGN: 30 sq. ft. permanent wall sign
MATERIALS METAL. /PLASTI
EXISTING SIGNS • 1
ELECTRICAL PERMIT REQUIRED: Y
BUILDING PERMIT REQUIRED..: N
ADMINISTRATIVE_ EXCEPTIONS.: N/A
PERMIT FEE: $ 50.00
This pereit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved
approved plans. A sign permit shall expire 90 days from approval date.
A temporary sign shall expire 30 days from approval date. A balloon sign
shall expire 10 days from approval date.
APPROVED BY: i3 �---�
PERMITTEE SIGNATURE: t91'1 AV/a (\ " (
DATE: 03/22/99
CITY OF TIGARD
DEVELOPMENT SERVICES -
. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SIGN PERMIT
PERMIT #: SGN99-0023 -'
DATE ISSUED ° 03/22/99
PARCEL • 25115BA- -00101
ZONE • C —G
JURISDICTION...: TIG
BUSINESS NAME..: BLOCKBUSTER
SIGN LOCATION..: 1.6200 SW PACIFIC HWY #S
APPLICANT /AGENT: PORTLAND SIGN & NEON CO
• BUSINESS TAX NO:
SIGN:
PERMANENT (X) FREESTANDING ( ) FREEWAY ( )
TEMPORARY ( ) WALL (Y) ELECTRONIC ( )
OTHER ( ) BILLBOARD ( ) BALLOON ( )
SIGN DIMENSIONS • 4' X 8'
TOTAL_ SIGN AREA 32 sq. ft.
WALL AREA • 640 sq. ft.
WALL FACE (DIRECTION) : NW
SIGN HEIGHT • 16 ft.
PROJECTION FROM WALL. r: 10 in.
ILLUMINATION.........: INT
DESCRIPTION OF SIGN: 32 sq. ft. permanent wall sign
MATERIALS • METAL /PL(aSTI
EXISTING SIGNS 1
ELECTRICAL PERMIT REQUIRED: Y
BUILDING PERMIT REQUIRED..: N
ADMINISTRATIVE EXCEPTIONS.: N/A
PERMIT FEE: $ 50.00
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved
approved plans. A sign permit shall expire 90 days .from approval date.
A temporary sign shall expire Al days from approval date. A balloon sign
shall expire 1@ days from approval date.
APPROVED BY: 6. i V.L(JJtf4 C.4 �--
PERNITTEE SIGNATURE: dirk. <Ur ( W\ ---- ftltitkif
DATE: 03/22/99
_ CITYOFTIGARD
11 DEVELOPMENT SERVICES SIGN PERMIT
PERMIT #: SGN99 -0024
DATE ISSUED • 03/22/99
PARCEL : 2S115BA -0 101
ZONE : C —G
JURISDICTION.•.: TIG
BUSINESS NAME..: BLOCKBUSTER
SIGN LOCATION..: 16200 SW PACIFIC HWY #S
APPLICANT /AGENT: PORTLAND SIGN & NEON CO
BUSINESS TAX NO:
SIGN:
PERMANENT (X) FREESTANDING ( ) FREEWAY ( )
TEMPORARY ( ) WALL (Y) ELECTRONIC ( )
OTHER ( ) BILLBOARD ( ) BALLOON ( )
SIGN DIMENSIONS • 2'6 X 18'10"
TOTAL SIGN AREA 47 sq.ft.
WALL AREA • 14401 sq.ft.
WALL FACE (DIRECTION): W
SIGN HEIGHT • 19 ft.
PROJECTION FROM WALL.: 12 in.
ILLUMINATION • TNT
DESCRIPTION OF SIGN: 32 sq. ft. permanent wall sign
MATERIALS • METAL /PLASTI
EXISTING SIGNS 1
ELECTRICAL PERMIT REQUIRED: Y
BUILDING PERMIT REQUIRED..: N
ADMINISTRATIVE EXCEPTIONS.: N/A
PERMIT FEE: $ 50. 00
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved
approved plans. A sign permit shall expire 9e days fro■ approval date.
A temporary sign shall expire 3e days from approval date. A balloon sign
shall expire le days fram approval date.
APPROVED BY: 6
PERMITTEE SIGNATURE: ®b'\ e t( 01 &
DATE: e3 /22/99
12/17/1999 Activities for Case #: ELC99 -00166
3:04:55 PM
•
• Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCC001 APPlication received 03/17/1999 GEO RECD BON 03/22/1999
ELCC003 Permit created 03/22/1999 B DONE • BON 03/22/1999
ELCC700 Ceiling Cover BON 03/22/1999
ELCC720 Wall Cover • • BON 03/22/1999
ELCC730 ElecYl Service • BON 03/22/1999
ELCC799 ElecYl Final 12/15/.1999 BP PASS DGW 12/16/1999
ELCC500 (F)Issue permit 03/22/1999 B PASS BON 03/22/1999
ELCC800 Case Finaled 12/16/1999 HAP PASS No Hold DGW 12/16/1999
•
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Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM PM BLD
Location /0 7tii) S c i / 1 v c. Suite S MEC
Contact Person Re; 7 Ph 3 ) S f/ d G PLM
Contractor / Ph SWR
BUILDING Tenant/Owner ELC /G
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire wall r ^ Q I / ���' ss
Fire Sprinkler �'� / T'
Fire Alarm
Susp'd Ceiling
Roof
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 \if I
Final PA S S PART FAIL
(LECT RICA �J
� �
Rough In
UG /Slab
Low Voltage
Fire Alarm
P SS PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA r p
Approach /Sidewalk Date /)-'-�V�' - L ? Inspector �� Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.