Permit CITY OF TIGARD ELECTRICAL PERMIT
. PERMIT #: ELC2007 -00792
COMMUNITY DEVELOPMENT DATE ISSUED: 11/26/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 25115AB - 01900
SITE ADDRESS: 16200 SW PACIFIC HWY E ZONING: C -G
SUBDIVISION: TIGARD TOWNE SQUARE LOT : JURISDICTION: TIG
•
PROJECT: GREAT CLIPS
Project Description: Installation of (1) sign lighting for relocated 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:
BIT HOLDINGS LTD PARTNERSHIP YOUNG ELECTRIC SIGN CO
BY FORUM PROPERTIES INC 20100 SW 112TH AVE
FIVE CENTERPOINTE DR STE 290 TUALATIN, OR 97062
LAKE OSWEGO, OR 97035 •
Phone: Contact #: PRI 503- 612 -6672
FAX 503 - 612 -0914
FEES
Description Date Amount Reg #: ELE 37 -51CLS
[ELPRMT] ELC Permit 1 1/26/200' $53.40 LIC 69308
[TAX] 8% State Surcharge II/26/200' $4.27 SUP 661 SIG
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, • r if work is
suspended fo . • e than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the 0 - c r Utility Notifi /'on Center.
Those r -s are set fo • in • - = 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain copies of th- _ . es or -ct • - stio s to OUNC at
503.24 f..6699 or 1.800.3''.2344.
Issue• By: k I / i � � . Permittee Signature: / Ii
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.
Electrical- Permit Application FOR OFFICE USE ONLY
City of Tigard Date/B Qp '/ Permit No.: SIX ; a 7V 7?
11 u 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/B : Other Permit:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: El See Page 2 for
Internet: www.tigard - or.gov Notified/Method: ME Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition 'Other: fei1.tI bVl where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1 - and 2- family dwelling A] Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
(700 so- QQ d Six or or o more more. R occupancy. r
Job no.: Job site address: 1
TtaCl �t G /f Wes/ ' 0 or more residential units. ❑Receational vehicle parks.
City / State/ZIP: . `,l 0.rt� ❑ OP • q i a a 3 ❑ Health -care facilities. ❑ Supply voltage for more than
Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: G re4 }- u ; p 5 ❑ Service or feeder 600 amps or more.
1 FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.40 I
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
((��
S; `` Limited energy, multi - family 75.00 2
kern�L'' St J r S- co t- l 1�`.. N q LOc.�. {tor Q 13 (�- -(oc l-e residential (with above sq. ft.)
J L Services or feeders installation, alteration, and/or relocation
A roue- d � Cc e ( heir or r��) k-e4 ` �at l 200 amps or less 80.30 2
❑ PROPERTY OWNER ' TENANT 201 amps to 400 amps 106.85 2
Name: 6rea- ( \ ' s 401 amps to 600 amps 160.60 2
V 601 amps to 1,000 amps 240.60 2
Address: ,u Up Sw e Pa el r t L 1 4W 4/ • E Over 1,000 amps or volts 454.65 2
City/State /ZIP: -r l �.rd l l7R . o - 9 !3 Temporary services or feeders installation, alteration, and/or
d relocation
Phone: (/efi ) 533 _ 1g 1 S Fax: ( ) 200 amps or less 66.85 1
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 599 amps 133.75 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
lk.•APPLICANT gii CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: [ `
you. � `1 Y ■ (. S ir CD. B. Fee for branch circuits
Contact name: k • � � without service or feeder fee, 46.85 2
I ( t first branch circuit
Address: A(!) bo sw • +'e V Each add'l branch circuit 6.65 2
Ale • Miscellaneous (service or feeder not included)
City/State/ZIP: 'rte l 11 r 0C. 1-701p a Each manufactured or modular 90.90 2
^ _ O � (� dwelling, service and/or feeder
Phone: ( ) (p J (xi
a . 4 � I Fax: (50 ) J Reconnect only 66.85 2
E -mail: - }t;t(k.‘ c ( ) yeses, err Pump or irrigation circle 53.40 2
7 CONTRACTOR Sign or outline lighting / 53.40 51 1 -tv 2
/�` Signal circuit(s) or limited -
Business name: �IOv,r Dethrl L Sil n W • energy panel, alteration, or
Address: do ib0 &N ua f _ ave extension. Describe: Page 2 2
City/State /ZIP: - r.( „1 r , a�.. q7 Die p a Each additional inspection over allowable in any of the above
` Per inspection 62.50
. Phone: (51/5 )g' ■ ulp-1 9 Fax: (5b0) u` ', - i Li Investigation per hour (1 hr min) 62.50
CCB Lic.: (2/3b$ Electrical Lic.:57, J f` C Suprv. Lic.: 710 Si & Industrial plant per hour 73.75
t+ ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: c )cf v1 Subtotal: E(S 3 U
Print name: J ei t j me,S Date: \ \ I a (c. 115 Plan review (25% of permit fee):
State surcharge (8% of permit fee): 4 9 • a
Authorized signature: TOTAL PERMIT FEE: 0 (P7
Print name: Q „,, / , R✓� -- ///V49/0 Thts permit application has b if a permit 7, t is not obtained within 180
„( / � �• r „, D ate: 7 days after r it it has been en n accepted as complete.
• Number of inspections allowed per permit.
I:\Building\Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(l1/05 /COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007..00792
13125 SW Hall Blvd., Tigard, OR 97223 - DATE ISSUED: 11/2612007
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 12/31/2007 TIME: 7 :00AM PAGE: 40
SITE ADDRESS: 16200 SW PACIFIC HWY E CLASS OF WORK:
SUBDIVISION: TIGARD TOWNS SQUARE LOT #: TYPE OF USE:
PROJECT NAME: GREAT CLIPS
DESCRIPTION: Installation of (1) sign lighting for relocated wall sign.
OWNER: BIT HOLDINGS LTD PARTNERSHIP, PHONE #:
CONTRACTOR: YOUNG ELECTRIC SIGN CO PHONE #: 503-612-6672
Inspection Request Scheduled For: Date: 12/31/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
109 Electrical final 062311 -02 503-612-6672 N
Corrections /Comments /Instructions:
Q
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N 6 Date: 121 31.01 Phone #: (503) 718- 21
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00792
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11126/2007
Phone: (503) 639 -4171 4(14•T411
Inspection Requests (24 Hrs.): (503) 639 -4175 -
INSPECTION WORKSHEET FOR DATE: 12/31/2007 TIME: 7 :00AM PAGE: 41
SITE ADDRESS: 16200 SW PACIFIC HWY E CLASS OF WORK:
SUBDIVISION: TIGARD l OWNE SQUARE LOT #: TYPE OF USE:
PROJECT NAME: GREAT CLIPS
DESCRIPTION: Installation of (1) sign lighting for relocated wall sign.
OWNER: BIT HOLDINGS LTD PARTNERSHIP, PHONE #:
CONTRACTOR: YOUNG ELECTRIC SIGN CO PHONE #: 503 612 - 6672
Inspection Request Scheduled For: Date: 12/31 /2pQ7 Pour Time:
Code # Inspection Description Confirm # Contact # Message
140 Sign installation 062311 -01 503-612-6672 N
Corrections /Comments /Instructions:
6 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ` % )12) Date: I �� 6 1 Phone #: (503) 718-