Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2008 -00459
COMMUNITY DEVELOPMENT DATE ISSUED: 8/8/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S 136AD -06504
SITE ADDRESS: 11462 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: AMERICAS TIRE COMPANY LOT : 003 JURISDICTION: TIG
PROJECT: DISCOUNT TIRE COMPANY
Project Description: Sign lighting for monument 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:
DISCOUNT TIRE ES & A SIGN AND AWNING CO.
4026 W. WHITTON 89975 PRAIRIE RD.
PHOENIX, AZ 85019 EUGENE, OR 97402
Phone: 602 - 272 -9356 Contact #: PRI 541- 485 -5546
FAX 541 -485 -5813
FEES
Description Date Amount Reg #: ELE 20 543CLS
[ELPRMT] ELC Permit 8/8/2008 $53.40 LIC 163470
[TAX] 12% State Surchar 8/8/2008 $6.41 SUP 305SIG
Total $59.81 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 Permittee Signature: . 5eP / G pf✓
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.
From:ES&A Sign&Awning CO. 541 485 5813 08/07/2008 12:28 11071 P.002/002
Electrical Permit Application FOR OFFICE USE OiNLV
City of Tigard Rece ived
/: 13125 SW Hall Blvd., Tigard, OR 1 \N
.. Phone: 503.639.4171 Fax: 503.5 �� \� D Other Permit:
Inspection Line: 503.639.4175 (� i
TIGARD Wt Date RtBdYBY• J = ® See Page 2for
Internet www.tigard Av , ., Notified/Method: Supplemental Information
`1 0 New construction . ❑ Addition/alteratio r ,, ., a Please cluck all that apply (submit 2 sets of p wrtems checked below):
II B ` V El Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition Ii • , et
C ater. where the available fault current ❑ Marinas and boatyards.
— , E _ , F, a , , t , r •: exceeds 10,000 r wraps
exc at 150 volts or F7 boil
[3 1- and 2- family dwelling i∎ Commercial/industrial ❑ Accessory building less to r a l l o a enseeds ons. ❑ Co ding l tae agricultural
amps for all other installations. buildings.
❑ Multi-family ❑ Master builder ❑ Other: ❑ Pite pump. ❑ Installation of 75 KV A or
i• - r ti ' r r w .a ❑ Emergency system larger separately derived system.
__., ��:�r= :.�_._5 »� „= �-- , - - = - --_ _....r. �....� � ._.__.. � - ,.._. _�.S __. _x_.:� ._,. '.�_.__ El Addition of new motor load of ❑ "A" "E” "l_2 ", "1.9"
Job no.: Br ('10 Job site address: (t4C,2 5tt.) F c_ Hwy tix or or more. occ�panoY.
"" J ❑ Sot or more residential units. ❑ Recreational vehicle parks.
CityIStatelZlP: I /t --
A ❑ Health-care facilities. El Supply voltage for more than
I n / t S 1,v+ }r ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: 1 „;_, ❑ Service or feeder 600 amps or more.
Cross street/directions to job Si te: �_ 1 :K , -
w it =;
P Qtr. Pe . Total
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: Ea. add'l 500 sq. R or portion 33.40 1
4 --��r : T , r � s• ," T Limited energy, residential
X' ) �a :2 7 E y)rF ( above sq. R) 7500 2
d
+�� Cam,, _.._ 171 Limited energy, multi- family 75.00 2
TA 9t rt u- ROL. l �VH(N 0 residential (with above sq. it)
a / �µ Services or feeders iostallation and/or relocatio
04 n
'r SI - 200 amps or less 80.30 2
t�. ? -�..� , r , i _.. :�. -. n. 2 �'F Pi .....,-74 , fi
- _• ;_._..._. i - 1 1 i -a '' ... — ti,, v :_ir• 201 amps to 400 amps 106.85 2
Name: 1)ISP. ulkii R'/�' 401 amps to 600 amps 160.60 2 .
601 amps to 1,000 amps 240.60 2
Address: 0, ( W .rrot.4 ki� Over 1,000 amps or volts 454.65 2
City /State/ZIP: ' `/ � - - �Z 7 j Q Temporary services or feeders Installation, alteration, and/or
1 relocation
Phone: ( ) I 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 exc ge according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner ature: Branch circuits- new, alteration, or extension, per panel
A. Fee for branch circuits with
_ _ S1gR ` Dat
c"�r— .-_ — 7 - 7.72.- i!: T {- • �. ;SaT:is!.'y'i; :ice i. ?'..�'-`.t4_I-I '. : - •C,:E" 4
.T._1 . -�, 7, , '.4. -t .. _ :' u'-et .._ - :. r. .. L .c. ��. r=� _ s above service or feeder fee
. :.�- -- -- - -, . ;- � . ,: .7.- . _ . ��;, �
each branch circuit 6.65 2
Business name: 11 A- 4 IAA *KM AviAIf r J i B. Fee for branch circuits
CA �� ,, I., n without service or feeder fee,
Contact name
(�.hev pi �i► c.(� Pit/— YQ (,[)Q�C I first branch circuit 46.85 2
Address: 4 -1 - S 7 pimp, I I Each add'1 branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State/ZIP: eta i a (2._ q,40 Each manufactured or modular 90.90 2
, [�� - (' dwelling, service and/or feeder
Phone:
) T ., S I Fax: : ( 1 ) t [)v" s8 3 Reconnect only 66.85 2
E -mail c.,, -ey G '' e$QS t' ✓IS x Pump or irrigation circle 53.40 2
.. 0 - x 7- ? ..._ E . . Sign or outline lighting t 53.40 55`M 2
C 'i Signal circuit(s) or limited -
Business name:
G 5 � r 4�i (� A m1/41 mill energy panel, alteration, or
Address: 014 1 extension. Describe: Page 2 2
�R- a-Ir�E' T
City/State/ZIP: et(,6,0\(L l O R (�" 2 Each additional Inspection over allowable In any of the above
Per inspection 6250
Phone: (9.fl) S. %go I Fax: ( 644 )( baC - ck i 3 Investigation per hour (i hr min) 62.50
CCB Lic.: Up (4 I Electrical Lic.: , ! Si Su. ; ic. Industrial plamitper hour 73.75
16 /I ��� /� � / = ���� :, > --` - r�� F�, r �- .:�� :<r?F :nom: - - -,
Su Electri an atu re, required I V Subtotal: 3•110
at
• e _ Date: e
. i ! Plan review (25% of permit fee):
1 State surcharge (12% of permit fee): & • 4
Authorized signature WA , / • i TOTAL PERMIT FEE: S'
J !�^ Thia permit applicadon expires if a permit h not obtained within 180
Print name: M l Fletiktey I Date: �7/D days after It has been accepted as complete.
• Ntmiber of inspections allowed per permit
I: Buildiva�Perm� IELC-PermitApp.doc 05/23106 440.4615T(11/05/COMAYEB
\
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: E.LC200B-00469
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639-4171 44
,.V.i
Inspection Requests (24 Hrs.): (503) 639-4175 802008
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
9/26/2008 7:00AM 27
SITE ADDRESS: CLASS OF WORK:
11462 SW PACIFIC HWY
SUBDIVISION: LOT #: TYPE OF USE:
AMERICAS TIRE COMPANY 003
PROJECT NAME: DI f3COUNT 'FIRE COMPANY
DESCRIPTION: Sign lighting for monument sign.
PHONE # - • 602-272-9366
OWNER: DISCOUllr TIRE,
PHONE #: 541-485.5516
CONTRACTOR: ES & A SIGN AND AWNING CO.
Inspection Request Scheduled For: Date: Pour Time:
9/26208
Code # Inspection Description Confirm # Contact # Message
\
199 Electlical final 075958-01 641-0613-1752 y
Corrections/Comments/ Instructions:
AT (...Ag EL c,-r tki c_
RAO oloba.N R.6 w\10 `
-'A) et Lt, c4 i 60-
7 4 L w i LL ()knit .
\\(
\
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X PASS 1 I PARTIAL APPROVAL Fl CANCEL NO ACCESS
fl FAIL fl CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: G Nr(%ll Date: cr 2.1 Phone #: (503) 718- IVA