Permit CITY OF TIGARD ELECTRICAL PERMIT
N f '
PERMIT #: ELC2007 -00016
COMMUNITY DEVELOPMENT
DATE ISSUED: 119!2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25111 BC -02800
SITE ADDRESS: 10445 SW CANTERBURY LN ZONING: R -3.5
SUBDIVISION: LOT : 3 - JURISDICTION: TIG
Project Description: CALVIN PRESBYTERIAN. (1) 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:
PRESBYTERY OF PORTLAND THE HIGHLIGHT SIGN CORP
CALVIN PRESBYTERIAN CHURCH PO BOX 23667
10445 SW CANTERBURY LN TIGARD, OR 97281 -3667
TIGARD, OR 97224
Phone: Contact #: PRI 503 - 620 -8205
FAX 503 - 624 -3725
FEES
Description Date Amount Reg #: ELE 37 - 660CLS
[ELPRMT] ELC Permit 1/9/2007 $53.40 LIC 104599
[TAX] 8% State Surcharge 1/9/2007 $4.27 SUP 517SIG
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 1.800.33. 344. ■
�� Permittee Signature:
Issued By: '� �,o� �
OWNER INSTALLATION ONLY
The installation is being made on property 1 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.
2 -j - o — 000 0
.Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard °' f Re n �� (� ^ , I /� /I
Y h - � • - Y - ^. a� Dat Re `7 Permit No.:6 Ct_-r-at`�V 7 0a0 ) U
it 13125 SW Hall Blvd., Tigard, OR 9722 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 , �` • ` — E? ')00 7
Date/By Other Pcmut:
TIGARD Inspection Line: 503.639.4175 DateReadyBy: Juns Ell See Page 2 for
Internet: tvtutv.tigard- or.gov Notified/Method: Supplemental Lnfonnation
TYPE OF woetJILOIN4: t1! +ri4:.0TH!
PLAN REVIEW
0 New construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans wfitems checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Mainas 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 ❑ Commercialindustrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi family ❑ Master builder MI Other: Sign ❑ 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 ",
Job no.: Job site address: 10445 SW CANTERBURY LN I00HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: TIGARD OR 97224 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: CALVIN PRESBYTERIAN ❑ Senice or feeder600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: SW 103 AVE Description 1 ctv. 1 Fee. 1 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'] 500 sq. ft. or portion 33.40 1
Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
Limited energy, multi - family
CONNECT NEWLY CONSTRUCTED MONUMENT SIGN TO EXISTING residential (with above sq. k.) 75.00
DESIGNATED SIGN CIRCUIT Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
a PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: PRESBYTERY OF THE CASCADES 401 ainps to 600 amps 160.60
601 amps to 1,000 amps 240.60 2
Address: 0245 SW BANCROFT STE D Over 1,000 amps or volts 454.65 2
City /State /ZIP: PORTLAND OR 97239 Temporary services or feeders installation, alteration, and /or
relocation
Phone: (503)227 -5486 Fax: (503) 74-7_ ( ti.G 200 amps or less 66.85 1
Owner installation: This inst ation is being made on property that I own which is not 201 amps to 400 amps 1 00.30 2
intended for sale, leas , rent, r 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:
��`C� 6 A. Fee for branch circuits with
IS APPLICANT 166 ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
B. Fe
Business name: HIGHLIGHT SIGN CORP. Fee for branch circuits
without service or feeder fee,
Contact name: MATTHEW BELL 46.85
first branch circuit
Address: PO BOX 23667 Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State /ZIP: TIGARD OR 97281 Each manufactured or modular
dwelling, service anti /or feeder 90.90 2
Phone: (503) 620 -8205 Fax: : (503) 624 -3725 Reconnect only 66.85 2
E -mail: MATT@HIGHLIGHTSIGN.COM HIGHLIGHTSIGN.COM Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 1 53.40 2
Signal ctrcu!t(s) 1 ;•• , :te :l- I
Business flame: HIGHLIGHT SIGN CORP. energy panel, alteration, or
Address: PO BOX 23667 extension. Describe: Page 2 2
City /State /ZIP: TIGARD OR 97281 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 620 -8205 Fax: (503) 624 -3725 ' Investigation per hour (1 hr min) 62.50
CCB Lic.: 104599 Electrical Lic.: 37- 660CLS , prv. Lie.: 517SIG Industrial plant per hour 73.75
Snirn_v. Elect / ELECTRICAL PERMIT FEES
Electrician signature, required: Subtotal: 3.40
Print name: MIKE CLEARY , Date:
Plan review (25% of permit fee):
I Z 2...0 AB State surcharge (8% of permit fee): 4.27
I
Authorized signature: r � T r TOTAL PERMIT FEE: 7 6 7
This permit application expires if a permit is not obtained within 180
Print name: MATT BELL Date:
4
days after it has been accepted as complete.
° Number of inspections allowed per permit.
11BuddmglPernutslELC- PerrmtApp doc 05/23/06 440- 4615T(I 1105 /COM/WEB
CITY OF TIGARD
• BUILDING DIVISION • PERMIT #: ELC2007-00016
• 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 102007
Phone: (503) 639-4171 VV.
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 3/20/2007. TIME: 7:OOAM PAGE: 61
SITE ADDRESS: 10445 SW CANTERBURY LN CLASS OF WORK:
SUBDIVISION: LOT #: 3 - 4 TYPE OF USE:
PROJECT NAME: CALVIN PRESBYTERIAN CHURCH
DESCRIPTION: CALVIN PRESBYTERIAN. (1) monument sign.
OWNER: PRESBYTERY OF PORTLAND THE, PHONE #:
CONTRACTOR: HIGHLIGHT SIGN CORP PHONE #: 503
Inspection Request Scheduled For: Date: 3/20/2007 Pour Time:
Code # Inspection Description on 1 Contact # • Message
195 Mic. inspection o45063-01 3-750-7156
Corrections/Comments/Instructions:
lor ON 51 -
•
n PASS I 1 PARTIAL APPROVAL CANCEL ri NO ACCESS
0 , FAIL CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: N 60 Date: 3 (It ( Phone #: (503) 718- *Jo