Permit rfr izip-24 CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 00160
COMMUNITY DEVELOPMENT
DATE ISSUED: 3/15/2007
? T, I 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S134BC-00100
SITE ADDRESS: 12100 SW SCHOLLS FERRY RD ZONING: C -G
SUBDIVISION: GREENWAY TOWN CENTER LOT : JURISDICTION: TIG
PROJECT: 7 - ELEVEN
Project Description: (1) sign lighting. Job No. 5654
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:
7- ELEVEN CORP ES & A SIGN &AWNING
271 1 N HASKELL 1210 OAK PATCH RD
DALLAS, TX 75206 EUGENE, OR 97402
Phone: 253 796 - 7169 Contact #: PRI 541 - 485 - 5546
FAX 541 485 - 5813
FEES
Description Date Amount Reg #: ELE 20- 243CLS
[ELPRMT] ELC Permit 3/15/2007 $53.40 LIC 163470
[TAX] 8% State Surcharge 3/15/2007 $4.27 SUP 305S1G
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 f . .: han 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those ru s are set fo in : A 52- 001 -0010 through OAR 952 -001 -0100. You may obtain copies hese rules or direct questions to OUNC at
503.24 .6699 or 1.800.3: .2
Issued y: / P (Q_AIV00; ) P Signatu I o , %� y
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
� ed �1;,
Er
City of Tigard ti ,By: �y / Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 RECEIV - Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 MAR 1 4 ZOOgatetBy. Other Permit:
TIGARD Inspection Line: 503.639.4175 ate Ready /By: 1uri 0 See Page 2 for
Internet: www.tigard- or.gov Notified /Method: el I (1.2 Supplemental Information
CITY OF TIGARD -
TYPE OF WOR NNING /FNGINFERING PLAN REVIEW
['New construction El 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: 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 Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A' . "E ", "I - ", "1 - ",
��� �� ^ n Z1 / ) � ��� a x or or more. occupancy.
Job no.: Job site address: -- ( f / / S y
/ ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: r/ CI )-?-3 ❑ Health -care facilities. ❑ Supply voltage for more than
T Q ( f ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ' - E(se (,Ae 6---) ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street /directions to job site: Description 1 Qty. 1 Fee. 1 Total 1
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map/parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with q ) 75.00 2
with above sq. fi. • ] j n Limited energy multi - family 75.00 2
W IC V e a61_C r I /1 S a- 1 / rut-0 1 `�C,j'l.-C e?C�'f --d residential (with above sq. 0.)
7 Services or feeders installation, alteration, and /or relocation
Fa �C C'(- sL e K. / L Z 5 200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
L 1 f. u e 41 O 6 r p 601 amps to 1,000 amps 240.60 2
Address: 'P 7t( 4/ /1 ((S)/ g `/ Over 1,000 amps or volts 454.65 2
/State /ZIP: '((�� (� Temporary services or feeders installation, alteration, and /or
City/State/ZIP: Da ac, S t et X ,,) 0 7 relocation
Phone: (7 "3) 7 e7 - 7i6, 9 Fax: ( ) 200 amps or less 66.85 I
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
l APPLICANT ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name:, 5 A N S., - L c_ 6-)V1-(--. ‘'1-- 'CI B. Fee for branch circuits
Contact name: d�/ (( j Ite_.,- x ithout service or feeder fee, 46.85 2
first branch circuit
Address: r---. mm C � �� Y1 Each add'l branch circuit 6.65 2
(L l!ra C Miscellaneous (service or feeder not included)
City/State/ZIP: ' ,, x ,49 01 q I t( Each manufactured or modular 90.90 2
Lit dwelling, service and /or feeder
Phone: (6 / ) .5 'L{6, Fax: : (SLIT ) Li V S .581 -- Reconnect only 66.85 2
E -mail: Tt j • f ,e (1 ca) e j1,,____s e D r v-' Pump or inigation circle 53.40 2
COI(fFRACtf'OR Sign or outline lighting / 53.40 53,t 2
Signal circuit(s) or limited- 1
Business name: 5 c{ S l0 (-A- ,` ,t' Qb energy panel, alteration, or
Address: i --- 1 , [C") D, 'Pic -I - � L•1 extension. Describe: Page 2 2
City/State /ZIP: LC `e 1 , \ c). � - 7 t- c) �- Each additional inspection over allowable in any of the above
I Per inspection 62.50
Phone: (Si(( ) P s - G - ``f ( Fax: (9 I ) l i g 5 - `�� I_ Investigation per hour (1 hr min) 62.50
CCB Lic.:h, 34 7 Cl Electrical Lic.a) - 51r3et S Suprv. Lic.: 3S -S)(„ Industrial plant per hour ELECTRICAL 73.75
PERMIT FEES
Suprv. Electrician signature, required • (' i _ 1 Lt fi � Subtotal: 3, /.../ Print name I _ I ��° C Date: �- I. 01 Plan review (25% of permit fee): 7
Cc L^ o �� f c C c! State surcharge (8% of permit fee): y, 0
Authorized signature: xd�'t („1.,.E-5 t( 0 TOTAL PERMIT FEE: 57, (, 7
���ddd��� (� This permit application expires if a permit is not obtained within 180
Print name: ' , i1 � ti ,„ 4 9 --(--,_ ( Date: 3 - C 7 days after it has been accepted as complete.
* Number of inspections allowed per permit.
1: \Bwlding\ Permits \ELC- Permit App.doc 05'23'06 440- 4615T(1 I /05 /COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007-00160
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/1611007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 .*:.,L- ,
INSPECTION WORKSHEET FOR DATE: 8/7/2007 TIME: 7:03AM PAGE: 26
SITE ADDRESS: 12100 SW SCROLLS FERRY RD CLASS OF WORK:
SUBDIVISION: GREINWAY TOWN CENTER LOT #: TYPE OF USE:
PROJECT NAME: 7 - ELEVEN
DESCRIPTION: (1) sign lighting. Job No. 5654
OWNER: 7- ELEVEN CORP, PHONE #: 253-796-7169
CONTRACTOR: ES & A SIGN & AWNING S ® 5 C P �� ? PHONE #: 541-485E616
fit
Inspection Request Scheduled For: Date: 8/7 /2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 053547 -01 541 -485 -5546 Y
v r
Corrections /Comments/ Instructions:
U. PASS I I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: & Nite, Date: 11 n Phone #: (503) 718- o