Permit CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC1999 -00556
TT �I� DEV W H P r SERVICES 639 -4171 \ ATE ISSUED: 9/13/99
- 13125 � PARCEL: 0
SITE ADDRESS: 15905 116TH `
SUBDIVISION: � ZONING:
BLOCK: L JURISDICTION:
Project Description: Sign lighting for sign replacement.
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:
NORTH SHORE CORP YOUNG ELECTRIC SIGN CO
17 NE 47TH ST 416 EAST 41ST ST
NEW YORK, NY 10017 BOISE, ID 83714
Phone: Phone:
Reg #: LIC 000693
SUP 445SIG
ELE 37-51CLS
FEES Required Inspections
Type By Date Amount Receipt
Elect'I Service
PRMT DEB 9/13/99 $42.75 99- 318275 Elect'I Final
5PCT DEB 9/13/99 $2.99 99- 318275
Total $45.74
This Permit is issued subject to the regulations contained in the Tigard Munidpal 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 , - as op e• : he Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may ob in copies of these ru es, or direct quests s to OUNC at (503)
246 - 1987. ,
\ i
PERMITTEE'S SIGNATURE\ 7f ISSUED BY: � � �
VU`
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 639 -4175 by 7:00pm for an inspection the next business day
CITY OF TIGARD Electrical Permit Application Plan
,SW HALL BLVD. Rec'd By
TIGARD OR 97223 Date Rec'd / '9Y
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST -----
Inspection (503) 639 -4175 Print of Type Permit# fl� /9Q9 CO550
Fax (503) 598 -1960 Incomplete or illegible will not be accepted Called
1. Job Address: t Complete Fee Schedule Below:
Name of Development Bank of America Number of Inspections per permit allowed
Name (or name of business) Panic of Amearir'a Service included: Items Cost Sum 4,
Address 1 5 9 0 5 SW 1 1 6th Ave 4a. Residential - per unit
1000 sq. ft. or less $ 117.75 4
City/State /Zip K I nq OR 97224 City , Each additional 500 sq. ft. or
portion thereof $ 2675 1
Commercial 11 Residential El Limited Energy $ 60.00
Each Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2
(Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders
information for COT data base). Installation, alteration, or relocation
Electrical Contractor Y rm n g F.1 P r t r i c Sign rc 200 amps or less $ 64.25 2
Address 1 0 5 3 5 SW Aver 201 amps to 400 amps $ 85.50 2
y 401 amps to 600 amps $ 128.50 2
City Tn a 1 a t i n State nR Zip 9 7 0 6 2 601 amps to 1000 amps $ 192.50 2
Phone No. 61 2 - 6672 Over 1000 amps or volts $ 363.75 2
Job No. Reconnect only $ 53.50 2
Elec. Cont. Lice. No. 17_ 51 Tcgs Exp.Date 1 0 -1 - 9 9 4c. Temporary Services or Feeders
OR State CCB Reg. No. 6 q 3 0 8 Exp.Date 9 _2 6 - 9 q Installation, alteration, or relocation
COT Business Tax or Metro No. 4 6 3 6 Exp.Date j 1 -1 - 9 9 200 amps or less $ 53.50 2
2
Signature of Supr. Elec'n Bob Gonzales 201 amps to 400 amps
401 amps to 600 amps $ 107.00 2
Over 600 amps to 1000 volts, $ 80.25
see "b" above.
License No. 4 6 5 S I G Exp.Date 1 0 - 1 - 9 9
4d. Branch Circuits
Phone No. 61 2 - 6 6 7 2 New, alteration or extension per panel
a) The fee for branch circuits
0 . For owner installations: with purchase of service or
feeder fee.
Print • er's Name Each branch circuit $ 5.35 2
Address b) The fee for branch circuits
without purchase of service
City State Zip or feeder fee.
Phone No. First branch circuit $ 37.50
Each additional branch circuit $ 5.35
The installation is being ma. - on property I own which is not 4e. Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or irrigation circle $ 42.75
Owner's Signature Each sign or outline lighting I $ 42.75 4..2, , "'lam;
Signal circuit(s) or a limited energy
(if required):* panL alteration or extension $ 60.00
3. Plan Review section
( Minor Labels (10) $ 107.00
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over
4 or more residential units in one structure the allowable in any of the above
Service and feeder 225 amps or more Per inspection $ 50.00
Per hour $ 50.00
System over 600 volts nominal In Plant $ 59.00
Classified area or structure containing special occupancy as
described in N.E.C. Chapter 5 5. Fees:
5a. Enter total of above fees $
* Submit 2 sets of plans with application where any of the above apply. 7� - g< Surcharge (.05 X total fees) $
Not required for temporary construction services. Subtotal $ -
5b. Enter 25% of line 5a for
NOTICE Plan Review if required (Sec. 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account #
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ 46,14--
i:\dsts\forms\electric.doc
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
Q q BUP
Date Requested / " 7 ^ - - I / AM PM BLD R57'
Location (SS D`' 1 1 lU �-t't i. Suite 1 MEC
Contact Person / L Ph (o/2 — (Q( '/ 2 PLM
Contractor n Ph SWR
�UILDI Tenant/Owner l , /,L of � yY'l.f/IA� C — ELC I � 7 `7 r� SS(C)
Retaining Wall ELR
0o Access:
Foundation FPS
Ftg Drain
Slab
Crawl Drain Inspection Notes: we i 5 SGT
S1T Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation ‘ 2) . )
Drywall Nailing
Firewall
Fire Sprinkler P (-?....4f Fire Alarm '
Susp'd Ceiling 1,L
Roof
Misc:
Final
PASS PART/FAD
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
Final
PASS PART FAIL
ELECTRICAL
Service
Rough
UG /Slab In
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ase e call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk � c
Other Date I — Z- '2
9 ,. Inspector 04P Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
.., _ CITY OF TIGARD BUILDING INSPECTION DIVISION i MST
24 -Hour Inspection Line: 639 -417 Business Line: 639 -4171
/ BUP
Date Requested 6 (.P o c2 AM PM BLD
Location / <942c //'. Suite MEC
Contact Person .8 Q &oT,) Z4-/o Ph (0/2-- PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC / ` 7 9 9 0c53 ?.,
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation C �t1 l .�
Drywall Nailing / /y �f�t,l, '2;�
Firewall
Fire Sprinkler ■ / _ , A ! .3 0o ' S
Fire Alarm
Susp'd Ceiling -I ...... _�
Roof � .4- v� ( D
Misc: �d
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
Final
PASS PART FAIL
CECTRICAL_,,
qervfe
Rough In
UG /Slab 6/%1
Low Voltage
Fir- alarm
` PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ]Unable to inspect - no access
ADA �
Approach /Sidewalk
Other Date (y �7 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.