Permit - CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2000 -00327
'I; DEVELO PMENT r o
SERVICES 639 -4171 ACES DATE ISSUED: 6/13/00
13125 SW Hall
PARCEL: 2S1 10 C D -07600
SITE ADDRESS: 15705 SW 116TH AVE
SUBDIVISION: KING CITY NO. 2 ZONING:
BLOCK: LOT : JURISDICTION: KIN
Project Description: Installation of one sign lighting.
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:
TOBIAS INVESTMENT CO HIGHLIGHT SIGN CORP
300 SE SPOKANE ST 8200 SW HUNZIKER
PORTLAND, OR 97202 TIGARD, OR 97223
Phone: Phone: 503 - 620 -8205
Reg #: LIC 00104599
SUP sig517
ELE 26- 888CLS
FEES Required Inspections
Type By Date Amount Receipt
Elect'l Service
PRMT DEB 6/13/00 $42.75 0002920 Elect'l Final
5PCT DEB 6/13/00 $3.42 0002920 (`�
Total $46.17 CS
\G`
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 ad.. - • the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 -101 -0080. You may obtain •• . es of these ru es direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE / ISS ED BY: 4
� OWNR INSTALLATION ONLY
The installation is being m Cr://
• I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTO - INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: V_ i ' 1 CC �1—•�� DATE:
LICENSE NO: V7 7
Call 639 -4175 by 7:00pm for an inspection the next business day
CITY OF TIGARD Electrical Permit Application Plan C eck
13125 SW HALL BLVD. Rec'd � ` __ �'yJ'
Date Rec'd 6' -/ ^
TIGARD OR 97223
Date to P.E. �-
Phone (503) 639 -4171, x304 Date to DST r --
Inspection (503) 639 -4175 Print of Type Permit # �G 2
Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development e T - f f--y) Number of Inspections per permit allowed
Name (or name of business) l� Service included: Items Cost Sum
7
Address 1 ) 7 9- s uJ / ) 1 0 Ili 4a. Residential - per unit
City/State/Zip ' 1000 sq. ft. or less $ 117.75 4
ry p - '7� Each additional 500 sq. ft. or
l portion thereof $ 2615 1
Commercial a Residential ❑ 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 /d--/./- , (4 7 Writ/ 200 amps or less $ 64.25 2
Address 09, , e) 5' 61-r .o� 201 amps to 400 amps $ 85.50 2
/ �/ 401 amps to 600 amps $ 128.50 2
City �i i State Y/A , Zip 601 amps to 1000 amps $ 192.50 2
Phone • . /• ^ ,ViQOr Over 1000 amps or volts $ 363.75 2
Job No. Reconnect only $ 53.50 2
Elec. Cont. Lice. No. < I CO c 17 Exp.Date /c9A /Poefo ,z 4c. Temporary Services or Feeders
OR State CCB Reg. No. / t7 -T' '9" Exp.Date Installation, alteration, or relocation
COT Business Tax or Metro No. Ex•.Da� 200 amps or less $ 53.50 2
201 amps to 400 amps $ 80.25 2
Signature of Supr. Elec'n // , , , C. ( ,1 ' / 401 amps to 600 amps $ 1 07.00 2
Over 600 amps to 1000 volts,
_
License No. S l SQ S ( 7 Exp.Date // / p'"� -1m� see "b" above.
/ n �_ 4d. Branch Circuits
Phone No.
G0P� , g�c New, alteration or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name Each branch circuit $ 5.35 2
b) The fee for branch circuits
Address 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 made 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 y9_ 7 5
Signal circuit(s) or a limited energy
(if required):* panL alteration or extension $ 60.00
3. Plan Review section
( Minor Labels (10) $ 46f789
/('.6d
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: 7
5a. Enter total of above fees $
* Submit 2 sets of plans with application where any of the above apply. 3 1).495 Surcharge (.e&X total fees) $ 3
Not required for temporary construction services. Subtotal • C 8' $
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 FORA PERIOD OF 180 DAYS ❑ Trust Account # J 7
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ ,
is \dsts \forms \electric.doc
. _
I
4i ]KING CITY
15300 S.W. 116th Avenue, King City, Oregon 97224 -2693
Phone: (503) 639 -4082 • FAX (503) 639 -3771
Notice To Contractors Working In King City
Due to an intergovernmental agreement with the City of Tigard, many building related permits
for projects in King City are issued and inspected by the City of Tigard.
If your permit application DOES NOT REQUIRE PLAN REVIEW, simply complete the
appropriate application legibly and submit it to the King City staff. The King City staff will
collect all fees and fax the application to the City of Tigard. City of Tigard staff will then create
the permit, issue the permit, and perform inspections. Please indicate on the permit application
whether you would like the Tigard staff to call you when the permit is ready for issuance or
whether you prefer it to be mailed without any notification. Any incomplete or illegible
application will be returned to King City staff for correction and no processing will occur until a
complete, legible application is received.
If your permit application DOES REQUIRE PLAN REVIEW, this form must be signed by a
King City staff person. King City staff will simply sign this form indicating land use approval.
Take this signed form to the City of Tigard Development Services Counter located at 13125 SW
Hall Blvd, Tigard, to submit applications and plans. Development Services Technicians are
available at 639 -4171 Ext. 304 should you have any questions concerning submittal
requirements. All permit fees will be assessed and collected at the City of Tigard.
The City of King City hereby authorizes applicant to pursue permits at the City of Tigard ae-C- Buil ding Department for the following project: - "'"'
located at: /5 S(! //( t-'
) 6,2 n tc.<16-il-
King City Representa ive
I DSTS DOC
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
/ BUP
Date Requested / 0 / 7 AM PM BLD
Location /5 7 05 s(Av �, ` I /6 4. c Suite MEC
Contact Person G uC c Uti Lar Ph 5� Z-v J � PLM
Contractor / 1 -// ‘// 4i7 J Ph SWR
BUILDING Tenant/Owner ELC e ) 2 7
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
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
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
CELECIELCAL-.
- Service
Rough In
UG /Slab V
Low Voltage
Fire Alarm
F i
PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
A
DA
Approach /Sidewalk
Other Date � /7/Co Inspector � � Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 5 I 1 AM PM BLD
Location / 5‘1,//c Suite Z MEC
Contact Person Ph 015 9 O PLM
Contractor Ph SWR 1 2
BUILDING Tenant/Owner ELC ,►, - (30
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
Drywall Nailing —�%l -G rL J / E_ /
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
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
c
tervice
Rough In
t
UG /Slab `,1
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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk ?k2700
Other Date Inspector ,t-e-{ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
BUP - Building Permit ELC - Electrical Permit
4 Inspection Description Date Passed By 4 Inspection Description Date Passed By
Footing /Setback Underground cover
Foundation walls Wall cover
Footing drain Ceiling cover
Waterproof bsmt walls Electrical rough -in
Slab Electrical service
Crawl drain Electrical final AV / 1/4�U
Underfloor insulation
Post/beam structural
Shear walls /anchors ELR - Restricted Energy Permit
Roof nailing 4 Inspection Description Date Passed By
Firewall Low voltage
Tilt -up panel Electrical final
Masonry /Reinforcement
Framing
MFG - Structure set -up MEC - Mechanical Permit
Insulation
Drywall nailing .4 Inspection Description Date Passed By
Post/beam mechanical
Suspended ceiling Gas line
•
Engineered soils Mechanical rough -in
Welding Lab Final Fire damper
Concrete Lab Final Duct work
Bolting Lab Final Smoke detector
Fireproofing Lab Final Mechanical final
Structural observation
Final inspection
PLM - Plumbing Permit
Inspection Description Date Passed By
BUP - Fire Protection System Permit Plumbing underslab
4 Inspection Description Date Passed By Crawl drain
Sprinkler underfloor /slab Post/beam plumbing
Sprinkler rough -in Plumbing top -out
Sprinkler final RP /backflow preventer
Fire alarm final Rain drain
Storm drain
Water service
SIT - Site Permit Sanitary sewer
Inspection Description Date Passed By Culvert/catch basin
Footings Pump /fill septic tank
Foundation walls Plumbing final
Sprinkler supply lines
Sprinkler underfloor /slab
Catch basin/Manhole SWR - Sewer Permit
Engineered soils 4 Inspection Description Date Passed By
Engineering acceptance Sanitary sewer
Final inspection Final inspection
INSPECTION RECORD - BUP, PLM, SWR, ELC, ELR, MEC SIT PERMITS
CITY OF TIGARD ELECvRlCALPERMIT
PERMIT*: CAL PERMIT 7
DEVELOPMENT SERVICES DATE ISSUED: 6/13/00
-i1,L __�i�l 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S110CD -07600
SITE ADDRESS: 15705 SW 116TH AVE
SUBDIVISION: KING CITY NO. 2 ZONING:
BLOCK: LOT : JURISDICTION: KIN
Project Description: Installation of one sign lighting.
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:
TOBIAS INVESTMENT CO HIGHLIGHT SIGN CORP
300 SE SPOKANE ST 8200 SW HUNZIKER
PORTLAND, OR 97202 TIGARD, OR 97223
Phone: Phone: 503 - 620 -8205
Reg #: LIC 00104599
SUP sig517
ELE 26- 888CLS
FEES Required Inspections
Type By Date Amount Receipt Elect'I Service
PRMT DEB 6/13/00 $42.75 0002920 Elect'l Final
5PCT DEB 6/13/00 $3.42 0002920
Total $46.17
This Permit is issued subject to the regulations contained in the Tigard Muniapal 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 r ,
forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -1987.
PERMITTEE'S SIGNATURE ISSUED BY
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
8/22/00 Activities for Case #: ELC2000 -00327
2:47:32 PM -
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCC001 Application received 6/13/00 DEB DONE No Hold DEB 6/13/00
ELCC003 Permit created 6/13/00 DEB DONE No Hold DEB 6/13/00 '
ELCC730 Elect'I Service No Hold DEB 6/13/00
ELCC799 Elect'I Final No Hold DEB 6/13/00 `
ELCC500 (F)Issue permit 6/13/00 DEB DONE No Hold DEB 6/13/00
ELCA510 (F) Reprint permit 8/15/00 ZZZ DONE No Hold ZZZ 8/15/00
ELCC920 Miscellaneous action 8/17/00 CD FAIL No Hold CD 8/17/00 scheduled in error by job super.
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