Permit 'Ili' CITY OF TIGAR ELECTRICAL PERMIT
PERMIT #: ELC2006- 00728
COMMUNITY DEVELOPMENT DATE ISSUED: 12/22/2006
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S13600 02503
SITE ADDRESS: 07501 SW DARTMOUTH ST 200 PETSMART ZONING: C -
SUBDIVISION: LOT : JURISDICTION: TIG
Project Description: (1) 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:
WAREMART INC. VANCOUVER SIGN COMPANY, INC
3336 E 32ND. ST. #217 6615 SW HWY 99
TULSA, OK 97435 VANCOUVER, WA 98665
Phone: Contact #: PRI 360- 693 -4773
FAX 360- 693 -2747
FEES
Description Date Amount Reg #: ELE 37 -46CLS
[ELPRMT] ELC Permit 12/22/200( $53.40 LIC 63951
[TAX] 8% State Surcharge 12/22/200( $4.27 SUP 525SIG
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 1.800.332.2344.
Issued By: �,, / i ,;., �
Permittee Signature: � �( V
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.
'. \, iv 2 . --C] O a-2 El Permit Applicati f �
� " ' FOR OFFICE USE ONLY
1 I.. �y
City g iv
CI of Tigard R eceed Date/B : ,6� _ i, . i mar • a - C7 r Y
11 a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
' o Phone: 503.639.4171 Fax: 503.598.196 20 Date /By: Other Permit:
Inspection Line: 503.639.4175. ��� Date Ready/By: 1 • 63 See Page 2 for
TIGARD
Internet: www.tigard- or.gov , ,A Notified/Method: Supplemental Information
TYPE ry PLAN REVIEW
T'' Trip T M_ Please check all that apply (submit 2 sets of plans w /items checked below):
❑ New construction El Additio al eratiorlfreplacement
❑ Service or feeder 400 amps or more ❑ Building over three stories.
ID Demolition / �t Cher: S 1 1\ 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: �j I IQ ❑ 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 - ",
Job no.: Job site address: c.) D 1 ' W DA4-1-M 4 41 100 or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/ State/ZIP: 7 ' t'._ 12 C) , 0 2 C -1 ZZ 3 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: p 1`T 5 &LA_ e'er ❑ Service or feeder 600 amps or more.
1 FEE SCHEDULE
Cross street/directions to job site: (_ S .eX 1 �- ••* " 3 / {-DI.V'5 r' Description I Qty. I Fee. I Total I •
14 /A! /...
C) K C t_) New residential single- or multi - family dwelling unit.
ST T. G i T U b eT o
A M `� 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
75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
S - r GL l�(. -�-'C t t 1� b -E c) , hi F. 1 L...1-4 AA, I J` 1 AT[jj Limited energy, multi- family 75.00 2
1.1,) residential (with above sq. ft.)
C.l.(AN ti 1... L ����� Q 1 (-7A-1 Services or feeders installation, alteration, and/or relocation
S 200 amps or less 80.30 2
0 PROPERTY OWNER I TENANT 201 amps to 400 amps 106.85 2
Name: h 401 amps to 600 amps 160.60 2
1 601 amps to 1,000 amps 240.60 2
Address: '1 C 1 ' z� D .ii 2- /Ik k R' I )z Over 1,000 amps or volts 454.65 2
City/ State/ZIP: ( C_'C A..>2-.r> , u 1Z q - Z23 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (jO3 ) tom' 4 - 3 23 H 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 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
e" APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each
Business name: u F' Sl branch circuit
�/ &l Lo "Lt 1J C � B. Fee for branch ci rcuits
without service or feeder fee,
Contact name: I S 4 . 1.4 4 W "/ L C (Gv f F first branch circuit 46.85 2
Address: G c , , G jC Hwy .t.„ci Each add'! branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State/ZIP: V Q N C DI uAOIC t C.0 4. ` ( (5 Each manufactured or modular
90.90 2
dwelling, service and/or feeder
Phone: (360) C '' - L "7 -7 3 Fax: : ( 360) 6 cl - 3 - Z t11 Reconnect only 66.85 2
E -mail: j 5 q t •- a. l•'1 Q- 1Ja=‘ ^ S 1 ein W • C.C. '11Th Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting I 53.40 5.3 T u 2
Signal circuit(s) or limited -
Business name: V 4 NL,v L-t !f !_ 5 ( C_,, iU G O . energy panel, alteration, or
Address: SjQ/
extension. Describe: Page 2 2
City/State/ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( )
Investigation per hour (1 hr min) 62.50
CCB Lic.: (:> Q S 1 Electrical ic.• - �l6 CA-5 Suprv Lic.: c t 3 - S -zL= Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: i . #� Subtotal:
Print name: 0 t S 1 itit �� A R. ( Date: d6 Plan review (25% of permit fee):
_ State surcharge (8 /0 of permit fee): t { a 7 • • (O 7
Authorized signature: - / l ,t TOTAL PERMIT FEE: • 5 7 • D ate: 17 �/ '� iU�U b This permit application expires if a permit is not obtained within 180
Print name: (S
.� l..d / �`� r-� ! days after it has been accepted as complete. %
* Number of inspections allowed per permit.
I:\ Building \Permits\ELC- PermitApp.doc 05/23 /06 440- 4615T(I1/05/COM /WEB i 41,01
CITY OF TIGARD
BUILDING DIVISION - • PERMIT #: ELC2006- 00728
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/22/2006
Phone: (503) 639 -4171 msµ ^u���
Inspection Requests (24 Hrs.): (503) 639 -4175 1. .
INSPECTION WORKSHEET FOR DATE: 5!14/2007 TIME: 7:01AM PAGE: 60
SITE ADDRESS: 07501 SW DARTMOUTH ST 200 PETSMART CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: PETSMART
DESCRIPTION: (1) sign lighting.
OWNER: WAREMART INC., PHONE #:
CONTRACTOR: VANCOUVER SIGN COMPANY, INC PHONE #: 360- 603.4773
Inspection Request Scheduled For: Date: 5/14/2007 Pour Time:
Code # Inspection Description Confirm #. Contact # Message
199 Electrical final 048177 -01 \ s, 360-693-473# N
orrection /Comments /Instr uctions:
N
c c
N
•
, PASS I I PARTIAL APPROVAL ❑ CANCEL ' I NO ACCESS
n FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: NO?) Date: r C Phone #: (503) 718-