Permit 1111 CITY OF TIGARD ELECTRICAL PERMIT
. PERMIT #: ELC2008 -00191
COMMUNITY DEVELOPMENT DATE ISSUED: 4/2/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S126CA
SITE ADDRESS: 09225 SW HALL BLVD ZONING:
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: LAROG JEWELERS
Project Description: (2) sign lightings.
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: 2
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:
BARRY MENASHE MULTI -LIGHT SIGN CO.
621 SW ALDER SUITE 605 809 NE LOMBARD ST
PORTLAND, OR 97205 PORTLAND, OR 97211
Phone: 503 - 221 -4040 Contact #: PRI 503 - 281 -3083
FAX 503 - 280 -9624
FEES
Description Date Amount Reg #: ELE 26 -90CLS
. [ELPRMT] ELC Permit 4/2/2008 $106.80 LIC 64107
[TAX] 12% State Surchar 4/2/2008 $12.82 SUP 34351G
Total $119.62 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 da s. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952- 1e -'.10 throw, OA' •5 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issu d By: � J /�` ! Permittee Signature
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
City Received
7,1 C1 of 1 gal d l' / Permit No.: �,^
° 13 125 SW Hall Blvd., Tigard, OR 97223 DateBy: ;It '�Q � a/�/ i ^ II
g Plan Review
0 Phone: 503.639.4171 Fax: 503.598.1960 Date/B : Other Permit:
TI GAR D' Inspection Line: 503.639.4175 Date Ready/By: � 0 See Page 2 for
Internet: www.tigard or.gov Notified/Method. Supplemental Information
TYPE OF WORK PLAN REVIEW ,
❑ New construction ❑ 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
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
0:1) 10OHP or more. occupancy.
Job no.: Job site address: g 2 c S k) Fl & I I l i ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: El Health facilities. ❑ Supply voltage for more than
C Di — 1---- ❑Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
�J FEE SCHEDULE
Cross street/directions to job site: H ail,/ V ,/ G (X, c A Description I Qty. I Fee. I Total
CJ 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 above sq. ft.) 75.00 2
Limited energy, multi - family 75.00 2
t (4 A t ( 0 ,7 � fl--(2 19� residential (with above sq. ft.)
Un � ��� � Services or feeders installation, alteration, and /or relocation
v� 200 amps or less 80.30 2
PROPERTY OWNER El NANT
TE 201 amps to 400 amps 106.85 2
/�
/ 401 amps to 600 amps 160.60 2
Name: e-1 i e_eyn,U -'Dl� �<, C6l'�L -LeA L ( _- c
) /� / 601 amps to 1,000 amps 240.60 2
Address: 6 Z SG✓ �/ �X
e � z v v Over 1,000 amps or volts 454.65 2
City/State /ZIP: / Q ' � Temporary services or feeders installation, alteration, and /or
relocation
Phone: (5 ) X21 — r./0 y 0 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
12 D CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: • ( /Zi4� 45 (701- �L- , B. Fee for branch circuits
Contact name: (6 0 .s --7 LI without service or feeder fee, 46.85 2
v6- first branch circuit
Address: p/� 0 (z___, Each add'1 branch circuit 6.65 2
1 Miscellaneous (service or feeder not included)
City/State /ZIP: e.�� A k _ Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Phone: ( -7 7 7 L S / Fax: : ( ) Reconnect only 66.85 2
E -mail: _Pump or irrigation circle 53.40 2
CONTRACTOR „ Sign or outline lighting 2 53.40 jd6 sir? 2
Business name: r � n Signal circuit(s) or limited -
f v `- V (- 1 1-1 t 9,-0 C- ener panel, alteration, or
Address: q 0 9 A) C f / e, -, -, OVLA en , S. extension. Describe: Page 2 2
2 1
City/State /ZIP: o_- Each additional inspection over allowable in any of the above
C) Per inspection 62.50
Phone: (� j) 7 7 7 , t f S c- Fax: ( ) Investigation per hour (1 hr min) 62.50
CCB Lic.: f '7 5 / 7 Electrical Lic.: 26 — 9a G LS Suprv. Lic.: 3 t� ; S'Z, c Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: . — Subtotal:
/� Plan review (25% of permit fee):
Print name Te r U) r Date: VI (z p 6.
State surcharge (12% of permit fee): / 2 X a
Authorized signature: 514__Q ._- -1 /' .----r--_ TOTAL PERMIT FEE: / / 9 2
This permit application expires if a permit is not obtained within 180
Print name: ( ye__ �G � K �� Date: 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( I I/05/COM/WEB
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008- 00391
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/212008
Phone: (503) 639 -4171 �NU 1 i'
Inspection Requests (24 Hrs.): (503) 639 -4175 ��' 'I �..
INSPECTION WORKSHEET FOR DATE: 5/8/2008 TIME: 7 :01AM PAGE: 26
SITE ADDRESS: 09225 SW HALL BLVD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: LAROG JEWELERS
DESCRIPTION: (2) sign lightings.
OWNER: MENASHE, BARRY PHONE #: 503.221 -4040
CONTRACTOR: MULTI -LIGHT SIGN CO. PHONE #: 503-281 -3083
Inspection Request Scheduled For: Date: 502008 Pour Time:
Code # Inspection Description » Confirm # Contact # Message
140 Sign installation \Q69590 01 503 -201 -3083 N
Corrections/Comments/Instructions:
ict FIN)AL-
qv
'Q PAS Ti PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: G--i Date: CiSt Phone #: (503) 718- 14A