Permit CITY T I G A R D ELECTRICAL PERMIT RMIT 1\1
DEVELOPMENT SERVICES DATE ISSUED: 8/10/00 00 00455
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`--' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S126DC -04500
SITE ADDRESS: 09575 SW LOCUST ST
SUBDIVISION: LEHMANN ACRE TRACT ZONING: C -P
BLOCK: LOT : 007 JURISDICTION: TIG
Project Description: Electrical for (2) signs
• 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:
VIP'S MOTOR INNS INC MARTIN BROS SIGN INC
29757 SW BOONES FERRY RD 3165 COMMERCIAL ST SE
WILSONVILLE, OR 97070 SALEM, OR 97302
Phone: Phone: 364 -2211
Reg #: LIC 00064761
SUP 399SIG
ELE 24 -23CLS
FEES Required Inspections
Type By Date Amount Receipt
Elect'I Service
PRMT GWL 8/1/00 $85.50 0004271 Elect'l Final
5PCT GWL 8/1/00 $6.84 0004271
Total $92.34
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 -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
CITY ()F TIGARD Electrical Permit Application Plan Check#
1125 W HALL BLVD. Recd By
r1 - Date Rec'd 8 / - Or
TIGARD OR 97223 (
z; ‘ (0 Date to P.E.
Phone (503) 639 -4171, x304 -- - - \ Date to DST
Inspection (503) 639 -4175 Print or Type Permit# Gt,G 2tQO0 �-/S
Fax (503) 598 -1960 Incomplete or illegible will not be ccepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Arypii,/t,..onh Number of Inspections per permit allowed
Name (or name of business) 0,,,,,,,,s,, , Service included: Items Cost Sum
Address ( 7.c . 7,s�se.{.) oCt)e-(./,� ..'4 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
City /State /Zip 7 f 2 r -./ , 0 Each additional 500 sq. ft. or
portion thereof $25.00 1
Commercial 0 Residential ❑ Limited Energy $25.00
Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all current licenses) 4b. Services or Feeders
Electrical Contractor` - Tha, vr, ,6ii -D,5 0 ` j �" " Installation, alteration, or relocation
/� 5.0-3-7,7-1,14 �9 � 200 amps or less $60.00 2
Address, /&.5 - P� aJ! ,4_-( 201 amps to 400 amps $80.00 2
City. jn State ('Sy' Zip 9 g.- 401 amps to 600 amps - $120.00 2
Phone No. , ,'R'- ,�6 d / / 601 amps to 1000 amps - $180.00 2
Job No. Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. c .W - „,?.3 CLS Exp.Date 10/6)
OR State CCB Reg. No. 6176 1 ut(Exp.Date 3 /SS /C 4c. Temporary Services or Feeders
COT Business Tax or Metro No. Exp.Date Installation, alteration, or relocation
200 amps or less $50.00 2
Signature of Su r. Elec'n 201 amps to 400 amps $75.00 2
9 P 401 amps to 600 amps $100.00 2
AA Over 600 amps to 1000 volts,
License No. acl �/ �S ! (, ql �� ° ' Exp.Date /CVO / see "b" above.
Phone No. ..57Y3 - ,�(o 1 /- a / / 4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
feeder fee.
Print Owner's Name
Each branch circuit - $5.00 2
Address b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee.
First branch circuit - $35.00 2
Each additional branch circuit $5.00 2
The installation is being made on property I own which is not
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle $40.00 2
_cc- $
Each sign or outline lighting &() - 2
3. Plan Review section (if required):* 10.1.5
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 $35.00
System over 600 volts nominal Per hour - $55.00
Classified area or structure containing special occupancy In Plant - $55.00
as described in N.E.C. Chapter 5
5. Fees: e � 6 S So
* Submit 2 sets of plans with application where any of the above apply. 5a. Enter total of above fees $
Not required for temporary construction services. '5 Surcharget8+5 .. total fees) $ � J
1 S�iktotal •,e'I J . $ r . b 0 W. 5
NOTICE 5b. Enter 25% of line 5a for
Plan Review if required (Sec.3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Subtotal $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY ❑ Trust Account #
TIME AFTER WORK IS COMMENCED. Total balance Due $
•
I: \DST \ELEC98.DOC REV 4/98
/44., CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested / U -( AM PM BLD
Location q.57) SW to Suite MEC
Contact Person Da ti-ta Ph :37 -34 -2 Z. / f PLM
Contractor li„, l .Fro S. Ph SWR
BUILDING: o ; Tenant/.Owner w4-Cf Ca) ELC X0 -o° qss
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: (� SGN
Slab �1 a i Cs-AL SIT / Z.
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
• T FAIL
- e
Rough In
UG /Slab
Low Voltage
Fire AI . rm
G%"
-A - 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 r -' spectio RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Date
Other 0 ) Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.