Permit ELECTRICAL PERMIT
CIT OF TIGARD PERMIT #: ELC2005 -00593
1� DEVELOPMENT SERVICES DATE ISSUED: 8/16/2005
° �I II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 102AA - 04100
SITE ADDRESS: 12230 SW MAIN ST ZONING: CBD
SUBDIVISION: MORINS ADDITION LOT : JURISDICTION: TIG
Project Description: Sign lighting. 10/11/05: Added (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: 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:
INTEGRITY INVESTMENTS INC MULTI -LIGHT SIGN CO.
2229 NE BURNSIDE SUITE 86 809 NE LOMBARD ST
GRESHAM, OR 97030 PORTLAND, OR 97211
Phone: 503 - 281 - 3083 Phone: 503 - 281 -3083
FEES Reg #: LIC 64107
Description Date Amount SUP 672SIG
ELE 26 -90CLS
[ ELPRMT] ELC Permit 8/16/2005 $53.40
[TAX] 8% State Surcharge 8/16/2005 $4.27 REQUIRED ITEMS AND REPORTS
[ELPRMT] ELC Permit 10/11/200' $53.40
(additional fees not listed here)
Total $115.34
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty - •des an all other -0 icable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 • ays of iss , ance, • /iTork is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon U '1 Notifi . on C- t4•:%Those rules are set
forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct • stions • OU /503- 246 -6699 or
1- 800 - 332 -2344.
� w
Issued By: 0 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.
C5 Cpl &r. S �.ql .,,. '1 S \ c iy \. S f ,)13 a a o_az y3
r Electrical Permit Applica on FOR OFFICE 1 s1: o\l_Y• •
City of Tigard / ®" Permit No. // :.gz 9
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
503.639.4171 Fax: 503.598.1960 /� ' ! A t+n, Lj i • D Other Permit:
Inspection Line: 503.639.4175 _ " Date Ready/By: 7 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: I ® Supplemental Information
TYPE OF WORK PLAN REVIEW
ew construction. ❑ Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑Other: ['Service over 225 amps, comm'I ['Hazardous location
['Service over 320 amps — rating ['Bulldog over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ 1 and 2 family dwelling ... ommercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi family ❑Master builder ❑Other; ['Building over three stories ['Feeders, 400 amps or more
['Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ['Egress/lighting plan RV park
Job no.: Job site address: 0 . - ❑Health -care facility DOther:
v /. d _ - Submit 2 sets of plans with any of the above.
s
City/State/ZIP: / 6 g O 7' / The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project I � / 4 FEE* SCHEDULE
� � - , i � . J Description I Qty. I Fee. I Total I ••
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION s F WORK Each manufactured or modular
,IL - dwelling, service and/or feeder 90.90 2
- i / '._� __ ,/L • // ■ Services or feeders installation, alteration, and/or relocation
t% C> �� � -- 200 amps or less 80.30 2 _
❑ PERTY OWNER l L E lANT 201 amps to 400 amps 106.85 2
. 401 amps to 600 amps 160.60 2
Name: L. , i _ ` /f '� 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
tS ) �C1 / /2e� l ( ) relocation
Phone: 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 10030 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits— new, alteration, or extension, per panel
❑ APPLICANT I CONTACT PERSON A. Fee for branch circuits with
/ service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: , /+ , , _ i� without service or feeder fee, 46.85 2
6 !/ each branch circuit
Address:
Each add'I branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) I Fax: : ( ) Pump or irrigation circle 53.40 12
Sign or outline lighting G 5340 2
E -mail: Signal circuit(s) or limited-
, CO ' • CTOR J energy panel, alteration, or
Business name:
���� extension. Describe: Page 2 2 —
Address: % A / Each additional inspection over allowable in any of the above
— , •�� '. ;
I Per inspection 62.50
City/State/ZIP: � I / — / Investigation per hour (1 hr min) 62.50
Phone: (1 r I i Industrial plant per hour 73.75
s i _ / a Fax: _ r /.� /
a ELECTRICAL PERMIT FEES*
CCB Lic.: / i Electrical Lic.: , Q S Lic.:� — Subtot'r I ' " ' nT
Suprv. Electrician signature, requi Plan review (25% of permit fee) • -
Print name: ,`, ' /_,,,, _ l Date: / AY State surcharge (8% of permit fee) ;' , I I
TOTAL PERMIT FEE 94/
Authorized signature: / � �
A ��
v / This permit application expires if a permit is not obtain.. d.._._ I ti0
days after it has been accepted as complete
Print name: I Date: / / /D /� Fre methntinlnov set by Tri-f nnnty Rnildinn Industry Service Rnaril
5-17.‘ 7
rte. CITY OF TIGARD • ELECTRICAL PERMIT
•
PERMIT #: ELC2005 -00593
;_: i DEVELOPMENT SERVICES DATE ISSUED: 8/16/2005
��' II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2 S 102AA -04100
SITE ADDRESS: 12230 SW MAIN ST ZONING: CBD
SUBDIVISION: MORINS ADDITION LOT : JURISDICTION: TIG
Project Description: 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:
INTEGRITY INVESTMENTS INC MULTI -LIGHT SIGN CO.
2229 NE BURNSIDE SUITE 86 809 N E LOMBARD
GRESHAM, OR 97030 PORTLAND, OR 97211
•
Phone: 503 - 281 -3083 Phone: 281 -3083
FEES Reg #: LIC 64107
SUP 343SIG
Description Date Amount ELE 26 -90CLS
[ELPRMT] ELC Permit 8/16/2005 $53.40
[TAX] 8% State Surcharge 8/16/2005 $4.27 REQUIRED ITEMS AND REPORTS
Total $57.67
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and - • er -'• • 'cable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 da • issuance, ork is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Or-! • n Utility Note - i• ri Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rule or di -ct questi. , • • UN C at
503 - 246 -6699 or.1- 332 -2
Issued By: �� /5472 , Permittee Signature' _ � /
4111■ 40,- 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.
CI,LAPKAA CP-4461 °-0)'l'1r le • SG N°2o a s -00.1.43
Electrical Permit Application �� �� �-^
H t, L I V J E D Date received /6/ -88 Permit no. �1�l,.e a95 -- ar
.,e it i , i s �!
—�L a ,.•j 1 City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd; Tigard/ Olj,j7723 Date issued: By56 Receipt no.:
Phone: (503) 639 -4171 L
Fax: (503) 598 - 1960 Case file no.: Payment type:
CITY OF TIGARD
Land use approval: BUILDING DIVISION
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ' Commercial/industrial ❑ Multi - family ❑ Tenant improvement
❑ New construction n Addition/alteration /replacement O Other: ❑ Partial
JOB SITE INFORMATION
Job address: _ �1 �� _ _Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: Block: ubdivision:
Project name ,y y.,f, � I Description and location of work on premises: ` e > ,6 ,I- A Ti�il
Estimated date of completion/insp ion: (�
. CONTRACTOR APPLICATION FEE SCIIEDU.E
Job no: Fee Max
Business name: (� Description Qty. (ea.) Total no. insp
�f>` Y� Lt , N e w residential - single or multi - fancily per
Address: ✓/ .—. . . —41 / dwelWcgunit Includes attached garage.
Era ffiri; - .` ral I I ZIP: . _, . Service lncluded
Phone(
1000 sq. ft. or less 4
j�%� r -
CCB no.: Each additional 500 sq. ft. or portion thereof
1�j0 7 Elec. bu ic. no�� -��- -- Limited / additional
residential 2
City /metro lic.no.: __„----77 , Limited energy, non- residential 2
� __ „� _ Each manufactured home or modular dwelling
Sig • ure of supervising • clan ' Nuire ' Da e / Service and/or feeder 2
Sup. elect. name (print . / L License no 3 -. Services or feeders—installation,
alteration or relocation:
PROPERTY OWNER 200 amps or less 2
Name (print): �� / / 201 amps to 400 amps 2
Mailing address: /��/ �' 1
601 amps to 600 amps 2
g � • ■ i . 601 amps to 1000 amps 2
III•Erig V2 ZIP: Over 1000 amps or volts 2
a ee - -.2J' /- 3O "2 Fax:a( . 2 , -mail: Reconnect only 1
Owner installation: The installation is being ade on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration,orrelocation:
200 amps or less 2
ORS 447, 455, 479, 670, 701.
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
ENGINEER Branch circuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E-mail: Each additional branch circuit:
PLAN REVIEW' (Please check all that apply) Misc. (Service or feeder not included):
❑ Service over 225 amps- commercial ❑ Health -care facility Each pump or irrigation circle 2
O Service over 320 amps -rating of 1 &2 0 Hazardous location Each sign or outline lighting 1 53 �� 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, 1
O System over 600 volts nominal more residential units in one structure alteration, or extension* 2
O Building over three stories ❑ Feeders, 400 amps or more *Description:
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lightingplan 0 Other. Per inspection I I
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other 2 • �0
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ S3
O Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $ ,
Credit card number: / / within 180 days after it has been State surcharge (8 %) $ h1 Al
Expires accepted as complete. TOTAL $ S7 - 60
Name of cardholder as shown on credit card
$
Cardholder signature Amount 440-4615 (6i00/COM)
.r
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total 4, Check Type of Work Involved:
Residential - per unit
1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40 1 ❑ Burglar Alarm
Limited Energy $75.00
Each Manuf'd Home or Modular ❑ Garage Door Opener
Dwelling Service or Feeder $90.90 2
Services or Feeders ❑ Heating, Ventilation and Air Conditioning System*
Installation, alteration, or relocation
200 amps or less $80.30 2
201 amps to 400 amps $106.85 2 n Vacuum Systems
401 amps to 600 amps $160.60 2
601 amps to 1000 amps $240.60 2 ❑ Other •
Over 1000 amps or volts $454.65 2
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each system $75.00
200 amps or less $66.85 2 (SEE OAR 918 - 260 -260)
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75 2 Check Type of Work Involved:
Over 600 amps to 1000 volts,
see "b" above. ❑ Audio and Stereo Systems
Branch Circuits
New, alteration or extension per panel ❑ Boiler Controls
a) The fee for branch circuits
with purchase of service or ❑ Clock Systems
feeder fee.
Each branch circuit $6.65 2 ❑ Data Telecommunication Installation
b) The fee for branch circuits
without purchase of service ❑ Fire Alarm Installation
or feeder fee.
•
First branch circuit $46.85
Each additional branch circuit $6.65 ❑ HVAC
Miscellaneous ❑ Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40 I:11 Intercom and Paging Systems
Each sign or outline lighting $53.40
Signal circuit(s) or a limited energy
panel, alteration or extension $75.00 ❑ Landscape Irrigation Control
Minor Labels (10) $125.00
Each additional inspection over ❑ Medical
the allowable in any of the above ❑
Per inspection $62.50 Nurse Calls
Per hour $62.50
In Plant $73.75 ❑ Outdoor Landscape Lighting
Fees: ❑ Protective Signaling
Enter total of above fees $ ❑ Other
8% State Surcharge $ Number of Systems
25% Plan Review Fee
See "Plan Review" section on $ No licenses are required. Licenses are required for all other installations
front of application.
Fees:
Total Balance Due $
Enter total of above fees $
❑ Trust Account # 8% State Surcharge $
Total Balance Due $
All New Commercial Buildings require 2 sets of plans.
i :\dsts\forms \e1c- fees.doc 08/30/01
CITY OF TIGARD
BUILDING DIV SION PERMIT #: ELC2005 -00593
13125 SW Hall Blvd., Ti • -rd, OR 97223 DATE ISSUED: 8/16/2005
Phone: (503) 639-4171
Requests (24 Hrs.). 503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/20/2005 TIME: 7:09AM PAGE: 8
SITE ADDRESS: 12230 SW MAIN S CLASS OF WORK:
SUBDIVISION: MORINS ADDITION LOT #: TYPE OF USE:
PROJECT NAME: CROWN CARPETS
DESCRIPTION: Sign lighting. 10/11/05: A, dad (1) sign lighting.
OWNER: INTEGRITY INVESTMENT INC, PHONE #: 503- 281 -3083
CONTRACTOR: MULTI - LIGHT SIGN CO. PHONE #: 281 -3083
Inspection Request Scheduled For: Nate: 10/20/2005 Pour Time:
Code # Inspection Description C. firm # Contact # Message
199 Electrical final 018:61 -01 503 - 281 -3083 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR IN. ' ECT N ❑ ADDITIONAL FEES ASSESSED
Inspector: - _ Date: � ( Phone #: (503) 718-