Permit CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2006 -00639
COMMUNITY DEVELOPMENT DATE ISSUED: 11/7/2006
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S133AD -16200
SITE ADDRESS: 12700 SW NORTH DAKOTA ST 180 ZONING: C -P
SUBDIVISION: PP1995 -073 LOT : 003 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:
PACIFIC CREST PARTNERS SCHOLLS L VANCOUVER SIGN COMPANY, INC
1430 EASTSIDE RD 6615 SW HWY 99
HOOD RIVER, OR 97031 VANCOUVER, WA 98665
Phone: Contact #: PRI 360 - 693 - 4773
FAX 360 - 693 -2747
FEES
Description Date Amount Reg #: ELE 37 - 46CLS
[ELPRMT] ELC Permit 11/7/2006 $53.40 LIC 63951
[TAX] 8% State Surcharge 11/7/2006 $4.27 SUP 5255[G
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 mo an 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those es are set fort in 952- 001 -0010 through OAR 952 -001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503. 46.6699 or 1.800.33 .2344' ^ /
Iss d By: ,(/ ./1/ W____4 C Permittee Signature: �� / ,� /
OWNER INSTALLATION ONLY """`\J//
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 FUR OFFICE ICi tJSE 0\1.1
City of Tigard Received Da : : . J PermitNo.: Al "0O ,3
• 13125 SW Hall Blvd., Tigard, OR 97223
Plan Review
C Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
T GA �t D Inspection Line: 503.639.4175 Date Ready/By: 1uris El See Page 2 for
Internet: www.tigard 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):
❑ Demolition ❑ Other: where Service or feeder 400 amps or more ❑ Building over three stories.
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 ", "l -2 ", "l -3 ",
Job no.: Job site address:' 21 0 0 S L., D A k k f\ St I or more r occupancy.
❑ Six or or r more residential units. 0 Recreational vehicle parks.
City /State/ZIP: ` k cp iv t 0 II ❑ healthcare facilities. 0 Supply voltage for more than
Y�
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: (4 IA L NOS ❑ Service or feeder 600 amps or more.
job site: FEE SCHEDULE
Cross street/directions to
S�-/ S CI. u �� S F c. f f y (fin � 1 D ku�r f� Dts erlptlan I Qt I Fee. I Total I •
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'I 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.)
Limited energy, multi- family 75.00 2
)c - (X tk Nj110,. k ( C) (1vr■V■4ke4 St ,{v r residential (with above sq. R)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I riff TENANT 201 amps to 400 amps 106.85 2
Name: Q (/k2, tv (i S 401 amps to 600 amps 160.60 2
nn 601 amps to 1,000 amps 240.60 2
Address: O. 10 0 S\ t (�, k OI ll A S V Over 1,000 amps or volts 454.65 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP: '� k ,A(n ( 011.. 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 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:
y A. Fee for branch circuits with
14 APPLICANT I (L CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: V/ (NN co (A/ 0./ S •
tf) f■ - C. (/, B. Fee for branch circuits
Contact name: T1 without service or feeder fee, 46.85 2
\ P �(, l e f first branch circuit
Address: ()CAS I\/( \Si i Each add'' branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State/ZIP: V jNc.v Wt l L A 6 \55665 Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: (3( ) C13-- 41 13 Fax: : (3(,Q) 6 4 1 ; - 11"(.7 Reconnect only 66.85 2
E -mail: A. k G)� I✓ pittkr tInC.. C fr.. Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting ` 53.40 $'t,,y0 2
S Signal circuit(s) or limited -
Business name:
V Net. 1 wQ u r energy panel, alteration, or
Address: 66' S kit (-k l.-7 °V\ extension. Describe: Page 2 2
City/State/ZIP: V ANCO(Nef L.. A G 9 66S Each additional inspection over allowable in any of the above
i
Phone: (3 ) G'\ 3 _ ( 13 F ( ) Per inspection 62.50
� Investigation per hour (t hr min) 62.50
CCB Lic.: 63 \ Electrical Li 3.7 _ .((, `L$ Suprv. Lic.: 513 - Si (T Industrial plant per hour 73.75
�� ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: . 1f? � � Subtotal: 55 . '{Q
Print name: 5:3 S11 \NA1l Date: ` \IG ( 1 5006 Plan review (25% of permit fee):
State surcharge (8% of permit fee): 1 1. a--7
Authorized signature: `1
Print name: ` Cr, P -�( Date: I �6(ptr P c TOTAL PERMIT FEE: 5 , t -7
This permit application expires If a permit is not obtained within 180
days after it has been accepted as complete.
• Number of inspections allowed per permit.
l:\ Building\Permits \H.GPamitApp.doc 0523/06 4404615T(11/05/COM/WEB
CITY OF TIGARD
i BUILDING DIVISION PERMIT #: ELC200G 00639
AM 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/7/2006
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 12/13/2006 TIME: 7:04AM PAGE: A7
SITE ADDRESS: 12700 SW NORTH DAKOTA ST 180 CLASS OF WORK:
SUBDIVISION: PP1995.073 LOT #: 043 TYPE OF USE:
PROJECT NAME: QUIZNOS
DESCRIPTION: (1) sign lighting
OWNER: PACIFIC CREST PARTNERS SCHOLLS L, PHONE #:
CONTRACTOR: VANCOUVER SIGN COMPANY, INC PHONE #: 360- 693-4773
Inspection Request Scheduled For: Date: 12113/7006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 041014 -02 360-693-4773 N
Corrections/Comments/Instructions:
K PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: NM N Y C Date: \ I (7 I Phone #: (503) 718 - vi �b
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005.00639
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/712006
Phone: (503) 639 -4171 g . N ����*
Inspection Requests (24 Hrs.): (503) 639 -4175 �'!�- p: _..
INSPECTION WORKSHEET FOR DATE: 12113/2006 TIME: 7 :04AM PAGE: 48
SITE ADDRESS: 12700 SW NORTH DAKOTA ST 180 CLASS OF WORK:
SUBDIVISION: pP'I995.073 LOT #: 003 TYPE OF USE:
PROJECT NAME:
G?UIZNOS
DESCRIPTION: (1) sign lighting
OWNER: PACIFIC CREST PARTNERS SCHOLLS L, PHONE #:
CONTRACTOR: VANCOUVER SIGN COMPANY, INC PHONE #: 360-693-4773
Inspection Request Scheduled For: Date: 12/13/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
140 Sign installation 041014 -01 360- 693-4773 N
Corrections /Comments /Instructions:
VI PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N (ye i_i f " Date: 12 10 66 Phone #: (503) 718- 2A '