Permit CITY OF TIGARD ELECTRICAL PERMIT
ia,.d,dp 1 DE VELOPMENT SERVICES PERMIT #: ELC98 -0178
r� � DATE ISSUED: 04/09/98
! +L ' - -.. 1 3125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171
PARCEL: 1S136AD -06507
SITE ADDRESS...:11460 SW PACIFIC HWY
SUBDIVISION ZONING:C -G
BLOCK • LOT • JURISDICTION: TIG
Proj ect Description : Installing a permanent 280 sq. ft. wall sign
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS • 0 0 - 200 amp • 0 PUMP /IRRIGATION • 0
EACH ADD'L 500SF...: 0 201 - 400 amp • 0 SIGN /OUT LINE LTG..: 1
LIMITED ENERGY • 0 401 - 600 amp • 0 SIGNAL /PANEL • 0
MANF. HM/ SVC /FDR..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (10)...: 0
- - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- -
0 - 200 amp • 0 W /SERVICE OR FEEDER: 0 PER INSPECTION • 0
201 - 400 amp • 0 1st W/O SRVC OR FDR.: 0 PER HOUR • 0
401 - 600 amp • 0 EA ADD'L BRNCH CIRC: 0 IN PLANT • 0
601 - 1000 amp • 0 PLAN REVIEW SECTION
1000+ amp /volt • 0 > =4 RES UNITS • > 600 VOLT NOMINAL..:
Reconnect only • 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: FEES
HOWARD JOHNSON type amount by date recpt
11460 SW PACIFIC HWY PRMT $ 40.00 DLH 04/07/98 98- 304740
TIGARD OR 97223 5PCT $ 2.00 DLH 04/07/98 98- 304740
Phone #:
Contractor:
BLAZE SIGN $ 42.00 TOTAL
PO BOX 23910
7340 SW HAZELFERN REQUIRED INSPECTIONS
TUALATIN OR 97281 -3910 Elect'1 Service
Phone #: 639 -3262 Elect'1 Final
Reg #..: 000643
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952-001 -1987. You may obtain a copy
of these rules or direct questions to OM by calling (5031246 -1987.
Permittee Signature: t Issued By: 0,4
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 ON
SIGNATURE OF SUPR. ELEC' N: F1 / 7/ C' / -" .I: � DATE: 1 1 - 4 - 15 /
LICENSE NO:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Community Development ELECTRICAL PERMIT APPLICATION
A I) 13125 SW Hall Blvd. IX----01 „c/
, roil
Tigard, OR 97223 Permit #
Date Issued
( p
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,,'' .� I Phone (503) 639 -4171
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: rr 4. Complete Fee Schedule Below:
Name of Development 4o,, c� / Number of Inspections per permit allowed
Address I / Li
C. • 5 t..%) ! 4.„,,,. Service included: Items Cost(ea) Sum
City /State /Zip �t P,a-J (9- 4 • q 7.2-3 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
Name (or name f business) Each additional 500 sq. ft. or
portion thereof $25.00
Commercial V Residential Limited Energy $25.00 1
Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
m ,, Installation, alteration, or relocation
Electrical ntractor `1= , 200 amps or less $60.00 2
Addr Z> 5a-2, a q lq c 201 amps to 400 amps $80.00 2
City State C9-.J Zip ` O / 401 amps to 600 amps $120.00 2
601 amps to 1000 amps $180.00 2
Phone No. 9 ?,g �-- a =. kT '-1 / 1 Over 1000 amps or volts $340.00 2
Job NO. �- , Co Reconnect only $50.00 2
contractor's license NO. .26 3 S C 4.--5 4c. Temporary Services or Feeders
Contractor's Board Reg. No. 4 a Installation, alteration, or relocation
Signature of Supr. Elec'n 11 .. � � � -' 200 amps or less 2
License No. /5 S t 9 "hone No. G, : " 37-6 y 201 amps to 400 amps $50.00 2
75
401 amps to 600 amps $75.00
Over 600 amps to 1000 volts $100.00
2b. For owner installations: see "b" above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane
Address a) The fee for branch circuits with
purchase of service or feeder fee. 2
City State Zip Each branch circuit $5.00
Phone No. b) The fee for branch circuits withou 2
The installation is being made on property I own which is purchase of service or feeder fee. 2
not intended for sale, lease or rent.
First additional circuit br $35.00
Each additional branch circuit $5.00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation circle $40.00 2
Each sign or outline lighting 1 $40.00��
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40.00
4 or more residential units in one structure Minor Labels (10) $100.00
Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.C. Chapter 5 Per inspection $35.00
Per hour $55.00
In Plant $55.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
5a. Enter total of above fees $ 4/4 , B'O
NOTICE • 5% Surcharge (.05 X total fees) $ 2 0-0
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter v i of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Reeview if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. wordkomdevleieo- ❑ Trust Account #
pim.ep
Balance Due $ ya . vo
•
7/27/99 Activities for Case #: ELC98 -00178
4:56:39 PM
Assigned Hold . Updated
Activity Description . Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCC001 APPlication received 4/7/98 DLH RECD BON 4/9/98
ELCC003 Permit created 4/9/98 B DONE BON 4/9/98
. ELCC730 Elect'I Service BON 4/9/98
ELCC799 Elect'I Final _ NOTE JT 1/13/99 1/13/99 inspection request
(research) sent to Chuck
ELCC500 (F)Issue permit 4/9/98 B PASS BON 4/9/98
ELCC920 Miscellaneous action 2/4/99 • CD FAIL CD 2/4/99 broken conduit fitting to sign,
• exposed wiring below sign.
ELCC800 Case Finaled 2/24/99 BRP PASS JT 2/24/99 Berk has hard copy at site pass
original permit
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Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested / �f AM PM BLD
I/(
Location // 0 PAeg ' i , Suite MEC
Contact Person � Ph PLM
Contractor &/q-2-e— 5i ' Ph 63y - 3 SWR
BUILDING Tenant/Owner ELC 9 t--or ( 78
Retaining Wall ELR
Footing Access:
Foundation 9 FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: I t ,I
Slab �-A.e SIT
Post Beam a ,).-e) ,).-e) 12
Ext Sheath/Shear eath /Shear
Int Sheath /Shear
Framing
Insulation / -_
_..4..4 . _ � _ ' :
Drywall Nailing
Firewall _
-
Fire Sprinkler i. % _
Fire Alarm
Susp'd Ceiling
Roof
Misc: CDY1d u V 1 S N / G wl el j e - cc>_ X 1 0 o s °_cl / w! r e, i$
Final 1 Qn � n5 D ' it bD / (1 -o m 5 ha S
PASS PART FAIL � S O � '/ 5 n
PLUMBING 5 p D se 6 A ru Ciij r e .
Post & Beam
Under Slab
Top Out ,[
Water Service L nn q vn cr C / e4 r S ( _D A pie - Or; 3 i zq 1
Sanitary Sewer ! ) G L/ / / 1
Rain Drains 11 S' �` r u Go Y
t 2 47)4 47)4 c / 14 ' iic �/' i if ✓1 • 1
Final
PASS PART FAIL
MECHANICAL t� Y`
Post & Beam � / -
Rough In
Gas Line - asismwAtir4;"
Smoke Dampers
Final
FAIL
ELECTRICAL )
- • «-
Rough In
UG /Slab
Low Voltage C --
Fir- • larm
PAR �t�rlillp
, ill rl1
S 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 reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Z
Date . Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.