Permit •
CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2008 -00479
COMMUNITY DEVELOPMENT DATE ISSUED: 8/19/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S136AD -06504
SITE ADDRESS: 11462 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: AMERICAS TIRE COMPANY LOT : 003 JURISDICTION: TIG
PROJECT: DISCOUNT TIRE COMPANY
Project Description: (1) branch circuit for monument sign. Job No. 17802
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:
LIMITED ENERGY: 401 - 600 amp: SIGNAUPANEL:
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: 1 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:
HALLE PROPERTIES LLC ATLAS ELECTRICAL CONTRACTORS
20225 N SCOTTSDALE RD 4403 SE ROETHE RD
SCOTTSDALE, AZ 85225 MILWAUKIE, OR 97267
Phone: Contact #: FAX 503- 659 -4944
PRI 503 - 659 -2212
FEES
Description Date Amount Reg #: ELE 3 -2C
[ELPRMT] ELC Permit 8/19/2008 $46.85 L1C 1532
[TAX] 12% State 8/19/2008 $5.62 SUP 50095
Total $52.47 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
suspende r more n 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those r es are set forth • 52- 001 -0010 through OAR 952 -001 -0100. You may obtain copje's these rules or direct questions to OUNC at
503.24 .6699 or 1.800.3 .2
Issue By: Permittee Si. ature: � , t � �
1
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: ), ' ; :uQ�/ . , i t 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.
ATLAS ELECTRICAL Fax:5036594944 Aug 19 2008 10:46 P.01
i.
. ;I
414 Electrical Permit Application FOR OFFICE 11SE ONLY
?City of Tigard D a" • r9 08 0 Pemrit No. : £' I S -edT 7
r C „ 13125 $W Hall Blvd., Tigard, OR 97223 Plan Review 1
' Phone: 503.639.4171 Fax 503;598,1960 a D�/B , Other Permit •
I' I C; ,1 R r) w Inspection Line: 503.639.4175 NuG 1 . Date It dy/lir.. ' ruri;; H - ee Page 2 for •
lniennat: ww.tigard -or.gov t .. ' Noti£ • abed
`/
a. . i SR laaeatel Information
1 • q
;'., %: "sti:' ' �� Vii_ w1.1'i �^ 3. •7�, ( 1 .P :71.,.: , 3 y ,r . ,. . r - q : x , 1"I m s ,
'•i- -r n L•1:1 st ,1 i714i .,,:J@ i.;*W� 'wi_ i'Si''6•:.1' _.'Ylil aw..h • - y! ; ... . ;- : :4' , .r•ry F kirit� - .y 3 .y l - -7 Ai V , - , a� : • ,_ - c.k;. 4�. k .���
�..':: ,�•'. ..� � '' , 2 , ,is< � 3 ., '�.i:+o�n� ,c Tit;, - �.,, Y: �:a,n'�: '��''� t'' S.,'�m. •
El Now construction ® Additionlalterati , 1 .1!, .\ `• Please check all that apply (submit 2 sets of plans writems checked below):
it ! ❑ Service or feeder 400 amps or more ❑ BUJ ing over.three stories.
❑ Demolition • ❑ Other: • I
.r rte• a _ ; ,n: � :r.: • m � where the available fault fault ciarent 0 and boatyards.
• ..::: , .•^ ,,, “ , , 4 , 44 "Z,7469 _ ^ :J,�,..4,V,K T : • :,;a less It enceedsl0, ❑ flo es braidings. • R le d or exceeds 14,000 ❑
etarl
(] 1- and 2- family dwelling 0 Commercial/industrial • ❑ Accessory building ' rnerctal - use agrrculMal
amps f or all other installations. bungs.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Firs per• 0 in anon of 75 KVA or
.# f . * ,, ^, r : r _ , , f .. ❑ limergeocy system. largIir separates derived system.
o. , A J �i t9N,, a�s::r'; -a .. • Y ::•' >:.; ❑ Addioroo of new motor load of ❑ "A'V °f^,1 "t
Job no.: 17802 L Job site address: 11462 SW PACIFIC HWY tookt.P or more. oeeppency.
❑ Six or more residential units. 0 Rec6eational vehicle parks,
City/State/ZIP: TIGARD, OREGON 97223 ❑ Healdreare facilities. ❑ Supgly voltage for more than
T dous loca
• tions. ❑ l5arar locati 6001volts nominal.
Suite/bldg. /apt. no.: Project name: AMERICA'S TIRE ❑ Service or feeder 600 amps or more. .,
Cross street/directions to job site: • a Da s , 4 i s ^ • '`Fe -`. ~ • Total ..
aipdoo ' Oty. ti Fes. 1
•
New residential single- or multi- family duelling unit.
Includes.attached garage.
Subdivision: Lot n o. : ' 1,000 sq. R. or less 45.15 4
Ea. add'l 500 sq. ft. or portion • H33.40 • 1
Tax.maplpareel no.: i Limited energy, residential •
:. • r, *, crx r wt ;. f1 75.00 2
. .. Z i0!.:.�!�n".`. e.,f/.Y' ?f: ,
:. -, , :- ;;:s ::r� ' d ;. .. , . _. r,,lF r ' ti (with above sq. R)
1
Limited energy, multi-family.
CONNECT MONUMENT SIGN •' I residential (with above sq. R) 75 2
Services or feeders installation aleeral c and/or relocation
L4 ' 200 amps or less 8 2
•
ill R 0) >g ,k f _s; 1 ; ' '.., . ' 201 amps to 400 amps 106. 2
Name: i 401 amps to 600 amps x}60.60 2
I
601 amps to 1.000 amps 0.60 2 • Address: Over 1,000 amps or volts 54.65 2
•
•
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
• relocation • C
Phone: ( ) I Fax: ( ) 200 amps or less _ t 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 71:q. 401. amps to 599 amps . 1133.75 . • 2
Owner signature: • Date Branch circuits - new, alteration, or extension; per. panel
_ M1 t above service feeder f A. Fee for branch circuits with i
� ; "�' :".. ' '-C At P R50N:k '''' rvce or eeer ee,
�`.,.:'.: ': u•i > 1
r..� ���: :rl� -3• .t. im, ;. 6.65 2
Business name:
. each branch circuit. n
B. Fee for:branch circuits r
w ithout s ervice or fe eder fe 1 46.85
Contact name: ! first branch circuit 146,85 • • . 2 • ,Address: . • • : , . ; Each add'I branch circuit b • 6.65 2
•
Ci / State/ZIP: Miscellaneous (service or feeder not inelsided)
t) Each manufactured or modular - • [' • dwelling, service and/or feeder
Phone: ( ) 90.90 • 2
( )... . .. P { Reconnect only 66.85 2 •
•
E - mail: Pump or irrigation circle 4 11 53.40 2
., ` r - r " ; . •
.. .. ''45b yv :; - i:y ; -v M a'- - .'• { ?'1 X47 "' Sign or outline lighting 53 .. %:i� .. .. .. .... .. '� '•
oaind- •.... ..�.'!� a ?:= r4' ;.. , �. , . vL;:Fc ;. '�: B f' ' I ' 2
i • Signal circuit(s) or limited -
Busi,neSs name: Atlas Electrical Contractors energy panel, alteration, or .,
Address: 4403 SE Roethe Road • . extension. Describe: ' . l'age 2 • . 2
City/State/ZIP: Mllwauki OR 97262 f
h' � • Each additional inspection over allowagt in an of the above • Per'inspection 62.50 • -
Phone: (503) 659 -2212 Fax: (503) 639 -4944 ]nyestigation per hour (1 hr min) . p 62:50 •
• CCB Lic.: 1532 • I Electrical Lic.: 3 -2C I Su iv. Lic.: 5009S Industrial plant per hour . 73.75 • •
• a e ' : '7," � Ll 74 , y r Kam•,:;: �t�,
7// /! '
- r :fif- .:Y.�r� ti�'a!�!'L4n'LHidy::'i_r �.4:;:i� _r.k':
Suprv. Electrician signature, required; : . SubOtal:• 46.85
Print name: TY SHEPERSKY D 8/19/08 •
Plan.review (25% of petmit(('ce):
State surcharge (12% of permit fee): 5.62
Authorized signature: TOTAL PERMIT FEE: 52.47
. Print name: TY SHEPERSKY Date: 8/19/08 This permit application expires if a permit ii-not obtained within 180 •
days after it has been accepted 4 complete. , '
•
• 'Number of inspections allowed per permit. -
1: �DwIainglRmuts�E[.c- Pam;wpp.doc os/ls/pv.. .. aatwstsl'(1��OSlco
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: El_C200B00479
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/19/2008
Phone: (503) 639 -4171 �aNPry 9b A A
Inspection Requests (24 Hrs.): (503) 639 -4175 .1 ��
INSPECTION WORKSHEET FOR DATE: 10/7/2008 TIME: 7 :00AM PAGE: 21
SITE ADDRESS: t 1162 SW PACIFIC HWY
CLASS OF WORK:
SUBDIVISION: AMERICAS TIRE COMPANY LOT #: 003 TYPE OF USE:
PROJECT NAME:
DISCOUNT TIRE COMPANY
DESCRIPTION: (1) branch circuit'for monument sign. Job No. 17802
OWNER: PHONE #:
CONTRACTOR: HALLS PROPERTIES LLC. _ PHONE #: �` -
ATLAS ELECTRICAL CONTRACTORS 503- 659.2212
Inspection Request Scheduled For: Date: •1017/2008 Pour Time:
•e # Inspection D= cription Confirm # Contact # Message
1
F--+ . 4 " ./slab cover � , i01 503 - 901 -9342 N
Corrections /Comments /Instructions: ,'
it) Pkc ) 4 I 1 -.CL- ()IQ S 1`tE _
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
— . ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: NIC)Q Lg Date: IIlit Phone #: (503) 718-
11 - A
__ CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008 -00479
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 81/9/2008
Phone: (503) 639 -4171 *400011•111111w
la
Inspection Requests (24 Hrs.): (503) 639 -4175 'I�I q
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
9/29/2008 7:02AM 33 ' .,
SITE ADDRESS: CLASS OF WORK:
11462 SW PACIFIC HWY
SUBDIVISION: AMERICAS TIRE COMPANY LOT #: 00,E TYPE OF USE:
PROJECT NAME: DI'r.:COUNT TIRE COMPANY
DESCRIPTION: (1) branch circuit for monument sign. Job No. 17802
OWNER: HALLE PROPERTIES LLC, PHONE #:
CONTRACTOR: ATLAS ELECTRICAL CONTRACTORS PHONE #: 503G59 27.12
Inspection Request Scheduled For: Date: 9l29/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 076026 -01 503 -901 -9342 N
Corrections /Comments /Instructions: CA \-1_
d E ftnoni ca Nib vil g WA Li._ - — 1 N51 A L . L .
W.I. (:60.6 Cv'R 1f bliv;11; 15 S 'I ®g .
The electrical installation defects noted
on this report shall be corrected and
an inspection request made within 20
calendar days per OAR 918 - 271 -0030
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
A FAIL yl CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: X7' N 66 L Date: 3 `Itt Phone #: (503) 718- 1•74>