Permit CITY OF TIGARD ELECTRICAL PERMIT
111 ° PERMIT #: ELC2008 00354
COMMUNITY DEVELOPMENT DATE ISSUED: 6/20/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S136AD-04301
SITE ADDRESS: 11475 SW PACIFIC HWY ZONING: C - G
SUBDIVISION: VILLA RIDGE LOT: 002 JURISDICTION: TIG
PROJECT: GATOR'S PUB
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:
SHAPIRO ENTERPRISES LLC HIGHLIGHT SIGN CORP
BY MIKE LEVY PO BOX 23667
17310 SE 45TH ST TIGARD, OR 97281 -3667
BELLEVUE, WA 98006
Phone: Contact #: PRI 503 - 620 - 8205
FAX 503 - 624 -3725
FEES
Description Date Amount Reg #: ELE 37- 660CLS
[ELPRMT] ELC Permit 6/20/2008 $53.40 LIC 104599
[TAX] 12% State Surchar 6/20/2008 $6.41 SUP 517SIG
Total $59.81 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 for
more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification C-nter. Those r -s are set forth in
OAR 952 -00 : ; - • ugh OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC - 503.246.6. • ° • 1.800.33 -344.
1. /
Issue By: ; �/i ,,L P ermittee Signature: ,'��i., • �.`,(�`
4r,...-- f
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.
66 a a-OV t 0 / 3 ,
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard y Received � n �, G , ,�
ECEtVE Date/By: W f j Permit No.: C.�styg--Q, 3j
; � 13 125 SW Hall Blvd., Tigard, OR 9 Plan Review II Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
TI c. n It D Inspection Line: 503.639.4175 JUN 2 02 Date Ready/By: 3u ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: "7 Supplemental Information
TYPE OF WEIII1 V OFF TII PLAN REVIEW
[iKr construction ❑ Addition/a1tr 1L 14IbM1�fitVISION Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: 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 emmercialindustrial ❑ 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 ", "1 -2 ", "1 -3 ",
Job no.: Job site address: j /�• 75. 9wr ilk., Fie- ht* y Six or s. occupancy.
/ ❑ Six o or r more a r reesidential units. ❑ R ecreatio
nal vehicle parks.
City/State /ZIP: ' t71 '4 ❑ Health -care facilities. ❑ Supply voltage for more than
t� . ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ('fbQ'j,J, ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
1/ 4' 7S Su) lP)C � 7Z�-.� New residential single - or multi- family dwelling unit.
ht, Inclodes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'l 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
/OPP) hciPig 2 0 yTA) P,lt Id - 1,10ASA { /id residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
1�'�f'/tT7� of ' 7 V47VR4f 200 amps or less 80.30 2
[}PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 5 1 14,1411/6A .- /gl {. /10
401 amps to 1, 0 amps amps 140.60 2
7 • 601 amps to 1,000 amps 240.60 2
Address: / / 4 pg.,. Meow /t v9. 97. Over 1,000 amps or volts 454.65 2
City/State /ZIP: rpihozo t ok. 9r7A 3 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (,174, OZ 9 s 07 r , Fax: (j ) gy3 ^ /79-, 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: A. Fee for branch circuits with
alEPPLICANT I [ '1 NTACT PERSON above service or feeder fee, 6.65 2
each branch circuit _
Business name: 14/91t J19 - c, I9/ 0 B. Fee for branch circuits
Contact name: �i(f .. j ell. without service ui feeder fee, 46.85 2
first branch circuit
Address: / 7() SW • Each add'1 branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: IsE80 ' /aidepQ t9,2, Each manufactured or modular n,, dwelling, service and/or feeder 90.90 2
Phone: JQ ;) �919-drst7� Fax: : (1"031 Gog4ti.. -37016- Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting J > 53.40 53. lb 2 -
Signal circuit(s) or limited -
Business name:
H S' 9 teA, . energy panel, alteration, or
Address: 1 g ?Ur Sw , 1 30, L7►)� extension. Describe: Page 2 2
City/State /ZIP: g (4.4t547 . ena Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (igjy) pppO. -8' Fax: (J ) (019gi. 0 S. Investigation per hour (1 hr min) 62.50
CCB Lic.: (t7L}' 5,9- Electrical Lic.: Sid 5 S uprv. Lic.: $ industrial plant per hour 73.75
�77 A ,Q ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: zel / Subtotal: 1/4 5".
AA
Print name: ,,// /� ,, Dat� Plan review (25% of permit fee):
K ;' �•-f� , G�� /�� State surcharge (12% of permit fee):i
Authorized signatu 7;, j , , /� TOTAL PERMIT FEE: 5q. g
qh �� This permit application expires if a permit is not obtained within 180
Print name: „!l ic�i >alrL , / � ,.p Date 6hv va, days after it has been accepted as complete.
/! i/f'� • Number of inspections allowed per permit.
I:\ Building \PermitstELC- PermitApp.doc 05/23/06 440- 46I5T(I I /05 /COM/wEB
Electrical Permit Application - City of Tigard . . - -
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other.
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system •
(SEE OAR 918- 309 -0000) •
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls N
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
•
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling • -
❑ Other > '
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\ Building \Peimits\ELC- PennitApp.doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC200B -00354
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/2012008
Phone: (503) 639- 4171 ,. ur�,,P l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/19/2008 TIME: 7:00AM PAGE: 36
SITE ADDRESS: 11475 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: VILLA RIDGE LOT #: 002 TYPE OF USE:
PROJECT NAME: GATOR'S PUB
DESCRIPTION: (1) sign lighting.
OWNER: SHAPIRO ENTERPRISES LLC, PHONE #:
CONTRACTOR: HIGHLIGHT SIGN CORP PHONE #: 503 - 620 - 13206
Inspection Request Scheduled For: Date: 9/19/2008 Pour Time:
Code # Inspection Description - # Contact # Message
140 Sign installation 075615 -01 503- 318 .650E N
•
Corrections /Comments /Instructions:
s PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: " Nob LE" Date: 8009 1 p Phone #: (503) 718 - Vilik)