Permit TIGARD CITY OF ELECTRICAL PERMIT
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T V PERMIT #: ELC2005 -00702
,�_� DEVELOPMENT SERVICES DATE ISSUED: 9/20/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S136AD -04000
SITE ADDRESS: 11513 SW-PACIFIC HWY ZONING: C -
SUBDIVISION: PACIFIC TERRACE LOT : 007 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:
SMITH, EDITA M VANCOUVER SIGN COMPANY, INC
833 NW 170TH DR 6615 SW HWY 99
BEAVERTON, OR 97006 VANCOUVER, WA 98665
Phone: Phone: 360 - 693 -4773
FEES Reg #: ELE 37 -46CLS
Description Date Amount LIC 63951
SUP 525SIG
[ELPRMT] ELC Permit 9/20/2005 $53.40
[TAX] 8% State Surcharge 9/20/2005 $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 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 Center. Those rules are set
forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699 or
1- 800 - 332 -2344.
Issued By: � ty . , e. 104 - 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.
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SC.fJ 0 0 5 —bea - )0
Electrical Permit Application roll OFIICL USE ONLY
City of Tigard Received : Permit No.: ��/ /� �/;3�OO / 7 0 , 2 _ 13125 SW Hall Blvd., Tigard, OR 97223 any �� �� ��` x�aC(J
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 / 4a.; � + Date/By: Other Permit
Inspection Line: 503.639.4175 -.1 Date Ready/By: hub: H See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: '- 1 (,r Supplemental Information
TYPE OF WORK PLAN REVIEW
0 New construction 0 Addition/alteration /replacement - Please check all that apply:
OService over 225 amps, comm'l ['Hazardous location
Demolition Other: j \ *04 \ NSA Aa A�o N
['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 ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
['Building over three stories ['Feeders, 400 amps or more
❑ Multi- family Master builder ® Other Sip, DNS\ A0�A�Iw ['Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION J ❑Egress/lighting plan RV park
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Job no.: Job site.address: t
❑Health-care facility Doer
`\�� Sw P p\t i... Wr Submit 2 sets of plans with any of the above.
City/State/ZIP: `� p,4 �� X11133 t The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: ' Project name: c r�y A MM tiAt AI S D FEE* SCHEDULE
^^ ALA Description I Qty. I Fee. I Total I ••
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Cross street/directions to job site: 1"4 W., 1ktf...y i P AL- � `(:. 'lei f RLt. 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
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited en
DESCRIPTION OF WORK energy, non - residential 75.00 2
Each manufactured or modular
dwelling, service and/or feeder 90.90 2
MN S k AIkANNO N (% '1, \vr■oi M e.0 w A\ S∎ y a . Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I EL TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: V ■I'Mky 1 M tAik•1'1\1 jS ActibuNsi 601 amps to 1,000 amps 240.60 2
Address: 115 SW P f tt �� Over 1,000 amps or volts 454.65 2
C Reconnect only 66.85 2
City/State/ZIP: n
A1 U �1 a'13 Temporary services or feeders installation, alteration, and/or
(
• . 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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
❑ APPLICANT I i$ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: V 03 Cp\N Lr S i 9 N GO ett AN y branch circuit
B. Fee for branch circuits
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Contact name: "Ti t� t k c., ke ( without service or feederfee,
Address: �J each branch circuit 46.85 2
1 S NF r1V"y q°1 Each add'l branch circuit 6.65 2
City/State/ZIP: V �,
pV V e � , A 4 ‘ CA a Miscellaneous (service or feeder not included)
Phone: (3L0) 60%3 �-�-7 Fax: : ('r ` Pump or irrigation circle ■ 53.40 2
3 i o ) 6° 13 " a Sign or outline lighting • . / 53.40 2
E -mail: 4 Kei ter az V AN S\' t' Lp .Co IN Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: • : • Page 2 2
Business name: V S 1yN Co •
Address: �f r� N 11 � o1 Each additional inspection over allowable In any of the above
V ! 1 \ Per inspection 62.50
City/State/ZIP: V (N c _ , Q. ( t t , a Gi i, C (5 . Investigation per hour (1. hr Lain) • • 62.50
Phone: ( ) G�3 _ �.� 1 Fax: 1 ( � O � Industrial plant per hour i 73.75
�3 ELECTRICAL PERMIT FEES*
CCB Lic.: 3C\C,1 Electrical Lic.: S".--: Suprv. Lic.: 513, Subtotal y 6
Suprv. Electrician signgture, required: Plan review (25% of permit fee
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Print name: ' v v •
41 ' IS 6 S State surcharge (8% of permit feed 6/,4 6/,4 '7
r).4Sw 5 c tys A Date:
�u TOTAL PERMIT FEE
Authorized si
gria re:
w'� P This permit application expires If a permit is not obtained within 180
days after It has been accepted as complete
Print name: k 1 Date: • Fee methodology set by Tri-County I h P fie, F Cf �I `� f * * Number of inspections per permit Building Industry Service Board
i :03uilding\Permits0E2-GPe mitA,p.doc 12/03 440 4615T(10 /02/COM/WEB .. •
CITY OF TIGARD
BUILDING DIVISION -' PERMIT #: ELC2005 -00702
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/2012005
Phone: (503) 639- 4171wtllll
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 12/1412005 TIME: 7 :01AM PAGE: 51
SITE ADDRESS: 11513 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: PACIFIC TERRACE LOT #: 007 TYPE OF USE:
PROJECT NAME: FAMILY MARTIAL ARTS
DESCRIPTION: Sign lighting.
OWNER: SMITH, EDITH M, PHONE #:
CONTRACTOR: VANCOUVER SIGN COMPANY, INC PHONE #: 360 - 693-4773
Inspection Request Scheduled For: Date: 12/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 023415-01 360-693-4773 N
Corrections/Comments/Instructions:
QC? t L N - - 5 ktk ,tJ
�]
airAvilD6 0141 btf wit' 6A Wsr.4 s,
The electrical installation defects noted
on this report shall be corrected and
an inspection request made within 20
calendar days per OAR 91S- 271 -0030
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: t _ Phone #: (503) 718 - 1 1 4 0 •
CITY OF TIGARD
BUILDING DIVISION 1 �/
DATE PERMIT # : ELC2 9/20/2005 5 -00702
13125 SW Hall Blvd., Tigard, OR 97223 /
Phone: (503) 639 -4171 - /emu '4'ljll
Inspection Requests (24 Hrs.): (503) 639 -4175 .�' . F.
INSPECTION WORKSHEET FOR DATE: 12/22/2005 TIME: 7:03AM PAGE: 54
SITE ADDRESS: 11613 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: PACIFIC TERRACE LOT #: 007 TYPE OF USE: �C�
PROJECT NAME: FAMILY MARTIAL ARTS - --`-'b TA— 7T1� 11 N i
DESCRIPTION: Sign lighting. 'Z, A 9. \:Cj� -)s )JA
OWNER: SMITH, EDITH M, PHONE #:
CONTRACTOR: VANCOUVER SIGN COMPANY, INC PHONE #: 360;_69_3-A773
*L�C e F
Inspection Request Scheduled For: Date: 12/2.2/2005 . Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 023894 -01 503 - 209 -6915 N
Corrections /Comments /Instructions:
Abes Lb L \ o\ ((\v d\ lion. ru nite
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
,, FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Alw ci"----- L /_ - Date: /ice ° 2 Phone #: (503) 718 C
CITY OF TIGARD _
BUILDING DIVISION 0 PERMIT #:EJL -66702_
13125 SW Hall Blvd., Tigard, OR 97223 i DATE ISSUED:
�
Phone: (503) 639 -4171 - my ' r �°41 ' i'I
Inspection Requests (24 Hrs.): (503) 639 -4175 W 11-
INSPECTION WORKSHEET FOR DATE: 1 2/7A / TIME: PAGE:
SITE ADDRESS: 1 i 1 a L• , ci- (. CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: /
DESCRIPTION: MA 1 r V \ 6X'4 A-("
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
1 Lk 0 4i. 5-4■3 le- k/)
■ G el 1—;►n c✓t
Corrections /Comments /Instructions: G
AI ,E,(/ (c›Opt
I , CI . , I (
. / .,,,,,-
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: /., , / / . Date: I - Phone #: (503) 71817//