Permit . CITY OF TIGARD ELECTRICAL PERMIT
a COMMUNITY DEVELOPMENT PERMIT #: ELC2007 - 00751
DATE ISSUED: 11/8/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S136AD - 04000
SITE ADDRESS: 11525 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: PACIFIC TERRACE LOT : 007 JURISDICTION: TIG
PROJECT: FAST SIGNS
Project Description: Relocate track lights. Job No. 5873
RESIDENTIAL UNIT TEMP SRVCIFEEDERS 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: 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: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 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 HILLSBORO ELECTRIC
833 NW 170TH DR 21185 NW EVERGREEN PKWY #110
BEAVERTON, OR 97006 HILLSBORO, OR 97124
Phone: Contact #: PRI 503- 439 -9666
FAX 503 - 601 -3680
FEES
Description Date Amount Reg #: ELE 34 -499C
[ELPRMT] ELC Permit 11/8/2007 $53.50 LIC 134481
[TAX] 8% State Surcharge 1118/2007 $4.28 SUP 4941S
Total $57.78 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 = •re - n 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those r -s are set forth 1 0; ' • 2 -• 11 -0010 through OAR 952 -001 -0100. You may obtain copies • • -se rules or direct questions to OUNC at
503.24:.6699 or 1.800.33 344. _
Issued :y: • . __ P Signat i - i A, / 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 INST ' LLATION ONLY
SIGNATURE OF SUPR. ELEC'N: � i - f • 0,1,–.."—.. 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.
11-7-'07 12/8 FROM-Hillsboro Electric 503-601-3680 T-835 P002/002 F-448
' le. ' Permit Application ..... Foil on•Ici.: Usu. ONE\
City of Tigard r 1:\t-i, : . • D a c e a t e fir. / 1741/r/EM Permit No.: 6.4 75
1 sw Halt Blvd., Tiward, 0
Phone: 503.639.4171 Fax: 50 59 Nint,' ,•T' `"'_rit', 4.sji,.1 DatefB : Other Permit:
11
Inspection Line: 503.639.4175 -13 ' I Date Ready/By: 13 See Page 2 far
Internet: www.eltigard,orms KW 0 7 20 I Notified/Method: EA Supplemental information
' ' ::. .:•'. • .. .. ''.. -* • • •• . - .. : TYPE 0 • :ART), • . . , '. :...;. .-:. .: :.:. • :,:., . .: • .. PLAN REVIEW .. • . •••••• ' :. :....,...:
0 New construction jeraliYan)agatatialthe a nent _ . Please check all that apply:
0 Demolition . AMDING D 7 SI ( I N . . OServiee•over 725 amps, Comm 'I ['Hazardous location
Service over 320 amps - rating 0Buildng over 10,000 sq. ft.,
' ....'...... • '.• • ECM' OF CONSTRICTION- . ..:' s ' .:;'• ::. • . .. .. • .. . [' of I. and 2-family dwellings 4 or more new residential
0 I- and 2-family dwelling laEommercial/industrial 0 Accessory building ['System over 600 volts nominal units in one structure
CIBuilding over three stories :Weeders, 400 amps or more
El Multi-family 0 Master builder ID Other:
Occupant load over 99 persons DManufactured structures or
. :. .:-:•...!.:...!:,:::::;;.:.”•.........:!.• .
JOB SITE INFORMATION AND LOCATION : : .,..'•.:1''.:.! .:•:.':.'.!.!*, . 04,9•ess/lighting plan RV park •
. ...-
DHealth-care facil °Other:
b site address: I 1 5 56-_...CLf. :."). k - Submit sets of plan s with any of the above. •
City/State/ZIP: 7 1 q qv e i r) 12 9 '1 3 14 _ ,.'" `•-•:
The are not applicable to temporary construction service.
,: SCREKILE..:!: ' ::!!:'.'•'!•:: •!:.:•. 7
Suite/bldg,/apt..no.: 1 Project name: .r 4.. 3 la
Description I Qty. I Ft* I TOW I ..
Cross street/directions to job site: New residential single- or multi-family dwelling unit.
Includes attached garage. .
- _ 1.00D sq. ft. or fess 145.15 4
Subdivision: . — 7 Lot no.: Ea. WWI 500 sq. ft or portion 33,40 I
Limited energy, residential 75.00 2
Tax map/parcel .no.:
.., •••<_ ;.• .. ..,.....,,.... .... .-, : .---•-•—=:''..-7---1-••••,--. DESCRIPTION _,,. .. ..,.. . .. , , ., r •- r .....„, Limited energy, non-residential 75.00 2
B
-"-•:. :i...; -:•51•::•"!::- : .f . :`,• - :. :..,:....-';': EI-;EIPTIPl OF WQRK: Each manufactured or modular
' •
dwelling. service end/or feeder 90.90
Services or feeders installation, alteration, and/or relocation 2
200 amps or less; • III 80.30 2
. 201 amps to 400 amps 106.85 2
! ."'::::'!•::;;•:-:'; . ' .r.
401 amps to 600 amps 160.60 2
Name:
• 601 amps to 1.000 amps 240.60 2
Address: • • Over 1,000 amps or volts 454.65 • 2 • - Reconnect only 66.85 2
City/State/ZIP:
Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( )
200 amps or less 66.85 I . 1
Owner installation: This installation is be ing made on property that I own which is not 201 amps to 400 amps 2
amps intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 11023:7350
401 am to 600 amps • 2
Owner signature: . Date: Branch circuits- new, alteration, or extension, per panel •
..... ,,_, P ERSON ,
Aopifickwri ; A. Fee for branch circuits with
scmcc or feeder fee, each
6.65 . 2
Business name: _ branch circuit
. — B. Fee for branch circuits
Contact name:
without service or feeder fee, /
each branch circuit 46.135 i/6 85 2 •
Address:
Each addi branch circuit 11111•32311117E.1- El
City/Statc/ZIP: • . Miscellaneous (service or feeder not included)
_ . _ '
Pump or irrigation circle 53.40 2
Phone: ( ) ii7x:: ( )
_.... Sign or outline lighting 53.40 2
E .
— . Signal circuit(s) or limited-
........ ....„ . ... . •
....;!.: 2 , : ;j!:4;•- r .'•.'::'''''.'CONTRACTOR:.::' , ..i.::::::::2.::;',:it•:.:7."!•:•;• : ..:i'...:: energy panel. alteration or.
extension. Describe: Page 2
Business name: Hillsboro Electric L . L . C - i
Each additional inspection over allowable in any of the above
Address: . 1
185 NW Evergreen PKWY Ste #110
■■•■•■•••••••. Per inspection 62.50
City/State/ZIP: Hi J. 1 sboro , OR . 97124 Investigation per hour ( I hr min) 62.50 II .
Industrial plant per hour 73.75
PhOnc: (503) 4 3 9 -9666 Fax:(503 ) 601-3680
.:...;' ',-: -.......' :: ELECTRICAL :PERMIT PEES*, : .....•:: - .;::...,
. . .
COI Lic.:1 34481 1 Electrical Lic.:3 4 I &spry. Lic.: 49418
Subtotal
Suprv. Electrician signature, required: ZA
—
, j• i ,4.
i /1,/ ,..er_ei r _. 5 •S__-.
Plan review (7.5% of permit fee) -.--
State surcharge OM of permit (cc) -.( fz121
Print name: Joey Vitacco Date: i I i•-• i
a .- 1
TOTAL PERMIT FEE 6 7
Authorized signature: • • This permit application expires if a permit is not obtained within 180
• days after it bat been accepted as complete
Print name:
Far • Fee methodolow sla by Iri-County Building Industry Service Board
.....
** Number of inspections per permit allowed.
imaimingurermitsIBIX-Pcrinitappeac IVO 440 lotaVCOmAvgg
. .
CITY OF TIGARD
BUILDING DIVISION . ' PERMIT #: ELG2007 00751
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/8/2007
Phone: (503) 639 -4171 „� i '�
Inspection Requests (24 Hrs.): (503) 639 -4175 �� I �..
INSPECTION WORKSHEET FOR DATE: 1/17/2008 TIME: 7 : 00AM PAGE: 66
SITE ADDRESS: 11525 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: PACIFIC TERRACE LOT #: Q07 TYPE OF USE:
PROJECT NAME: FAST SIGNS
DESCRIPTION: Relocate track lights. Job No. 5873
OWNER: SMITH, EDITA M, PHONE #:
CONTRACTOR: I - IILLSBORO ELECTRIC PHONE #: 503-439 -9666
Inspection Request Scheduled For: Date: 1/17/2008 Pour Time:
Code # Inspection Description hfirm Contact # Message
199 Electrical final 063374 -01 5034399666 N
Corrections /Comments /Instructions:
kill\)
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: v r ("5 Date: 1 • I 1" n Phone #: (503) 718- Ititit