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Permit • CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2004 -00596 r = BA DEVELOPMENT SERVICES DATE ISSUED: 9/17/2004 rl II 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 PARCEL: 1S136AD -04000 SITE ADDRESS: 11535 SW PACIFIC HWY SUBDIVISION: VILLA RIDGE ZONING: C -G BLOCK: LOT : 007 JURISDICTION: TIG Project Description: Hook up for (2) signs to existing service. 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: 2 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: SIGNCRAFT LLC 9033 SW BURNHAM TIGARD, OR 97223 Phone: Phone: 503 - 639 - 4910 Reg #: LIC 155420 ELE 34- 674CLS FEES Description Date Amount Required Inspections [ELPRMT] ELC Permit 9/17/2004 $106.80 [TAX] 8% State Surcharge 9/17/2004 $8.54 Rough - Elect'l Final Total $115.34 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: .1422 Permit Signature: S, r ,p_ QI 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• DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day - -5'67Al —v• zY Electrical Permit Application FOR OFFICE USE ONLY CI of Ti and Received 4 permit No.: /� n� /� �' g RECEIVED Date/By: /(p /Qy r 6� /c2A�(/V-SI{ 13125 SW Hall Blvd., Tigard, O Plan Revie Phone: 503.639.4171 Fax: 503.598.1960 41 " 11 0'..''''' 00 •t\ DateB Other Permit: Inspection Line: 503.639.4175 SEP 16 � Date Ready/By: Juris: RI See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information $ C �� 1 PL New construction U 1 on/a teratio replacement Please check all that apply: ❑ Demolition ❑ Other: ❑Service over 225 amps, comm'l ❑ Hazardous location ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., • CATEGORY -OF. CONSTRUCTION . , - of 1- and 2- family dwellings 4 or more new residential ❑ 1- and 2- family dwelling D,Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑ Multi - family ❑Master builder ❑ Other: ❑Building over three stories ['Feeders, 400 amps or more ❑Occupant load over 99 persons ❑Manufactured structures or ' - ' ' JOB" SITE INFORMATION AND .LOCATION , RV park ❑E g ress /li P Job no.: I Job site address: \( &. S a)•/ r Pe. IA ❑Health -care facility ❑Other: Submit 2 sets of plans with any of the above. City / State/ZIP: - 116-464) _ C"7 2:2:1 The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: I Project name: piC1r / FEE* SCHEDULE:- Qty. Description I Qty. I Fee. I Total I ** Cross street/directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: I Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1 Tax map/parcel no.: Limited energy, residential 75.00 2 Limited energy, non - residential 75.00 2 .:DESCRIPTION OF .WORK Each manufactured or modular V v P E a - a C �� / XI 7D N � _ dwelling, service and/or feeder 90.90 2 K— l- l Services or feeders installation, alteration, and/or relocation \11 200 amps or less 80.30 2 ' , '•' ❑.;PROPERTY. OWNER „ 1 ' ' ❑ TENANT, 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: . b (Tii 1 ' ,M \ 601 amps to 1,000 amps 240.60 2 Address: (' ,4 �- • ' (J i t /\,� e r t/ °' Over 1,000 amps or volts 454.65 2 V , t Reconnect only 66.85 2 City/State/ZIP: 40,1"-(A446 UV ,�A Temporary services or feeders installation, alteration, and/or Phone: (569z3 �) —I) I Fax: ( ) 2000 0 a 2 a mmps p s 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 . , ❑ .APPI:IICANT : "_ _ :. - - <' ❑ CONTACT PERSON _ A. Fee for branch circuits with service or feeder fee, each Business name: ,, __ '' � branch circuit 6.65 2 �� �/� B. Fee for branch circuits Contact name: J o- YC, ( 0 I. I without service or feeder fee, � 0 2;.? �� �� , A _ each branch circuit 46.85 2 Address: �4 ` Each add'1 branch circuit 6.65 2 City/State/ZIP: Il 6i OIL _ cr-72.2,7 Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: (03) ( 39 (,E0 I Fax: : ( ) 9 e -14er ci 9 Sign or outline lighting 53.40 2 E ,f Q_ 4 ?� Z, CO 1 ' " Signal circuit(s) or limited- i = ", - CON�I'RACTOR ,, ' energy panel, alteration, or ' ' extension. Describe: Page 2 2 Business name: `i / r Each additional inspection over allowable in any of the above Address: d � ���� �� �� Per inspection 62.50 City/State/ZIP: 1' i) ® ca g 3 Investigation per hour (1 hr min) 62.50 Phone: ( ) Gr yl �1 (0 0 l ( ( 9 I Fax: ( ) (9*/ . 1 C( Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES* - CCB Lic.: ) 20 I Electrical Lic .'.34 -‘61L .0L Suprv. Lic.:'SS(6 Subtotal 1 .! Suprv. Electrician signature, required:� Plan review (25% of permit fee) Print name j� (1n l I I Date: q n l b C7 fj State surcharge L of permit fee) 1J TOTAL PERMIT FEE Authorized signatur - . TAO This permit application expires if a permit is not obtained within 180 , days after it has been accepted as complete Print name: p ■ ( ( Date: q -1 Of • Fee methodology set by Tri- County Building Industry Service Board ( •• Number of inspections per permit allowed. i:\ Building \Permits\EL.C- PelmitApp.doc 17103 440 - 4615[(10 /O2JCOM/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 system $75.00 (SEE OAR 918 260 - 260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ 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 is\ Building \Pemtits\ELC- PemtitApp.doc 04/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested l AM PM BUP Location / Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC i'& Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear _N I A Int Sheath/Shear Framing Insulation Z S(G-711S Drywall Nailing t' Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL • MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In 5(60 UG/Slab Low Voltage F e Alarm PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. El Please call for reinspection RE: ❑ Unable to inspect — no access Fire ADASupply Line © .., /� 4P Wi35t6_ Approach/Sidewalk Date [ Inspector - Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL