Permit A , CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2002 -00634
DEVELOPMENT SERVICES DATE ISSUED: 12/11/02
' JI 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S136AD-04001
SITE ADDRESS: 11539 SW PACIFIC HWY
ZONING: C -G
SUBDIVISION: VILLA RIDGE
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of lighting for (1) sign.
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:
NORRIS STEVENS HIGHLIGHT SIGN CORP
PACIFIC TERRACE LEASING 8200 SW HUNZIKER
520 SW 6TH AVE #400 TIGARD, OR 97223
PORTLAND, OR 97204
Phone: 503 - 223 -3171 Phone: 503 - 620 -8205
Reg #: LIC 104599
SUP 517SIG
FEES ELE 26- 888CLS
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 12/11/02 $53.40
[TAX] 8% State Tax 12/11/02 $4.27 Rough -in
Elect'l Final
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 f• •• - •- an 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the 0 - s -n Utility N • ic. ion Center. Those
rules a : -t forth in OA 152- 001 -0010 rough OAR 952- 001 -0100. You may obtain copies of these r direct • stio = t. OUNC - r 03)
2466:99 or 1 :00- 332 -23 • • ,'
Iss d By: - �i / Permit Signature: !/ �� ,(/ 4„diA
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
• Electrical Permit Application
Date received: / Afir Q 9 Permit no.: , ..,--,00
^ ._ y, ..1 I! City of Tigard Project/appl. no.: - � i --- . 6',3/ ■
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: 1.101,212 Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 �! l Case file no.: Payment type: .
Land use approval: C� ",,JR0 *— C0 0 ?7/
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory Gir mmercial/industrial ❑ Multi - family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial
JOB SITE INFORMATION
Job address: // 5 - ' Ae,/ A t✓ / Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: I Block: 'Subdivision:
Project name: PAe►ff` pit). 1 ' .574,20, I Description and location of work on premises: NN¢&7a.) / a'4 4 - c.i
Estimated date of completion/inspection: AVIV A L Q ' U )o 00 01 9)7920 riatayl*
CONTRACTOR APPLICATION FEE SCIIEDU.E
Job no: Fee Max
Business name: #11 GM1ii (v/'" 1 /torAi CQM, Description Qty. (ea.) Total no. insp
Address: gP€'I oaf, ou /.G/ryQ t New residential - single or multi-family per
dwelling unit Includes attached garage.
City: -1-170/124, dy I State: eV I ZIP: 17p x3 . Service Included:
Phone: 4440.3,0p I Fax: 491f.,..37 A3- I E -mail: gilpkt Ns 4 1000 sq. ft. or less 4
CCB no.: )o1' fell I Elec. bus. lic. no: 61.4—MC e.�g Each additional 500 sq. ft. or portion thereof • Limited energy, residential 2
City/metro lic. no.: 376 L imited energy, �
it rte) non- residential 2
Each manufactured home or modular dwelling
Signature of supervising e ct (required) Date Service and/or feeder 2
Sup. elect. name (print): M l 4 , _ tI, a1,Qr/= License no: S)rj , 7 Services orfeeders — installation,
alteration or relocation:
PROPERTY OWNER 200 amps or less 2
Name (print): fi4'Gl r l . -rifle/20.4g_ G. WA AS , 201 amps to 400 amps 2
Mailing address: 401 amps to 600 amps 2
601 amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: ,223 j — 3 /7/ I Fax: I E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteratton,orrelocation:
ORS 447, 455, 479, , 701. 200 amps or less 2
201 amps to 400 amps 2
Owner's signature: Date: 0 1110-2. 401 to 600 amps 2
ENGINEER Branch circuits - new, alteration,
Name: or extension per panel:
• A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
Phone: Fax: E-mail: of service or feeder fee, first branch circuit: 2
Each additional branch circuit:
PLAN REVIEW (Please check all that apple) Misc. (Service or feeder not included):
❑ Service over 225 amps- commercial ❑ Health -care facility Each pump or irrigation circle 2
❑ Service over 320 amps -rating of l &2 ❑ Hazardous location Each sign or outline lighting / 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
❑ System over 600 volts nominal more residential units in one structure alteration, or extensions 2
❑ Building over three stories ❑ Feeders, 400 amps or more *Description:
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable In any of the above:
❑ Egress/lightingplan ❑ Other. Per inspection I I I
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application
Permit fee $ .r7 . �0
❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: I / within 180 days after it has been State surcharge (8 %) .... $ l i' a 7
Expires accepted as complete. TOTAL $ - ,5 7 . /0 7
Name of cardholder as shown on credit card
$
Cardholder signature Amount
440 -4615 (6J(X/COM)
4 m
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: -
•
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Inspections per Restricted Energy Fee $75.00
Number of Ins
pe p permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total 4
Check Type of Work Involved:
Residential - per unit
1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40 1
Limited Energy $75.00 ❑ Burglar Alarm
Each Manufd Home or Modular
Dwelling Service or Feeder $90.90 2 ❑ Garage Door Opener`
Services or Feeders ❑ Heating, Ventilation and Air Conditioning System'
Installation, alteration, or relocation
200 amps or less $80.30 2 El amps to 400 amps $106.85 2 Vacuum Systems
401 amps to 600 amps $160.60 2
601 amps to 1000 amps $240.60 2 ❑ Other
Over 1000 amps or volts $454.65 2
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each system $75.00
200 amps or less $66.85 2 (SEE OAR 918- 260 -260)
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75 2 Check Type of Work Involved:
Over 600 amps to 1000 volts,
see "b" above. • ❑ Audio and Stereo Systems
Branch Circuits •
New, alteration or extension per panel ❑ Boi ler Controls .
a) The fee for branch circuits
with purchase of service or ❑ Clock Systems
•
feeder fee.
Each branch circuit $6.65 2 ❑ Data Telecommunication Installation
b) The fee for branch circuits
.without purchase of service ❑
or feeder fee. Fire Alarm Installation . .
First branch circuit $46.85
Each additional branch circuit $6.65 ❑ HVAC
Miscellaneous
(Service or feeder not included) ❑ • Instrumentation
Each pump or irrigation circle $53.40
Each sign or outline lighting $53.40 .❑ Intercom and Paging Systems
Signal circuit(s) or a limited energy •
panel, alteration or extension $75.00 ❑ Landscape Irrigation Control
Minor Labels (10) $125.00
Each additional inspection over ❑ Medical
the allowable in any of the above
Per inspection $62.50 ❑ Nurse Calls
Per hour $62.50
In Plant $73.75 ❑ Outdoor Landscape Lighting
Fees: ❑ Protective Signaling
Enter total of above fees $ ❑ Other
8% State Surcharge $
Number of• Systems
25% Plan Review Fee
See "Plan Review" section on $ * No licenses are required. Licenses are required for all other installations
front of application.
Fees:
Total Balance Due $
Enter total of above fees $
❑ Trust Account #
8% State Surcharge $
All New Commercial Buildings require 2 sets of plans. -
Total Balance Due $
i:\dsts\forms\elc- fees.doc 08/30/01
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested ? � 2- AM PM BUP
Location I 1 :39 Suite MEC
Contact Person Ph ( ) PLM
Contractor /-hIi1i-- Ph ( ) Lo a O - Sa- OS SWR
BUILDING enant/Owner - TPr")C F S ELC a- 0 63
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: � � SIT
Post & Beam
Shear Anchors g 8(9 ter' K
Ext Sheath/Shear J
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
. _ i �i ►;iii �I�
Other: - • -- i ` , f
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab Y / -
Rough -In
Water Service ' /=
Sanitary Sewer •� — �Z
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
UG/Slab
Low Voltage
Fire Alarm
j -
PART ❑ Reinspection fee of $ required before next inspection. Pa _ _ —Kw_ = vd.
S E " -- ❑ Please call for reinspection RE: - — �
Fire Supply Line
ADA A /
Approach/Sidewalk Date / 1 ��C _ �l'7 03 Inspector z (Y Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL