Permit CITY OF T ELECTRICAL PERMIT
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PERMIT S: D: 10/13/98
��P�JfI\ DEVELOPMENT SERVICES � DATE ISSUED: 10/ 13/98
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171
PARCEL: 1S136CD -00200
SITE ADDRESS... :11705 SW PACIFIC HWY #L
SUBDIVISION ° °..: ZONING :C -G
BLOCK ° LOT ° ° ° ° ° ° ° ° ° ° ° ° °: JURISDICTION: TIG
Project Description: Permanent 102 sq. ft. wall sign
- -- RESIDENTIAL UNIT --- -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS - 0 0 - 200 amp - 0 PUMP/IRRIGATION. .: 0
EACH ADD'L 500SF ° °.: 0 201 - 400 amp ° 0 SIGN /OUT LINE LTG..: 1
LIMITED ENERGY.....: 0 401 - 600 amp - 0 SIGNAL /PANEL. ° ° ° °..: 0
MANF° HM/ SVC /FDR °° 0 601 +amps -1000 volts.: 0 MINOR LABEL (10)...: 0
- - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- -
0 - 200 amp : 0 W /SERVICE OR FEEDER: 0 PER INSPECTION ° 0
201 - 400 amp......: 0 1st W/0 SRVC OR FDR °: 0 PER HOUR °..........: 0
,401 - 600 amp : 0 EA ADD'L'BRNCH CIRC: 0 IN PLANT ° 0
601 - 1000 amp.....: 0 PLAN REVIEW SECTION
1000+ amp /volt - 0 ) =4 RES UNITS........: ) 600 VOLT NOMINAL ° °:
Reconnect only ° 0 SVC /FDR )= 225 AMPS..: CLASS AREA /SPEC OCC °:
Owner: -• FEES
BIG 5 SPORTING GOODS type amount by date recpt
BY WYSE INVESTMENT SERVICES CO PRMT $ 40.00 B 10/12/98 98- 309897
200 MARKET STE 345 5PCT $ 2.00 B 10/12/98 98- 309897
PORTLAND OR 97201
Phone #:
Contractor:
HIGHLIGHT SIGN CORP $ 42.00 TOTAL
8430 SW 37TH
RE6UIRED INSPECTIONS
PORTLAND OR 97219 Ceiling Cover Elect'1 Service
Phone #: 499 -5821 Wall Cover Elect'l Final
Reg #. ° : 000104
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 190 days. ATTENTION: Oregon law requires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952 1 -0010 through OAR 952- ,.,, -1997. Yo may obtain a copy
of these rules or direct questions to OUNC b calling : %3)246 -1997. / /
i
Permittee Signat�.�re :�/ /f / Issued By: �l 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: .0
DATE: /
LICENSE NO:
+4-++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7 :00 p.m. for an, inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++,+ ++ + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY(OF TIGARD Electrical Permit Application Plan Check #-
13'125 SW HALL BLVD. Rec'd By 13, InkAO 6 41.4-
TIGARD OR 97223 Date Rec'd lt7 -
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST t ^� �. U
Inspection (503) 639 -4175 Print or Type Permit # �� 0 - 0(i4
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development ? C.. ' . _5 i ?O s !► Number of Inspections per permit allowed
Name (or name of business) 8i6r siberG gf�-, 6-00v) Service included: Items Cost Sum
Address /170S
! 7c S - I -I C t•c_ 4E09) 4a. Residential - per unit
City/State/Zip Each additional 500 sq. ft. or
1000 sq. ft. or less $110.00 4
i
ty p &A-rz-, , G �-
Commercial 2 Residential ❑ portion thereof $25.00 1
Limited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of al urrent licenses 4b. Services or Feeders
Electrical Contractor . Lt C. [ RP Installation, alteration, or relocation
200 amps or less $60.00 2
Address . g200 kIGil 7-+ f;►Z 201 amps to 400 amps $80.00 2
City 1(a 1 State C3 ZipZ Z 401 amps to 600 amps $120.00 2
Phone No. g 601 amps to 1000 amps $180.00 2
Job No., Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. _ -it* • CL-5 Exp.Date 2-11 -C20 Reconnect only $50.00 2
OR State CCB Reg. No. I b tic Exp.Date ' -1 _- -- e 4c. Temporary Services or Feeders
COT Business Tax or Metro No. o.Date L . -' -- Installation, alteration, or relocation
/ e 200 amps or less $50.00 2
201 amps to 400 amps $75.00 2
Signature of Supr. Elec'n J.-L / ,a_. - - � 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No6(637 7 Exp.Date 10 ( °- 7 j see "b" above.
Phone No. 6.0 8'lO S
4d. Branch Circuits
• New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address Each branch circuit $5.00 2
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 2
The installation is being made on property I own which is not Each additional branch circui $5.00 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle $40.00 90•C°:)2
2
Each sign or outline lighting $40.00
3. Plan Review section (if required):* Signal circuit(s) or a limited energy
panel, alteration or extension $40.00 2
Minor Labels (10) $100.00
Please check appropriate item and enter fee in section 5B.
4 or more residential units in one structure 4f. Each additional inspection over
Service and feeder 225 amps or more the allowable in any of the above
System over 600 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00
as described in N.E.C. Chapter 5 In Plant $55.00
* Submit 2 sets of plans with application where any of the above apply. 5. Fees: a o
Not required for temporary construction services. 5a. Enter total of above fees $ �' '
5% Surcharge (.05 X total fees) $ Z 0 C)
NOTICE Subtotal $
5b. Enter 25% of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account # q , m
Total balance Due $
I: \DSTS \ELC96.APP Rev 9/96
3/7/00 Activities for Case #: ELC98 -00619
8:46:59 AM
Assigned • Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. -Level By Updated Notes
ELCC001 Application received 10/12/98 B RECD BON 10/12/98
ELCC003 Permit created 10/12/98 B DONE BON 10/12/98
ELCC700 Ceiling Cover BON 10/12/98
ELCC720 Wall Cover BON 10/12/98
ELCC730 Elect'I Service BON 10/12/98
ELCC799 Elect'I Final BON 10/12/98
ELCC117 DST Post - Review complete 10/12/98 B DONE BON 10/12/98
ELCC400 (F)Ready to issue 10/12/98 B PASS BON 10/12/98
ELCC500 (F)Issue permit 10/13/98 GEO PASS DST 10/13/98
ELCC799 Elect'I Final 11/3/98 CD FAIL CD 11/3/98 need varification of listing &
sign disconnect
ELCA920 Miscellaneous action 2/14/00 JMT DONE No Hold JMT 2/14/00 research inspection request
ELCA580 Expired by limitation 3/2/00 JMT DONE No Hold JMT 3/2/00 per Hap W.
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