Permit CITY ELECTRICAL PERMIT
ITY O F TIGARD G A R�
PERMIT #: ELC2001 -00185
illA DEVELOPMENT SERVICES DATE ISSUED: 4/11/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 102AA -00600
SITE ADDRESS: 11940 SW PACIFIC HWY A
SUBDIVISION: TIGARD HIGHWAY TRACTS ZONING: CBD
BLOCK: LOT : 012 JURISDICTION: TIG
Project Description: Installationof sign lighting for two signs, SGN2001 -00068 & SGN2001- 00069.
Job No. 5- 27397.
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:
ALPROP CO RAMSAY SIGNS
6149 SW SHATTUCK RD 9160 SE 74TH AVE
PORTLAND, OR 97221 PORTLAND, OR 97206
Phone: Phone: 777 -4555
Reg #: SUP 157SIG
LIC 63422
ELE 26 -106cl
FEES Required Inspections
Type By Date Amount Receipt Wall Cover
PRMT CTR 4/11/01 $106.80 2720010000( Elect'l Final
5PCT CTR 4/11/01 $8.54 2720010000(
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 rul- - . • •p - s u e Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 thro - OAR 952 - 001 -0080. You may obt copies of these rule or direct questions to OUNC at (503)
246 -1987. '
PERMITTEE'S SIGNATURE IS UED BY: l� 411
OWNER INS ALLATION ONLY
The installation is being ma a on • operty 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
Y' t
A Electrical Permit Application
Date received: 9 // O/ Permit no.: FedPo l —CO /gs
` 2.' i 1 � 1 City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: I Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approval:
TY P1. OF PERMIT
O 1 & 2 family dwelling or accessory 1-commercial/industrial O Multi- family O Tenant improvement
ew construction Addition/alteration/replacement other. SI CZ 1 9 O Partial
JOB SITE INFORtNIAT1ON
Job address: it9 46 50N , VACItt Q. 4-vJ Bldg. no.: Suite no.: -p. Tax map /tax lot/account no.:
Lot: I Block: (Subdivision: 1'A.- tpie.-- pl_prZA,
Project name: Pd. e.w.tr3 e. pvwp',TEI >l Description and location of work on premises: -to =I Q Stp.AL. .1 SETS e
Estimated date of completion/inspection: ?A•t. ct +A' N EL— L E.fii2.S OKI 1 -e-E ' et t ?4 I7-t+ t W ESTp t DE
CONTRACTOR APPLICATION FEE SCHEDULE
Job no: 5 — 29397 Fee Max
Business name: IRA- As StQA S Description Qty. (ea) Total no. [lisp
i- � New residential - single or mall- family per
Address: a 1(a0 s.E. 7L4 A.de ' dwelling unit.lncludesattadredgarage.
City: 1 ,2:r -A-N b I State:pl.I ZIP: q-) Za (, Service included:
P(4W — 7'77 -4,555 I Fax: 777 -b220 I E -mail: 1000 sq. ft. or less 4
Each additional 500 sq. ft. or portion thereof
CCB no.: [ 4,22 I Elec. bus. lic. no: 24 iO (p CLS 510 l Limited energy, residential 2
City /metro lic. no.: Limited energy, non- residential 2
14 _ I I_0 ( Each manufactured home or modular dwelling
Si at of supervising electrician (requir ) Date Service and/or feeder 2
Sup. elect. name(print):JirM j_, $LAG{LCl2 Licenseno:'N57 Se^t orfeeders-t installation,
alteration or rel
PROP( RTY �OWNER 200 amps or less 2
Name (print): \ � 1 2.Q W
• 201 amps to 400 amps 2
g (0 (� St,) 401 amps to 600 amps 2
Mailin address: c] a- u, 601 amps to 1000 amps 2
City: f L, , I State: On24ZIP: 77 ` 2 / Over 1000 amps or volts 2
. Phone: 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 ,alteratioa, °rrelocation:
200 amps or less 2
ORS 447, 455, 479, 670, 701.
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 am s 2
Branch circuits - new, alteration,
or extension per panel:
Name: 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; B -mail: of service or feeder fee, first branch circuit: 2
Each additional branch circuit:
I'I.AN REVIEW (Please check all that appl)) Misc .(Service orfeedernotIncluded):
O Service over 225 amps - commercial O Healthcare facility Each pump or irrigation circle 2
O Service over 320 amps -rating of 1 &2 O Hazardous location Each sign or outline lighting 2
family dwellings O Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
O System over 600 volts nominal mote residential units in one structure alteration, or extension• 2
O Building over three stories O Feeders, 400 amps or more •Description:
O Occupant load over 99 persons O Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lightingplan O Other: Per inspection I 1 I
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
IP
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ /D L '
O Visa O MasterCard expires if a permit is not obtained Plan review (at %) $
credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ g' S
Name of cardtiolder as shown o° credit card Ex accepted as complete. T OTAL $ // S ' .
$
Cardholder signature Amount 440 -4615 (6100/COM)
. ,, ` \
Electrical Permit Fees: ' • Limited Energy Fees:
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total `, 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 ❑ Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular Garage Door Opener
Dwelling Service or Feeder $90.90 2 El
Services or Feeders ❑ Heating, Ventilation and Air Conditioning System* .
Installation, alteration, or relocation
200 amps or less $80.30 '2 Vacuum Systems
201 amps to 400 amps $106.85 2
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 i $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) , _ N
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 Controls
New. alteration or extension per panel
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 ❑ Fire Alarm Installation
or feeder fee.
First branch circuit $46.85
Each additional branch circuit $6.65 ❑ HVAC
Miscellaneous ❑ Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40 Intercom and Paging Systems
Each sign or outline lighting $53.40
Signal circuit(s) or a limited energy Landscape Irrigation Control
panel, alteration or extension $75.00
Minor Labels (10) $125.00 ❑
Medical
Each additional inspection over
the allowable In any of the above 1:11 Nurse Calls
Per inspection $62.50
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 licenses are required. Licenses are required for all other installations
See "Plan Review" section on $
front of application.
Fees:
Total Balance Due $
Enter total of above fees $
❑ Trust Account # 8% State Surcharge $
Total Balance Due $
—1°6 CL io - I -o/
i:'dsts\forms\elc- fees.doc 10/09/00 ( 5 t 5 1 So �° __I...02
• •
/0.334
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST .441
24 Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 1/45 '3 AM PM BLD
G
Location / f q S I✓ AC L Ce i fr' y Suite A MEC
Contact Person T.C. C 4 46 , Ph 777 (13" PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC "00 / -00 /X
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler lC e Y / O r — a -S's'
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
IL •
E CTRICA �� I
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
F'
. PASS PART FAIL
lit
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA (PO �j
Otheoach /Sidewalk Date `� O Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.