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Permit CITY OF TI GARD ELECTRICAL PERMIT PERMIT #: ELC1999 -00657 .A 4101 & DEVELOPMENT SERVICES DATE ISSUED: 11/03/1999 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2 S 103 D D -00400 SITE ADDRESS: 13727 SW PACIFIC HWY 400 SUBDIVISION: ZONING: C -G BLOCK: LOT : JURISDICTION: TIG Project Description: Electrical for two signs 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: PETER STIVEN VITAL SIGNS INC 1300 SW 5TH AVE 14413 NE 10TH AVE STE 2600 C -105 PORTLAND, OR 97201 VANCOUVER, WA 98685 Phone: 503 - 221 -4810 Phone: 360- 573 -3686 Reg #: LIC 119801 ELE 37- 735CLS FEES Required Inspections Type By Date Amount Receipt Elect'I Service PRMT BON 10/28/199c $85.50 99- 319408 Elect'l Final 5PCT BON 10/28/199 $6.84 99- 319408 Total $92.34 ORIGINAL 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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -1987. PERMITTEE'S SIGNATURE I SSUED BY: eve < < cec .— g mxe 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: CONTRACT R INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: � - 1l DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day CITY OF TIGARD Plan Check # • Electrical Permit Application 13125 SW HALL BLVD. Recd By Date Rec'd /6 $ 1 TIGARD OR 97223 Date to P.E. Phone (503) 639 -4171, x304 Date to DST Inspection (503) 639 -4175 Print of Type Permit # t a Z 7 Fax (503) 598 -1960 Incomplete or illegible will not be accepted Called 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Number of Inspections per permit allowed Name (or name of bu gne s) j Loc zL �dlffv>. Service included: Items Cost Sum Address /2 7 2:7 Pe .7r.i }t c, t-W y #$ 4-oo 4a. Residential - per unit 1 1000 sq. ft. or less $ 117.75 4 City /State /Zip I leta,. _ (7,r Each additional 500 sq. ft. or 1 portion thereof $ 2675 1 Commercial p Residential ❑ Limited Energy $ 60.00 Each Manufd Home or Modular 2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2 (Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders information for COT data e). Installation, alteration, or relocation Electrical Contractor -6.\ Cl ks fir. 200 amps or less $ 64.25 2 Address /444 3 NC is 4A. u e., a,- IaC 201 amps to 400 amps $ 85.50 2 401 amps to 600 amps _ $ 128.50 2 City V,�vtp State a .. Zip 9 cg b g S- 601 amps to 1000 amps $ 192.50 2 Phone No. 3 foo - 73` 3(08 c., Over 1000 amps or volts $ 363.75 2 Job No. Reconnect only $ 53.50 2 Elec. Cont. Lice. No. .i7 ` 13 c . Exp.Date IGL I 1 oc) 4c. Temporary Services or Feeders OR State CCB Reg. No. 119 8 I Exp.Date 13 00 Installation, alteration, or relocation COT Business Tax or Metro No. �`7 2Z. Exp.Date Z II ••• 200 amps or less $ 53.50 2 201 amps to 400 amps $ 80.25 2 Signature of Supr. Elec'n 401 amps to 600 amps $ 107.00 2 Over 600 amps to 1000 volts, see "b" above. License No. • CV Gr h;Ka., 05 9oC- Fxp.Date ISIea Phone No. O -57 3 - 3(08(0 4d. Branch Circuits New, alteration or extension per panel a) The fee for branch circuits 2b. For owner installations: with purchase of service or feeder fee. Print Owner's Name Each branch circuit $ 5.35 2 Address b) The fee for branch circuits without purchase of service City State Zip or feeder fee. Phone No. First branch circuit $ 37.50 ' ‘t4 Each additional branch circuit $ 5.35 The installation is being made on property I own which is not 4e. Miscellaneous intended for sale, lease or rent. (Service or feeder not included) Each pump or irrigation circle $ 42.75 ��] Owner's Signature Each sign or outline lighting . 5 $ 42.75 5 `^ - "' Signal circuit(s) or a limited energy panel, alteration or extension $ 60.00 3. Plan Review section (if required): * Minor Labels (10) $ 107.00 Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over 4 or more residential units in one structure the allowable in any of the above Service and feeder 225 amps or more Per inspection $ 50.00 Per hour $ 50.00 System over 600 volts nominal In Plant $ 59.00 Classified area or structure containing special occupancy as described in N.E.C. Chapter 5 5. Fees: 5a. Enter total of above fees $ ' J , * Submit 2 sets of plans with application where any of the above apply. � 1 0 5 o Surcharge (.05 X total fee $ Not required for temporary construction services. ���JJJ Subtotal $ ,' 5b. Enter 25% of line 5a for p NOTICE Plan Review if required (Sec. 3) $ PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account # ' r AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ i:\dsts\forms\electric.doc CITY OF TIGARD 24 -Hour BUILDING „ Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST / BUP • Received Date Requested f ?I ` AM PM BUP Location i < Suite -' MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner a^ €l t�� ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath /Shear Int Sheath/Shear Framing Insulation Drywall Nailing 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 UG /Slab Low Voltage Fire Alarm °W Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SS PART FAIL SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA ` T /�'Z Approach /Sidewalk D 41 m oa_ Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL