Permit C ELECTRICAL PERMIT
CITY O F TIGARD G A R D
PERMIT #: ELC1999 -00217
"� a 4, DEVELOPMENT SERVICES DATE ISSUED: 4/22/99
II 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S102C6 -03101
SITE ADDRESS: 12950 SW PACIFIC HWY 3B
SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING: C -G
BLOCK: LOT : 021 JURISDICTION: TIG
Project Description: Electrical permit for an awning 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:
MARILYN HENDERSON BLAZE SIGNS OF OREGON
12950 SW PACIFIC HWY STE 5 PO BOX 23910
TIGARD, OR 97223 PORTLAND, OR 97281 -3910
Phone: Phone:
Reg #: SP-34SIG
LIC 000643
ELE 26- 380CLS
FEES Required Inspections
Type By Date Amount Receipt Ceiling Cover
PRMT BON 4/12/99 $40.00 99- 314178 Wall Cover
Elect'I Service
5PCT BON 4/12/99 $2.00 99- 314178 Elect'l Final
Total $42.00
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.
Permit Signature: _ Issued By: 7,f/ /
WNER 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 /l
SIGNATURE OF SUPR. ELEC'N: O & - DATE: 7 ' ? a - . y
LICENSE NO: / S ? / .
Call 639 -4175 by 7:00pm for an inspection the next business day
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # C- (19 (f 'b1DZ17
1 , (.,_\ Date Issued
711I Phone (503) 639 -4171
CITY OF TIGARD FAX (503) 684 -7297
TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Address /,2 q 5 S 1ki .�. U c.> Kr -e • Service included: Items Cost(ea) Sum
City /State /Zip Lt o .�A (9a . 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
Name (or name of business) lit, . -11.,,., Each additional 500 sq. ft. or
l " � ` portion thereof $25.00
Commercial V ' esid: ial ❑ Limited Energy $25.00 1
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
4b. Services or Feeders
Installation, alteration, or relocation
Electrical ontractor S 200 amps or less $60.00 2
Address 6 �B Ca 201 amps to 400 amps $80.00 2
$120.00 2
City P, i j ' t -A I State02 Zip �f7� / 401 amps to 600 amps
6 "3 3 Over amps to amps or volts $340.00 2
amps $180.00 2
Phone No. �- Over 1000 amps
Job NO. 18 L. y Reconnect only $50.00 2
contractor's license NO. Dh - 32o GL,S (O - 9
4c. Temporary Services or Feeders
Contractor's Board Reg. No. Co 4 4 D a 5 Installation, alteration, or relocation
Signature of Supr. Elec'n titzc,,,. 6L, 200 amps or less 2
201 amps to 400 amps $50.00
License No. ► �] 5 (tom Phone No. L. ?, ( �_ 2
401 amps to 600 amps $75.00
Over 600 amps to 1000 volts $100.00
. 2b. For owner installations: see "b" above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane
Address a) The fee for branch circuits with
purchase of service or feeder lee. 2
City State Zip Each branch circuit $5.00
Phone No. b) The fee for branch circuits without
The installation is being made on property I own which is purchase of service or feeder fee. 2
not intended for sale, lease or rent.
First additional circuit br $35.00
Each additional branch circuit $5.00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00 ye , era
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40.00
4 or more residential units in one structure Minor Labels (10) $100.00
Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.C. Chapter 5 Per inspection $35.00
Per hour $55.00
In Plant $55.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
5a. Enter total of above fees $ yo, c7O
NOTICE 5% Surcharge (.05 X total fees) $ '2.ao
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal - $- - - --
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS • Subtotal $
COMMENCED. wordecomdeve c- ❑ Trust Account #
$
p,m.app
Balance Due $ ya, 6 4
•
6 /29 /99 • Activities for Case #: ELC1999 -00217
12:38:08 PM
Assigned Hold Updated
Activity Description • Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCC001 Application received • 4/1/99 DLH RECD No Hold BON 4/12/99
ELCC003 Permit created 4/12/99 BON DONE No Hold BON 4/12/99 Sent along with BUP and sign
permits to PE's to keep
together as one package.
ELCC700 Ceiling Cover 4/12/99 4/12/99 No Hold BON 4/12/99
ELCC720 Wall Cover 4/12/99 4/12/99 No Hold BON 4/12/99
ELCC730 Elect'I Service 4/12/99 4/12/99 No Hold BON 4/12/99
ELCC799 Elect'I Final 4/12/99 4/12/99 5/12/99 CD FAIL No Hold AKJ 5/12/99 Corrections not made
ELCC500 (F)Issue permit 4/22/99 GEO DONE No Hold GEO 4/22/99
ELCC799 Elect'I Final 5/24/99 5/24/99 5/24/99 CD PASS No Hold AKJ 5/24/99
ELCC800 Case Finaled 5/24/99 AKJ DONE No Hold AKJ 5/24/99
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