Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC96 0405
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 06/24/96
13125 SW Hall Blvd. Tigard. Oregon 97223.8199 (503) 639 -4171
PARCEL: 2S102CB- 031091
SITE ADDRESS...: 12950 SW PACIFIC HWY #3A
SUBDIVISION
•
BLOCK LOT
Project Description: SIGN WORK FOR INVESTMENT CO IN TENANT SPAC
PULL ONE SIGN CIRCUIT FOR FLOURESCENT 11 SO FT 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
EDWARD D JONES INVESTMENTS type amount by date recpt
. - 12950 SW PACIFIC HWY PRMT $ 40.00 JMH 06/24/96 96 -280894
SUITE 3A 5PCT $ 2.00 JMH 06/24/96 96- 280894
TIGARD OR 97223
-Phone #:
Contractor:
MEYER SIGN CO $ 42.00 TOTAL
7340 SW LANDMARK
REQUIRED INSPECTIONS
TIGARD OR 97223
Phone #: 503 -620 -8200
Reg #..: 64014
This permit is issued subject to the regulations contained in the y
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permittee Signature
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 i _ - i L 444 �J
than 180 days. sued By
OWNER INSTALLAT'1N 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 for inspection - 639 -4175
•
-SI 0 03/ 0
• Community Development ELECTRICAL PERMIT APPLICATION
• 13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # <,(, 0
�
Permit #
��,I Phone (503) 639 -4171 Date Issued (o' 'q&
CITY TIGARD FAX (503) 684 -7297 Issued by �-
TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development&DWARD D 3 I,JVEsTMEnlTS Number of Inspections per permit allowed
Address 12.15 SW PAcAp'w Hinly "#3`i Service included: Items Cost(ea) Sum
City/State/Zip T i &A21), OK 9 2-23 4a. Residential - per unit 4
1000 sq. ft. or less $110.00
(or name of business)
Each portion ion additional re 500 sq. ft. or
Name nm ss
( ) 1
portion thereof $25.00
Commercial ® Residential ❑ Limited Energy $25.00
Each Manut d Home or Modular 2
Dwelling Service or Feeder $68.00
2a. Contractor installation only:
4b. Services or Feeders
Installation, alteration, or relocation 2
Electrical Contractor N1F.YF.g s( cosi Co OF nQ€ Go N 200 amps or less $60.00 2
20 1 amps to 400 amps $80.00
Address 734o St../ !- AtJDMAKK 1-Anl 2 2
401 amps to 600 amps $120.00 -
City fi I &4 R. D State OR_ Zip Q ?2.23 sot amps to 1000 amps $180.00 2
-
Phone No. ( 2p --cic 2 04 Over 1000 amps or volts $340.00 2
-
Contractor's License No. aL0 - 1 q ()C.C.S Di . , Reconnect only $50.00
Contractor's Board Reg. No. - / yi . T
cf 4c. Temporary Services or Feeders
Installation, alteration, or relocation 2
Signature of Supr. Elec'n �,4f S n ( 0R p 2 - 200 amps or less $50.00 2 -
License No. C( 1 `b F one No. Is,,,,,4
20 -02d0 201 amps to 400 amps $75.00 2
- 401 amps to 600 amps $100.00
Over 600 amps to 1000 volts
2b. For owner installations: see - b• above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per panel
Address a) The fee for branch circuits with
CI State Zi purchase of service or feeder fee. 2
ty p 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 branch circuit $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 - 7 - $40.00 y p 2
Signal circuit(s) or a limited energy
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 $ 4/0' _°
NOTICE 5% Surcharge (.05 X total fees) $ °=
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. ❑ Trust Account # R $
Balance Due 0"
�f0 •D
•adbanMaNMorpm.app
4/10/00 Activities for Case #: ELC96 -00405 •
7:02:00 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELCC700 Ceiling Cover 6/24/96 J'H 6/24/96
ELCC720 Wall Cover 6/24/96 J'H 6/24/96
ELCC730 Elect'I Service 6/24/96 J'H 6/24/96
ELCC799 Elect'I Final 6/24/96 J'H 6/24/96
ELCC500 (F)Issue permit 6/24/96 . JMH PAID J'H 6/24/96
ELCC520 (F)Print ELC Signature form 6/24/96 JMH PAID J'H 6/24/96
ELCA580 Expired by limitation 4/5/00 HAP DONE No Hold • AKJ 4/5/00
•
Page 1 of 1