Permit r CITY OF T I GAR D ELECTRICAL PERMIT
PERMIT #: ELC2005 -00119
0 1 ft, DEVELOPMENT SERVICES DATE ISSUED: 2/28/2005
13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171
PARCEL: 2S 102CC -00500
SITE ADDRESS: 13500 SW PACIFIC HWY 50 ONE HOUR
SUBDIVISION: PHOTO ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: Sign Lighting
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:
13500 PACIFIC CORP GRAPHIC D'SIGN LLC
BY CAP ADVISORS 2255 SE 122ND. AVE.
38345 W TEN MILE RD, STE 170 PORTLAND, OR 97233
FARMINGTON HILLS, MI 48335
Phone: Phone: 503 - 256 -2064
FEES Reg #: ELE 26- 1235CLS
LIC 154462
Description Date Amount
[ELPRMT] ELC Permit 2/28/2005 $53.40
[TAX] 8% State Surcharge 2/28/2005 $4.27 REQUIRED ITEMS AND REPORTS
Total $57.67
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 OA 952 - 001 -0010 through OAR 52- 001 -0100. You may obtain copies of these rules r direct questions to OUNC at (503)
246 -6699 or 1 -800-3 -2344. •
Issued By: / t�� ` � � it/C� Permittee Signature: 4/ 4 )
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: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Electrical Permi IlrilLAI, r 'I? ! D • FOR OFFICE USE ONLY
City of Tigard n � eat a-� D, . A3 it e_.(34) -Doi/
13125 SW Hall Blvd., Tigard, OR 97223 C 2 005 Plan Review
Phone: 503.639.4171 Fax: 303.5980 (� ��'" ° t � j DateBy: Other Permit:
Inspection Line: 503.639.4175 CITY OF TIGARD ` '1 DateReadyBy: ions: ® See Page 2 for
Internet: www.Ci.tigard.or.us Notified/Method: Supplemental Information
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.......................... ............................... ...... .
❑ New construction ❑ Addition/alteration/replacement Please check all that apply:
❑ Demolition ®Other: ['Service over 225 amps, comm'l ['Hazardous location
❑ Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
:: �» r�»<>: ��:: �E': pE::; isE: E�: <�:<�:: >< > #:<�:� >: »:::: »:'�'..: ti. ....... .
............ of - and 2-family dwellings .»;::.;;;:.;:.;:.;:.:.:.: �::.::.;:.;;;:.;:. ;:.;::.;:.;;:.;:C..�`..A..� :: ::::::::.:::... ���!;:.;:.;:.;:.;:.>:.;:.>.;:.;:.;:<.;:. >;:.:;- :::.:::.::::.::::::::::. 1 an 2 f Y s 4 or more new residential g
........ ............... ................
❑ 1- and 2- family dwelling !] Commercia : dustrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Multi-famil Ma a , r der ['Building
over three stories ['Feeders, 400 amps or more
y ❑ ❑ Other:
['Occupant load over 99 persons ❑Manufactured structures or
OS..: SI' �E> Yl! Tt?C] Rl�'` �C�NI::' i1A'Ik: > : ":` >; ' <; ::`':�': >: �::> :
<: >: ::
' >;': > >: : >s:�< »;' ❑ Egress/lighting
RV
ark
�:.::�•:::.::::; :•;::::•::::: �.? C�. ttT.. TC�i! � :::::::::.::::.::::.::::::::: ess/li in plan P
Job no.: Job site address: 13SUy S'w Pau,�'t1c, " - / 0 Healt2 -care facility ❑��.
Submit 2 sets of plans with any of the above.
City /State/ZIP: -TA 9pp fd 91 214 The above are not applicable to temporary construction service.
Suite/bldg./apt. no.: I Project name: Vim) (Yr. lx - &AWN :: >:::: >:: ; >:::: <: >::;<::::: >:::< :: s:: : >:::: >:< :. . . . . ................
Description I Qty. I Fee. I Total I '•
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 l
Limited energy, residential 75.00 2
Tax map/parcel no.:
Limited energy, non - residential 75.00 2
..................................................... .......................::.:.::: . ... .............. Each manufactured or modular
dwelling, service andlor feeder _ 90.90 2
. Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
201 0 s
am s to 40 am
P
P
... ...........:.......................................:......:...:::...:..::........ .... . ............... .. .... ... ..... ...... .... .... ..... 106 .85 2
401 amps to 600 amps 160.60 2
Name: CAP ( tirr Pr orr"y l ) 601 amps to 1,000 amps 240.60 2
Address: ro SW pvr� SA % _^ • l t
Q Over 1,000 amps or volts 454.65 2
r � "-� * Reconnect only 66.85 2
City /State/ZIP: R)� I.kfj b G IL g`1 w4 Temporary services or feeders installation, alteration, and/or
Phone: (S 22 r Fax: ( ) ZZ � 200 a don
)
4 ` G1 ( S b5 g - I (p 200 amps or less 66.85 1
. Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: cal A44 rv'q --+ 14..... Date: Branch circuits - new, alteration, or extension, per panel
circuits A. Fee for branch tr with
:::::: �A' BPIIG`, t5; 1! 1'. �>> �> s;?':'':' ;'_.:':''z;:::�<11�E.TAdT: . . I+T . ,.:..� >: > >:::<: >:::
s
Business name: (lira' r service or feeder fee, each rxx branch circuit 6.65 2
B. Fee for branch circuits
Contact name: 1 At_ AU y■ 44. without service or feeder fee, 46.85 2
Address: each branch circuit
se 11t -' Av E Each add'I branch circuit 6.65 _ 2
City /State/ZIP: pi -LAN () oft, 917_33 Miscellaneous (service or feeder not included)
Phone: ( SU - 5 ) 2SG _ 2A 04, Fax: : ( 3 ) L I - I Il
3 Pump or irrigation circle 53.40 2
Sign or outline lighting 1 53.40 2
E -mail: Signal circuit(s) or limited -
energy r panel, alteration, or
3 > sip :,::.,.: ;;: . : . ' ,: ' . `[;:;<; > >` >> >z[i >z » >�t >:[ > >[ 1< [ > " > >;:> � > `. ? ?: 8Y P
4
\ us extension. Describe: Page 2 2
Bi ness name: &D A P�11 C., o Sl (N S U L
T Address: qq A - A „�� Each additional inspection over allowable In any of the above
r6 QC !Ss S . i�- 6► E Per inspection 62.50
City /State/ZIP: A Q N� 97Z 1-2, Investigation per hour (1 hr min) 62.50
Phone: ( sbs ) Zs-6, ..4,0( 2 4, I Fax: (5 - ) 2.s( - 11 Industrial plant per hour 73.75
3 >.::::: :,:: :::::::: ESC. : > ,T:: S.>':::::::::::::::::::::: :;
CCB Lie.: 1 S 4430 Z Electrical Lie.: Z( .- j23S cu. Suprv. Lic.: Subtotal
_
Suprv. Electrician signature, required: 4E::. 7/0 / /U (o Plan review (25% of permit fee)
State surcharge (8% of permit fee) y( a'
. Print name: C to i► 3 To P' t-- ' e - NI Gi y Date: 9 j 2, 7 / U S /
/ � M ''1 TOTAL PERMIT FEE 69,
Authorized signature: tit ,l (----/ (----/ This permit application expires if a permit is not obtained within 180
'v r days after it has been accepted as complete
Print name: LAC v.v.) y' r u l J_ Date: ,Q k 2. 105 • Fee methodology set by Tri County Building Industry Service Board
•• Number of inspections per permit allowed.
i:\ Building \Pernits\ELC- PemmitApp.doc 12/03 440.4613T(l0/02/COM/WEB
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 -00119
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/28 /2005
Phone: (503) 639 -4171 � %,a� �' MlI i�
Inspection Requests (24 Hrs.): (503) 639 -4175 & `I_ ..
INSPECTION WORKSHEET FOR DATE: 4/20/2005 TIME: 7:11AM PAGE: 85
SITE ADDRESS: 13500 SW PACIFIC HWY 50 ONE HOUR PHOTO CLASS OF WORK:
SUBDIVISION: TIGARD MARKETPLACE LOT #: TYPE OF USE:
PROJECT NAME: IN STYLE SALON
DESCRIPTION: Sign Lighting
OWNER: 13500 PACIFIC CORP, PHONE #:
CONTRACTOR: GRAPHIC D'SIGN LLC PHONE #: 503-256-2064
Inspection Request Scheduled For: Date: 4/20/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 004886-01 503-2562064
)
Corrections /Comments/ Instructions: rr -
`� q / Y 140(
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 0...4 Date: Lt - 10 - OS Phone #: (503) 718 -