Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00797
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DEVELOPMENT M Tigard. 97223 DATE ISSUED: 12/14/2004
13125 3 (503) 639 -4171
PARCEL: 2S102CC -00500
SITE ADDRESS: 13500 SW PACIFIC HWY 42 I SOLD IT
SUBDIVISION: 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 MEYER SIGN CO OF OREGON
BY CAP ADVISORS 15205 SW 74TH AVE
38345 W TEN MILE RD, STE 170 TIGARD, OR 97223
FARMINGTON HILLS, MI 48335
Phone: Phone: 620 - 8200
Reg #: LIC 64014
SUP 566SIG
FEES ELE 20- I90CLS
Description Date Amount Required Inspections
[ELPRMT] ELC Permit 12/14/200' $53.40
[TAX] 8% State Surcharge 12/14/200' $4.27 Elect'I Final
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 OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -6699 or 1 -800- 44.
Issued By: Permit Signature: ' \
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
•
S G N _ Da y —00 3 8 •
Electrical Permit Application FOR OFFICE USE ONLY
•
R eceived Electrical
Date/B : . / y d-f . L ' Permit No._ 6 . 4, I — r> A
Planning A'.rova Sign
City of Tigard Date/B : Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/B : Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 Post Land Use
/dnr + � Date/B : Case No.:
Internet: www.ci.tigard.or.us • • i4 e I Contact ® See Page 2 for
-
24 -hour Inspection Request: 503 -639 -4175 Name/Method: Brijr,,E Su • . lemental Information.
- `7 1.:::.:•'::: ^TYPE•OF. ; - . 1 :: PLANREV. IEW;( Pleisectieck , iill:thataPPIY)'��
';°
1=1 New construction ❑Demolition ❑ Service over 225 amps- ❑ Health -care facility
commercial ❑ Hazardous location
❑ Addition/alteration/replacement 1 / ii Other: /6/1/ ❑ Service over 320 amps - rating of ❑ Building over 10,000 square feet,
:_,;;r ":, " "11 ,- + CATEGORY OF CONSTRUCTION '_:. =n" ;' , i•, - 1 & 2 family dwellings four or more residential units in
❑ I & 2- Family dwelling laCommercial/Industrial ❑ System over 600 volts nominal one structure ._
❑ Building over three stories ❑ Feeders, 400 amps or more
❑ Accessory Building ❑ Multi- Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
❑ Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other:
Submit _ sets of plans with any of the above.
'. JUB SITE INFORMATIONarid`hOCASPION The above are not applicable to temporary construction service.
Job site address: j. Soo 5W DACi Flc l -1 " . - `' . - ' '' - y
`:: >: _ '> FEE *. SC ^REDUCE:; ° ?_r,,*r". _ � „ - . _, .
Suite #: y ,- Bldg. /Apt. #: V Number of inspections per permit allowed
Project Name: Z _ Lb j r O N E j2jf I Description Qty Fee (ea.) Total
New residential - single or multi - family per j
Cross street/Direchori to job site: Pc--)L (� dwelling unit. Includes attached gaiage. _ • _
�/ y � a a �j 1 ,Q 1. --- t” 2r( - Service included:
1 rr Q / e y— \ 1000 sq. ft. or less 145.15 4
Pae,1.• /( . 2 ; 4 ,9,� ! �" �ff�' j Each additional 500 sq. ft. or portion thereof 33.40 1
G J t Limited energy, residential 75.00 2
Subdivision: Lot #: Limited energy, non residential 75.00 2
Tax map /parcel #: Each manufactured home or modular dwelling
x•g 4;•;:-- service and/or feeder . 90.90 2
......, .,. :- . '.DESGRIP.T'ION.OF:WORK' a. • _.'-
,.':.-;,.,:-• / ( 1 ) aed - I1 k/ J Services or feeders - installation,
alteration or relocation:
200 amps or less 80.30 2
201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
601 amps to 1000 amps • 240.60 2
' ❑, PROPERTY OWNER '.::1 TENANT ` ;" ' ': Over 1000 amps or volts 454.65 2
7 §r Cr f j'l ( ti Reconnect only 66.85 2
Name:
Address: / 3.o 4 f Q tic !� _ �
Sa J # V Temporary services or feeders - installation,
alteration, or relocation:
City /State /Zip: - - ff G41--/2_ i' 1 8 . q 72 2 200 amps or less _ 66.85 1
Phone: F ' 201 amps to 400 amps 100.30 2
401 to 600 amps 133.75 2
❑ APPLICANT. '4. ' [CONTACT PERSON - Branch circuits - new, alteration, or
Name: -,V� 4,2-p f extension per panel:
A. Fee for branch circuits with purchase of
Address: S A-e as 0.7Y17'1 aQ ) service or feeder fee, each branch circuit 6.65 2
City /State /Zip: B. Fee for branch circuits without purchase of
service or feeder fee, first branch circuit 46.85 2
Phone: I Fax: Each additional branch circuit 6.65 2
E -mail: Misc.(Service or feeder not included):
Each pump or irrigation circle / 53.40 2
CONTRA Each sign or outline lighting 53.40 2
Job No: -, Signal circuit(s) or a limited energy panel,
alteration, or extension Page 2 2
Business Name: #4 - � 6/ 0 (7).. 6 D� C ' r De ratatiio on:
Address: /5249 tSw 7 ciL ax-.e
Each additional inspection over the allowable in any of the above:
City /State /Zip: 7767¢12-1) 02 . Q 7 Z Zt ` P • spection per hour (min. 1 hour) 62.50
_ Phone: / Z> --s2 200 Fax: 40 2_0-70 7 y Investigation fee: _
le 4 / L . #: ZD -1 0 C L S Other:
'
CCB Lic. #: Electrical Permit Fees *' -.`:
Supervising electricia • Subtotal $ 5 3.10
signature required: Plan Review (25% of Permit Fee) $
4 )( #: S(( S6 4 State Surcharge (8% of Permit Fee) $ 4 /. . y
Print Name: {�f L 1 i D I TOTAL PERMIT FEE $ 5 7. 0 Authorized —' I iI I / , / Noti ce: This perm a pplication expires if a permit is not obtained within
Signature: �i � �y∎� Date: / Z ' - / 7 ` 180 days after it has been accepted as complete.
s� ' //r A1 12I' • *Fee methodology set by Tri- County Building Industry Service Board.
cJ V /w �
(Please print name)
i:'Dsts\Permit Forms\ElcPetmmitApp.doc 01/03
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information .
f' '�.,
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all systems $75.00 '
Check Type of Work Involved:
❑ .Audio and Stereo Systems* . .
Burglar Alarm _ . _
❑ Gi .� - _ . , . _ - _ - -- -
Garage Door Opener*, .. . _ , •
❑ Heating, Ventilation and Air Conditioning System -.+ c
Vacuum Systems
s
Other - - - - - - _ • - - - - - - - - -- - - -- . . .
COMMERCIAL WORK ONLY: - ., ' .
Fee for each system _ $75.00
- (SEE OAR 918 - 260 -260) _.- - -
Check Type of Work Involved: ! : - - - , - - -" - - ' " ' .. - _
1 1i.
Audio and Stereo Systems —
El
•
lip Boiler Controls `
❑ Clock Systems -- - — -
❑ Data Telecommunication Installation „
❑ Fire Alarm Installation . -
El HVAC - - - .
❑ Instrumentation .
D Intercom and Paging Systems '
LI Landscape Irrigation Control
O Medical - -
0 Nurse Calls
D Outdoor Landscape Lighting
CI Protective Signaling
❑ Other
Number of Systems
* No licenses are required. Licenses are required for all
other installations
i:\Dsts\Permit Forms \ElcPermitAppPg2.doc 01/03
CITY OF TIGARD .,
BUILDING DIVISION • PERMIT #: ELC2004 -00797
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/14/2004
Phone: (503) 639 -4171 �
Inspection Requests (24 Hrs.): (503) 639 -4175 ' �+�- `:-
INSPECTION WORKSHEET FOR DATE: 3/28/2005 TIME: 7 :10AM PAGE: 75
SITE ADDRESS: 13500 SW PACIFIC HWY 421 SOLD IT CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: I SOLD IT ON E -BAY
DESCRIPTION: Sign lighting.
OWNER: 13500 PACIFIC CORP, PHONE #:
CONTRACTOR: MEYER SIGN CO OF OREGON PHONE #: 620 -8200
Inspection Request Scheduled For: Date: 3/28/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 002903 -01 503. 620 -8200 N
Corrections/Comments/Instructions:
c E
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: _02 Date:3 ` d J Phone #: (503) 718