Permit C ITY OF T I CARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00503
7 DEVELOPMENT SERVICES DATE ISSUED: 8/13/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S102CC -00500
SITE ADDRESS: 13500 SW PACIFIC HWY 58 MAILBOX
SUBDIVISION: EXPRESS ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of (1) 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: SIGNAUPANEL:
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 TUBEART SIGNS
BY CAP ADVISORS 4243 -A SE INTERNATIONAL WAY
38345 W TEN MILE RD, STE 170 MILWAUKIE, OR 97222
FARMINGTON HILLS, MI 48335
Phone: Phone: 503 - 653 - 1133
Reg #: LIC 70956
SUP 366SIG
FEES ELE 37- 554CLS
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 8/13/03 $53.40
[TAX] 8% State Tax 8/13/03 $4 Rough -
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 starte• within 180 days of issuance, or if work is suspended
for mo - an :• :. . ATTENTION: Oregon law requires you to follow rules adopted by the Or- •on Utility Notification Center. Those rules are set
fo • in OAR 952 -001 -i • 10 through R 952 - 001 - 0100. You may obtain copies of these rules or dir- t questions to 0 ' - 503) 246 -6699 or
1 :00- 332 -2344. /
I ued By: ✓� Permit Signature:
OWNER INSTALLATION ONLY Pr
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
Electrical Pe
'-1 • ; - Date received: - --- _ ... Perntit no. t.Cncn. -- riO.Cao3
em V,' 111 City of Tigard Project/ appl.no.: • -. • Expired :' • .. .
City ofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date i ssued: ' • - ' • •: By: - • - Receipt no.:
Phone: (503) 639 -4171 .. . - _ ., _
Fax: (503). 598 -1960 - • Case file no.: - ... -..... - - Payment type: .. , • ..: . •
Land use approval: � h0 5-001., .
r r,c
TYPE OF PERMIT
r.
O 1 & 2 family dwelling or accessory - Co m mercial/industrial ; r, O Multi- family O Tenant improvement
quo, .
O New construction , O ddition/alteration/replacement `O Other. - `" " "" O Partial .
JOB SITE INFORMATION
Job address: / ! • itt ) . C?; , - 6, I c -_ : Bldg. no.: —' Suite -,. , Tax lot/account tie.: ` , ` .
Lot: I Block: ISubdivision:7 4 -1 ,p Ao - - -
Project name: CPS s t . I Description and location of work on premises: _ _ . ,
Estimated date of completion/mspection: ' — 8 - c' •l: /6:- -- ,// C/aCel/ 7
CONTRACTOR APPLICATION "' '., FEE SCIIEDU.E
Yob no: 5 • / 7 / . . .. . .., ..«... _ - t Fee . Max
Business name: t'.f4 644 "Dscrfptlon Qty. (ea.) Total no. Imp
Address: /< A �L Newreddmtial- tiogleor®lfl- famltyper 4
1
dwelWgtmit .lndadesattachedgarage.
City: )U« ' _ State:Ole : 97zr Servicehtrinde& .
Phone: , • ig — Fax:. ,rf E -mail: 1000 sq. ft. or less 4
CCB no.: 70 f'c s Elec. bus. lic. no:, 7 t t.0 s . Ea additional 500 sq. ft or portion thereof
Lim energy, residential 2
Ci ' 1, IC. no.: 7-
Limited energy, non - residential 2
` "- dA 0 Each manufactured home or modular dwelling
Signature o su. * T ng el ian (required) • s ate Service and/or feeder 2
Sup. elect name (print):�. ` , License no: S/ 6 — Servicesorfeedets iasfsllation,
PROPERTY OWNER alteration or relocation: ,
200 amps or less 2
Name (print): ,.• . 201 amps to 400 amps 2
Mailing address: 401 amps to 600 amps 2
601 amps to 1000 amps 2
City: 'State: I ZIP: Over 1000 amps or volts • . 2
Phone: I Fax: I E -mail: Reconnect only _ . 1
Owner installation: The installation is being made on property I own . Temporary services or feeders - • .. -
which is not intended for sale, lease, rent, or exchange according to fastallatloa,alterstion , orrelocation:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 am .s - . 2
ENGINEER Branch drealts- new, alteratlon, .. , - , • •
Name: or extension per paneli —
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: . I State: . I ZIP: B. Fee for branch circuits without purchase
Phone Fax E-mail: service or feeder fee, first branch circuit: • 2
Each additional branch circuit:
PLAN REVIEW' (Please check all that apply) Misc.- (Service or feeder not included): , •
O. Service over 225 amps-commercial 0 Healthrazefacility Each pump or irrigation circle / 2
O Service over 320 amps- rating of lea O Hazardous location Each sign or outline lighting 514/0 - 2
family dwellings Cl Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, .
0 System over 600 volts nominal more residential units in one structure alteration, or extension _ 2
O Building over three stories O Feeders, 400 amps or more • *Description:
O Occupant load over 99 persons O Manufactured structures or 1W park Each additional Inspection over the allowable In any of the aboye
O Egressllightingplan Cl Other Per inspection I I I I
Submit _ seis of plans with any of the above. Investigation fee
. The above are not applicable to temporary construction service. Other -
Na all ca eo
ons aept uedrt cards, please eau jurisdiction for more information. - Notice: This permit application " Permit fee $ 5 ND
�
O Visa Cl MasterCard expires if a permit is not obtained' Plan review (at _ %) $
Credit card comber: I / within 180 days after it has been State surcharge (8%) .... $ _ 7
• Expires accepted as complete. TOTAL $ �i r7 ' (P7
Name of cardholder as shown on credit card
$
Cardholder signature Amount 440 -4615 (600/COM)
•
Electrical Per Fees: • Limited Ener Fees:
m /ete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Co
. _ Restricted Energy Fee $75.00
' Number of Inspections per permit allowed , ' (FOR ALL SYSTEMS) .
Service included: ! Items Cost Total Check Type of Work Involve
Residential - per unit
1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or
. portion thereof . $33.40. 1 ❑ Burglar Alarm
Limited Energy . • $75.00 •
Each Manufd Home or Modular • El Garage Door Opener'
Dwelling Service or Feeder ' $90.90 2
Services or Feeders ❑ ' Heating, Ventilation and Air Conditioning System' '
Installation, alteration, or relocation .
200 amps or less $80.30 2 ❑ Vacuum Systems'
- -201 amps to 400amps ' -_ $106.85 2
401 amps to 600 amps $160.60 2
• 601 amps to 1000 amps $240.60 • • . 2 ❑ Other
Over 1000 amps or volts $454.65 - 2 -
Reconnect only $66.85 2
Temporary Services or Feeders . TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each system $75.00
200 amps or less $66.85 2 • (SEE OAR 918-260 -260) •
201 amps to 400 amps $100.30 2 .
401 amps to 600 amps $133.75 2 Check Type of Work Involved:
Over 600 amps to 1000 volts, ❑
see "b" above. Audio and Stereo Systems
Branch Circuits - •
❑ Boiler Controls
New, alteration or extension per panel
a) The fee for branch circuits
with purchase of service or • ❑ Clock Systems
feeder fee. •
- Each branch circuit - - • $6.65 2 ❑ Data Telecommunication Installation
b) The fee for branch circuits
without purchase of service ❑ Fire Alarm Installation
or feeder fee.
First branch circuit $46.85
Each additional branch circuit $6.65 El HVAC
• Miscellaneous ❑
Mi Instrumentation
(Service or feeder not included) • Each pump or irrigation circle $53.40 ❑ Interco and Paging Systems
Each sign or outline lighting -- $53.40 m .
Signal circuit(s) or a limited energy
panel, alteration or extension $75.00 ❑ Landscape Irrigation Control'
Minor Labels (10) - $125.00
Each additional Inspection over - ❑ Medical
the allowable In any of the above
Per inspection $62.50 ❑ Nurse Calls
Per hour $62.50
In Plant $73.75 ❑ Outdoor Landscape Lighting' •
Fees: ❑ Protective Signaling .
' Enter total of above fees $ 4 E, ' Other
8% State Surcharge $ - • Number of Systems
25% Plan Review Fee
See "Plan Review" section on $ No licenses are required. Licenses are required for all other installations
front of application.
Fees:
Total Balance Due $ L
Enter total of above fees $
. ❑ Trust Account # 8% State Surcharge $
Total Balance Due $
i :\dsts\fornss\elc- fees.doc 10/09/00 .
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (504639-4175
INSPECTION DIVISION 'r Business Line: (503) 639 -4171 MST
BUP
Received Date Reque ed ' — 2 AM PM BUP
Location 0. • fti M1,11 . uite 515 MEC
Contact Person A Ph ( I ) t - /t3.3 PLM
Contractor Ph ( ( [ � ) SWR
BUILDING Tenant/Owner t./ n s �rr� r'r-. 3 £ () 5c 2
Footing ELC
Foundation Access:
Ftg Crawl ELR
Dr ain ` tuL. ‘ Crl Dr
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
LEG�TRICAI�.
Service
Rough -In
UG/Slab
Low Voltage
• in Reins on fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART � `
D Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA ��
Approach/Sidewalk Date o Insp eeto /v iL.. ° EXt
Other:
Final DO OT REMOVE this Inspection recor • rom the Job = ite.
PASS PART FAIL