Permit CITY OF TIGARD ELECTRICAL PERMIT
III 7 ° PERMIT #: ELC2007 -00223
° COMMUNITY DEVELOPMENT DATE ISSUED:
4/10/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 103 D D - 01201
SITE ADDRESS: 13920 SW PACIFIC HWY ZONING: C -
SUBDIVISION: GOODWILL INDUSTRIES CENTER LOT: JURISDICTION: TIG
PROJECT: GOODWILL INDUSTRIES
Project Description: (4) sign lighting wall signs.
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: 4
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:
•
GOODWILL INDUSTRIES SECURITY SIGNS INC
1943 SE 6TH AVE 2424 SE HOLGATE BLVD
PORTLAND, OR 97221 PORTLAND, OR 97214
Phone: 503 - 238 - 6190 Contact #: PRI 503 - 232 - 4172
FAX 503 - 230 -1861
FEES
Description Date Amount Reg #: ELE 26- 560CLS
[ELPRMT] ELC Permit 4/10/2007 $213.60 LIC 122809
[TAX] 8% State Surcharge 4/10/2007 $17.08
Total $230.68 REQUIRED ITEMS AND REPORTS
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 1.800.332.2344.
i
Issued By: 66Lt LzA.s. Permittee Signature: °2 . .
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 503.639.4175 by 7:00 a.m. for an inspection that 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 Permit Application FOR OFFICE USE ONLY
City of Tigard p , f f ,. Permit No' _ .....t ar _bfJa
13125 SW Hall Blvd., Tigard, OR 972 Plan R
��qqpp
Phone: 503.639.4171 Fax: 503.598.7'�rR 1 0 2007 _ _ 7 '' , li Date/B Other Permit:
Inspection Line: 503.639.4175 -1.: . I
' Date Ready/By: 65 See Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method Supplemental Information
dtil _ . PLAN REVIEW �:
❑ New construction ra 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.,
• •• - , , ' CATEGORY OF _CONSTRUCTION - . .. of I - and 2- family dwellings 4 or more new residential
❑ I- and 2 family dwelling 0 CommerciaUindustrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders, 400 amps or more
❑ Multi - family 0 Master builder ID Other:
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan . RV park
- , ❑Health care facility ❑Other:
Job no.: Job site address: Submit 2 sets of plans with any of the above.
City /State/ZIP: / ) - The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: (( g t 1 FEE* SCHEDULE .
\ XV A� 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: I Lot no.: Ea. add'I 500 sq. ft. or portion 33.40
Limited energy, residential 75.00 2
Tax map /parcel no.:
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
4 i tornlmlleCl L t'H l
zio, � ' 7 ,� �� dwelling, service and/or feeder 90.90 2
l Services or feeders installation, alteration, and /or relocation
....-------- 200 amps or less 80.30 2
❑ PROPERTY OWNER . ' I ❑ TENANT 201 amps to 400 amps 106.85 2
��� I 401 amps to 600 amps 160.60 2
Name: % 601 amps to 1,000 amps 240.60 2
Address: !: 1 aZeVi icic i -'q Over 1,000 amps or volts 454.65 2
1GJ "'"" `" Reconnect only 66.85 2
City/ State/ZIP: \ V-5 Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( )
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: Date: Branch circuits - new, alteration, or extension, per panel
❑ APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
each branch circuit 46.85 2
Address:
Melissa Hayden, Security Signs Each add'I branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
2424 SE Holgate Blvd
Pump or irrigation circle 53.40 2
Phone: ( ) Portland, OR 97202 Sign or outline lighting 53 .40 1 2
E - mail: p: 503 546 7114 f: 503 230 1861 Signal circuit(s) or limited - j 1 )' ` _/
Melissa @SecuritySigns.com energy panel, alteration, or
:xtension. Describe: Page 2 2
Business name: CCB: 122809
Address: 26560CLS metro #: 2561 ?ach additional inspection over allowable in any of the above
'er inspection 62.50
City /State/ZIP: Investigation per hour (I hr min) 62.50
Phone: ( • ) Fax: ( ) Industrial plant per hour 73.75 _
ELECTRICAL PERMIT FEES*
CCB Lie.: Electrical Lie.: Suprv. Lie.: Subtotal
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print name: �� ate: State surcharge (8% of permit fee) OA
TOTAL PERMIT FEE _] (Qi
Authorized signature � This permit application expires if a permit is not obtained within 180
ll days after it has been accepted as complete
Print name: e , - ; dt�,� Date: Z • Fee methodology set by Tri- County Building industry Service Board
• Number of inspections per permit allowed.
i:\Building\Permit \F1.0 -P itApp.doc 12/03 410- 1615T(I0102ICOAUWEB ?3 a CO
CITY OF TIGARD
., BUILDING DIVISION PERMIT #: ELC2007 -00223
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/10/2007
Phone: (503) 639 -4171 V . lit
Inspection Requests (24 Hrs.): (503) 639 -4175 �: _..
INSPECTION WORKSHEET FOR DATE: 6/11/2007 TIME: 7:00AM PAGE: 53
SITE ADDRESS: 13920 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: GOODWILL INDUSTRIES CENTER LOT #: TYPE OF USE:
PROJECT NAME: GOODWILL INDUSTRIES
DESCRIPTION: (4) sign lighting wall signs.
OWNER: GOODWILL INDUSTRIES. PHONE #: 503 -238 -6190
CONTRACTOR: SECURITY SIGNS INC PHONE #: 503232 -4172
Inspection Request Scheduled For: Date: 6/11/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 049907 -01 503-546-7114 N
Corrections /Comments /Instructions:
illi
Y 'd PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G-• o t V L Date: 6 •q- ()"-) Phone #: (503) 718- 2 446