Permit CITY OF TIG A R D ELECTRICAL PERMIT
�� \ DEVELOPMENT SERVICES PERMIT #: ELC97 -0513
,1"1 DATE ISSUED: 09/10/97
,I. . 1.1- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171
PARCEL: 2S110DC -00300
SITE ADDRESS...:15700 SW PACIFIC HWY
SUBDIVISION •WILLOW BROOK FARM ZONING:C -G
BLOCK • LOT •16 JURISDICTION: TIG
Project De scr i pt ion : Electrical permit for sign permit, S8N97 -8885.
- -- 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
SSC PROPERTY HOLDINGS INC type amount by date recpt
BY SHURGARD INC PRMT $ 40.00 DRA 07/30/97 97- 297773
1201 THIRD AVE STE 2200 SPCT $ 2.00 DRA 07/30/97 97- 297773
SEATTLE WA 98101
Phone #:
Contractor:
DWINELL'S VISUAL SYSTEMS $ 42.00 TOTAL
1112 E NOB HILL BLVD
REQUIRED INSPECTIONS
YAKIMA WA 98901 -3699 Elect'l Service
Phone #: 800- 932 -8832 Elect'1 Final
Reg #..: 006441
This permit is issued subject to the regulations contained in the Tigard Nunicipal Code, State of Oregon 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 the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 0014010 through OAR 952-001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (5831 -1987.
Permittee Signature: ,,SQL � iV .d2..ei Issued By:__ .6.
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 : , ti . A l7p � 0�1, DATE: �D �7
LICENSE NO: 4 Q /'
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + ++ + + + + + + + + + + + + ++
a-
' Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # EL -C 91 DS i ?j
,� ° ii l Date Issued - C! -/O- - 47
Phone (503) 639 -4171
� ""' FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development 1 7tfifi 'f Sift)/ Number of Inspections per permit allowed
Address /57t 9 l.(.) 17 jt Pic i`FW`f Service included: Items Cost(ea) Sum
City /State /Zip 71 GPm-0 1 0Z . q - 7 -a_a4 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
Name (or name of business)`] �t112.(2M-1) c 7j p ++,= Each additional 500 sq. ft. or
portion thereof $25.00
Commercial Residential El Limited Energy $25.00 1
Each Manurd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
1/
7'� ,.0 9' 4b. Services or Feeders
Electrical Contractor 7 /je�•l..s lit SUM_ S yST $60.00 emc Installation, alteration, or relocation
T • 200 amps or less 2
Address III a a . /JD6 Hi (-L- 6 LvD 201 amps to 400 amps $80.00 2
City VA.j4. vvt 14 State WA $190.00 2
Zip q�0/ 401 amps to 600 amps $120.00 2
601 amps to 1000 amps
Phone No. eD? I 3a$$3ot Over 1000 amps or volts $340.00 2
Job NO. Reconnect only
$50.00 2
contractor's license NO. .3 - t ) (!1S 4c. Temporary Services or Feeders
Contractor's Board Reg. No. A 4 _ Installation, alteration, or relocation
1 �
Signature of Supr. Elec'n l , , �� ■ 200 amps or less 2
.
201 amps to 400 amps
$50.00
License No. 0..9,10‹,/6 Phone No.$D4 µ77-79 401 amps to 600 amps $75.00 2
. • Over 600 amps to 1000 volts $100.00
. 2b. For owner installations: see "b" above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane
Address a) The fee for branch circuits with
purchase of service or feeder fee. 2
City State Zip 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
First additional c br $35.00
not intended for sale, lease or rent.
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 T $40.00
Signal circuit(s) or a limited energy 2
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 00
NOTICE 5% Surcharge (.05 X total fees) $ / 2 _12
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
5b. Enter 25% of line A for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF
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. wordlramdMelea ❑ Trust Account # $
prm.epp 1
Balance Due $
1q
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: _ A.M. P.M. MST:
Location: 7 0 el / - z u BUP:
Tenant: _ A , ,g I Suite: Bldg: MEC:
' w
Contractor: lrt i ,yt �, / Phone: PLM: (� .14
Owner: Phone: ELC: -/ 7 «_573
ELR:
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFI/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt .
Approved Approved Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FIN FINAL
i
f
1:1010:07
1".'..
O Call for reinspec ' O Reinspection of $ required before nexxtt inspection O Unable to inspect
Inspector: Date: - Z4 9 Page of