Permit i z CITY OF TIGARD ELECTRICAL PERMIT
ll ° PERMIT #: ELC2007 -00382
° , COMMUNITY DEVELOPMENT . .
DATE ISSUED: 6/7/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S1 12 DA -01300
SITE ADDRESS: 06640 SW REDWOOD LN * *' ZONING: I -
SUBDIVISION: PACIFIC CORPORATE CENTER LOT: 001 JURISDICTION: TIG
PROJECT: PORTLAND CLINIC
Project Description: Illuminated wall sign.
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:
PACIFIC REALTY ASSOCIATES SECURITY SIGNS INC
15350 SW SEQUOIA PKWY #300 2424 SE HOLGATE BLVD
PORTLAND, OR 97224 PORTLAND, OR 97214
Phone: Contact #: PRI 503 - 546 - 7114
FAX 503 - 230 -1861
FEES
Description Date Amount Reg #: ELE 26- 560CLS
[ELPRMT] ELC Permit 6/7/2007 $53.40 LIC 122809
[TAX] 8% State Surcharge 6/7/2007 $4.27 SUP 383 SIG
Total $57.67 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 o , .246.6699 or 1.800.332.2344.
ID 4111
Issued By: /I /j,A _ t� ` Permittee Signature.„,eu
4111 111.1P \
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.
AJ z - 0 0 S0
Electrical Permit Application FoR 01-1-1( A.: t SI: o\1.1
City of Tigard "` Permit No.:
19125 SW Hall Blvd., Tigard, OR 97223 Dat°/B C • 2
Plan Review
u._
Phone: 503.639.4171 Fax: 503.598.1960 J i Date/B . Other Permit: SG • a —1 040
Inspection Line: 503.639.4175 -. r a •'! � , Date Ready/By la See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑Service over 225 amps, comm'l ['Hazardous location
❑ er ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ 1 and 2 family dwelling ❑ Commercial/industrial ❑ 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 ❑Other:
JOB SITE INFORMATION AND LOCATION ❑Occupant load over 99 persons ❑Manufactured structures or
❑Egress/lighting plan park
no.: I Job site address: 6 , 6 4 0 az woltet. CA. ❑Health -care facility ❑Other:
Submit 2 sets of plans with any of the above.
City/State/ZIP: The above are riot applicable to temporary construction service.
•
Suite/bldg./apt no.: Project name: c /'� ` FEE SCHEDULE
��" � ��1 r«
Description I Qty. I Fee* I Trial 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 1
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, gy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
1 dwelling, service and/or feeder 90.90 2
`t )1m 1 ' � c �� e "` ' t i�� 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
(�, 401 amps to 600 amps 160.60 2
Name: 1'�rl C . R e.C�-1 ASSnc ( t (A 601 amps to 1,000 amps 240.60 2
Address: I S 3S O ` ` S w ` , a P )y . Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: P c 0kx\A ) ' C_ 44 Temporary services or feeders installation, alteration, and/or
Phone: ( ) F ax: ( ) relocation
• 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 P anel
❑ APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with
� service or feeder fee, each
Business name: -tc.lt w ' t -i c6,op5 branch circuit 6.65 2
� d f B. Fee for branch circuits
Contact name: rn� a � F C� `�
(-n , without service or feeder fee,
Address: each branch circuit 46.85 2
Each add'l branch circuit 6.65 2
City/ State/ZIP: Miscellaneous (service or feeder not included)
Phone: (z 544 '� I Fax: • ( LTs. 7 l f
Pump or irrigation leig lighting I 53.40 2
circle 53.40 2
1 Sign or outline lighting
E - mail: Mp f 1 A l 12 9 0 F se 1 Signal circuit(s) or limited-
CONTRACTOR energy panel, alteration, or
Business name: . .5. >,2 a S extension. Describe: Page 2 2
Address: '� - I M / \ Each additional inspection over allowable In any of the above
City /State/ZIPC 1 ` �, t/ „ • q 3 foz Per Investigation P er hour ( 1 hr miD n ) 62.50
`' 62.50
Phone: (' Industrial plant per hour 73.75
J� r • t' Fax: ( • _ a - ELECTRICAL PERMIT FEES" •
CCB Lic.: I 72M01 Electrical Lic.: Cc.xo iIi 1 Suprv. Lic.: )s1 Subtotal 5-3.10
Suprv. Electrician signature, required: . 0 I ft ` oZ Plan review (25% of permit fee)
Print name: -"s State surcharge (8% of permit fee) Lg-. 2-9
/1 (mo 1 •
Authorized signature: ly TOTAL PERMIT FEE S*3- �'—
This permit application expires if a permit Is not obtained within 180
days after it has been accepted as complete
Print name: , X , I Date: • Fee methodology set by Tri -County Building Industry Service Board
•• Number of inspections per permit allowed
is EuildingWermib\ELC- PnmitApp.doe 12/03 440.4615T(10/04/COM/WEB
•
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
; '0 Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial system. $75.00
(SEE OAR 918 - 260 - 260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
is\ Building \Pumits\ELC- PamitApp,doc 09/03
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00382
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/7/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/20/2007 TIME: 7:03AM PAGE: 23
SITE ADDRESS: 06640 SW REDWOOD LN'''' CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: 001 TYPE OF USE:
PROJECT NAME: PORTLAND CLINIC
DESCRIPTION: Illuminated wall sign.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: SECURITY SIGNS INC PHONE #: 503 546 - 7114
Inspection Request Scheduled For: Date: 7/20/2007 Pour Time:
Code # Inspection Description f ••nfir-m # Contact # Message
199 Electrical final 052452 -01 503 - 232 -4172 Y
Corrections /Comments /Instructions:
-i i r ec)
* kik
• \
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: -+ Date: 1 16 in Phone #: (503) 718- 2491