Permit CITY OF TI GARD ELECTRICAL PERMIT
PERMIT #: ELC2002 -00006
A-toge Ai' DEVELOPMENT SERVICES DATE ISSUED: 1/8/02
13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171 PARCEL: 1 S134BC -00300
SITE ADDRESS: 12220 SW SCHOLLS FERRY RD
SUBDIVISION: ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of (3) sign lightings.
- 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: 3
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:
LAMBS THRIFTWAY SECURITY SIGNS INC
12220 SW SCHOLLS FERRY RD 436 SE 12TH AVE
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: Phone: 503 - 232 -4172
Reg #: LIC 122809
ELE 26- 560CLS
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FEES Required Inspections
Type By Date Amount Receipt Wall Cover
PRMT CTR 1/8/02 - $160.20 2720020000( Elect'I Final
5PCT CTR 1/8/02 $12.82 2720020000(
. Total $173.02 .
This Permit is issued subject to the regulations contained in the Tigard Muniapal 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 t• • • ' . • - - dopted by the Oregon Utility Notification
Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952-001-01:1. You may obtain opies of these rules or dired questions to
Permit Signature: Issued By: �I f ftwidir 440. /1
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 _
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Electrical Permit Application
Date received: / g 09-- Permit no.: acroR—
A7 IL City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171 .
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: MaCc .41 ail
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory jii.Commercial/industrial ❑ Multi - family ❑ Tenant improvement
0 New construction ❑ Addition/alteration/replacement 0 Other: ❑ Partial
JOB SITE INFORMATION
Job address: 12 VZt2) Svc( Scf1o4..c5 C-- fain Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: : k: i , j , SubdivisioIj:
Project n. _ Description and location of work on premises: N Fkf S /Gl_.l
Estimated date of c% pletion/inspection:
CONTRACTOR APPLICATION FEE SCI IEDU,E
Job no: C o r "7 j—-' ' 1 C . a..-C C Fee Max
Business name: Description Qty. (ea.) Total no. Imp
Address: Lc-k S 1 'j�-r� New residential - single or multi- family per
dwelling unit. Includes attached garage
City: '?d er_..r I State: CA. I ZIP: o Z ( c.,1 Serviceincluded
Phone: 92, 23 L ti /7 L I Fax: �b323c /$EItE -mail: 1000 sq. ft. or less 4
I Z c„,,
Each additional 500 sq. ft or portion thereof
2
CCB no.: i Z„� Elec. bus. tic. no:
Limited energy, residential 2
City/ • . n0.: Limited energy, non- residential 2
/ • SS • Z Each manufactured home or modular dwelling
pervising a clan (required) Date Service and/or feeder 2
Sup. elect. name (print): PAM Ca License no: 2 6,51(4 Services or feelers— installation,
alteration or relocation:
PROPERTY OWNER 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: I 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 Installation, alteration, 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 circuits - new, alteration,
Name: or extension per panel:
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 of 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 ❑ Health-dare facility Each pump or irrigation circle 2
❑ Service over 320 amps -rating of 1 &2 ❑ Hazardous location Each sign or outline lighting "5. 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
❑ System over 600 volts nominal more residential units in one structure ' alteration, or extension' _ 2
O Building over three stories 0 Feeders, 400 amps or more *Description:
0 Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lightingplan ❑ Other. Per inspection
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $
❑ Visa 0 MasterCard expires if a permit is not obtained' Plan review (at _ %) $
Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $
Expires accepted as complete. TOTAL $
Name of cardholder as shown on credit card •
$
Cardholder signature Amount
440 - 4615 (6/00/COM)
Electrical Permit Fees: Limited Energy Fees:
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
p Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total 4
Check Type of Work Involved: .
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 ❑
Dwelling Service or Feeder $90.90 2 Garage Door Opener`
Services or Feeders ❑ Heating, Ventilation and Air Conditioning System*
Installation, alteration, or relocation
200 amps or less $80.30 2
201 amps to 400 amps $106.85 2 ❑ Vacuum Systems
401 amps to 600 amps $160.60 2
601 amps to 1000 amps $240.60 . 2 p 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
New, alteration or extension per panel ❑ Boiler Controls •
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 ❑
or feeder fee. Fire Alarm Installation
First branch circuit $46.85
Each additional branch circuit $6.65 ❑ HVAC
Miscellaneous ❑ Instrumentation
(Service or feeder not included) .
Each pump or irrigation circle $53.40
Each sign or outline lighting •—_ $53.40 ❑ Intercom and Paging Systems
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 $ /&0' go
° �9 . f0 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.
o� Fees:
Total Balance Due $ / 73
Enter total of above fees $
❑ Trust Account # 8% State Surcharge $
Total Balance Due $
i :\dsts\forms \elc- fees.doc 10/09/00
CITY OF TIGAI3D 24-Hour
BUILDING Inspection Line: (503) 639 -4175 MS
INSP TION DIVISION Business Line: (503) 639 -4171
BUP
R eived 3 d Date Requ sted 3/2":0) Z AM PM BUP
Location / 4? 2-6 SW 1(S Suite MEC
Contact Person ✓' Met— Ph ( ) 3 d 7 ° a 3 S PLM
Contractor J Ph ( ) SWR
BUILDING Tenant/Owner j ELC
Footing < e )-002-- O Odd 6
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: -/ � csOCIAl24:10 SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation P -A
Drywall Nailing
Fire wall
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— pArtT FAIL
EfaCTWAL
Service
Rough -In
UG/Slab
Low Voltage
J Fir: rm
` '" Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
111 Please call for reinspection RE: 1=1 Unable to inspect — no access
Fire Supply Line
ADA _ 1
Approach/Sidewalk Insp or Ext
Other:
Final DO NOT REMOVE this inspection record from th ob site.
PASS PART FAIL
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