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Permit CITY OF T I G A R D ELECTRICAL PERMIT PERMIT #: CAL ELC2001-00073 DEVELOPMENT SERVICES DATE ISSUED: 02/02/2001 'f �! 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S134BC-00300 SITE ADDRESS: 12272 SW SCHOLLS FERRY RD SUBDIVISION: ZONING: C -G BLOCK: LOT : JURISDICTION: TIG Project Description: 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: SIGNAL/PANEL: MANF HMI 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+ amplvolt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: MULTI -LIGHT SIGN CO. 3255 NE BROADWAY PORTLAND, OR 97213 Phone: Phone: 281 -3083 Reg #: LIC 64107 SUP 343SIG ELE 26 -90CLS FEES Required Inspections Type By Date Amount Receipt Elect'I Final PRMT CTR 02/02/2001 $53.40 2720010000( 5PCT CTR 02/02/2001 $4.27 2720010000( EXPIRED 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 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. Thos rules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -1987. PERMITTEE'S SIGNATURE 07v - , , , o/eve9T/' ISSUED BY ter . 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: O LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day BUP - Building Permit ELC - Electrical Permit Inspection Description Date Passed By Q Ins ection Descri . tion Fi ate Passed lril' Footing /Setback • Under:round cover A iMPIPIPINME Foundation walls • Wall cover ,1 ff.1 J.I:4 =1 1_'1 Footing drain • Ceilin: cover Waterproof bsmt walls II Electrical rou :h -in �� , d 1311M Slab IMMEETZEIMIIMMIEWIMIN Crawl drain R..r IEW Underfloor insulation Post/beam structural - Shear walls /anchors ELR - Restricted Energy Permit Roof nailing 4 Inspection Description Date Passed By Firewall Low voltage Tilt -up panel Electrical final Masonry/Reinforcement Framing MFG - Structure set -up MEC - Mechanical Permit Insulation Drywall nailing 4 Inspection Description Date Passed By Post/beam mechanical Suspended ceiling Gas line Engineered soils Mechanical rough -in Welding Lab Final Fire damper Concrete Lab Final p Duct work Bolting Lab Final Smoke detector Fireproofing Lab Final Mechanical fmal Structural observation Final inspection PLM - Plumbing Permit 4 Inspection Description Date Passed By BUP - Fire Protection System Permit Plumbing underslab Inspection Description Date Passed By Crawl drain Sprinkler underfloor /slab Post/beam plumbing Sprinkler rough -in Plumbing top -out Sprinkler final RP/backflow preventer Fire alarm final Rain drain Storm drain Water service SIT - Site Permit Sanitary sewer 4 Inspection Description Date Passed By Culvert/catch basin Footings Pump /fill septic tank Foundation walls Plumbing final Sprinkler supply lines Sprinkler underfloor /slab Catch basin /Manhole SWR - Sewer Permit Engineered soils 4 Inspection Description Date Passed By Engineering acceptance Sanitary sewer Final inspection Final inspection INSPECTION RECORD - BUP, PLM, SWR, ELC, ELR, MEC, SIT PERMITS CITY O F T I G A R D ELECTRICAL PERMIT r PE RMIT #: ELC2001 -00073 , � DEVELOPMENT SER VICES DATE ISSUED: 02/02/2001 s- j --' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1 S134BC -00300 SITE ADDRESS: 12272 SW SCHOLLS FERRY RD SUBDIVISION: ZONING: C -G BLOCK: LOT : JURISDICTION: TIG Project Description: 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: 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: MULTI -LIGHT SIGN CO. 3255 NE BROADWAY PORTLAND, OR 97213 Phone: Phone: 281 -3083 Reg #: LIC 64107 SUP 343SIG ELE 26 -90CLS FEES Required Inspections Type By Date Amount Receipt Elect'l Final PRMT CTR 02/02/2001 $53.40 2720010000( 5PCT CTR 02/02/2001 $4.27 2720010000( 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 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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -1987. PERMITTEE'S SIGNATURE 02ven.9ue977 ISSUED BY: � 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. ELECN: DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day , f . l ` Electrical Permit Application Date received- A /0/ Permit no.:Ezz g _6 r u•.e • , .J 1 _ City of Tigard Project/appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By:491 Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 SG•v.200/ — oo o 2.S Case file no.: Payment type: Land use approval: -SG/v 200 / — 000 2 6 TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement ❑ New construction ❑ Addition/alteration /replacement ❑ Other: ❑ Partial JOB SITE INFORMATION Job address: , ag7// s �' 5 : ,Ef] Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: Block: Subdivision: Project name: //P ice/ iall Description and location of work on premises: l i g /Nfl Estimated date of completion/inspection: CONTRACTOR APPLICATION —' J '` ", FEE SCHEDULE Job no: Fee Max Business name: 1 i L Z ' 1 I i i Ce • Description Qty. (ea.) Total no. insp �� ' _ / New residential - single or multi- family per Address: Woo 1irg �aii �� dwellinguait . Includes attachedgarage. ®� : �' %fV� iPAEDI ZALIM Service included: I� 1000 sq. ft. or less 4 Phone: / , Fax: E -mail: CCB no.: ,p 4, 1 J 7 Elec. bus. lic. no: • !3 r1 Each additional 500 sq. ft. or portion thereof _ Limited energy, residential 2 City /metro lic. no.: 1p L/10 /7 /ate Limited energy, non- residential 2 _ ,� = / .11 . . Each manufactured home or modular dwelling ignature of s `; � isin` trician (required) Dat O /Oi D / Service and/or feeder 2 Sup. elect. name (print): License no: , - c10 a4 g Services or feeders— installation, alteration or relocation: PROPERTY OWNER 200 amps or less 2 Name (print): 201 amps to 400 amps 2 Mailing address: � j r / 401 amps to 600 amps 2 y , I� g , i l/ 4� _. 601 amps to 1000 amps 2 n . ZIP: Over 1000 amps or volts 2 Phone: ' Fax: 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, or relocation: 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, I OM N 701 or tes pa nel: / rl _ � A Fee ex n for b ion per circuits with purchase of Address 9r �• /a service or feeder fee, each branch circuit 2 - «} �� / ��ym B. Fee for branch circuits without purchase ® IJ( . ///1///r tr+r�+�t tr1:>i+ of service or feeder fee, first branch circuit: 2 Phone: �� Fax: E -mail: Each additional branch circuit: PLAIN REVIEW (Please check all that apply) Misc. (Service or feeder not included): ❑ Service over 225 amps - commercial ❑ Health -care facility Each pump or irrigation circle 2 ❑ Service over 320 amps -rating of 1&2 ❑ Hazardous location Each sign or outline lighting / 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 .0 Building over three stories ❑ Feeders, 400 amps or more *Description: ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above: ❑ Egress/lightingplan ❑ Other. Per inspection I I I 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 ❑ 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: j . w 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 y 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 ❑ 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 El Vacuum Systems' 201 amps to 400 amps $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 ❑ HVAC Miscellaneous ❑ Instrumentation (Service or feeder not included) . Each pump or irrigation circle $53.40 ❑ Intercom and Paging Systems Each sign or outline lighting / $53.40 <' • 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: 2 ^ ❑ Protective Signaling Enter total of above fees $ 5 3' iVtJ n Other 8% State Surcharge $ __. a 7 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 $5747 Enter total of above fees $ ❑ Trust Account # 8% State Surcharge $ • Total Balance Due $ i:\dsts\forms \elc- fees.doc 10/09/00