Permit CITY -OF TIGARD ELECTRICAL PERMIT
Il
° PERMIT #: ELC2008 -00235
= COMMUNITY DEVELOPMENT DATE ISSUED: 4/28/2008
T A K 13125 SW Hall Blvd., Tigard, ,OR 97223 503.639.4171
• PARCEL: 2S113AB-00300
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD ZONING: I -L
SUBDIVISION: FANNO CREEK PLACE LOT : JURISDICTION: TIG
PROJECT: OREGON STATE BAR
Project Description: Installing two illuminated cabinet signs.
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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: 2
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: •
AKERMAN, RICH/WATHEY, JAMES E VANCOUVER SIGN COMPANY, INC
16075 SW UPPER BOONES FERRY RD 6615 SW HWY 99
TIGARD, OR 97224 VANCOUVER, WA 98665
Phone: Contact #: PRI 360 - 693 -4773
FAX 3 60- 693 -2747
FEES
Description Date Amount Reg #: ELE 37 -46CLS
[ELPRMT] ELC Permit 4/28/2008 $106.80 LIC 63951
[TAX] 12% State Surchar 4/28/2008 $12.82 SUP 525SIG
Total • $119.62 • 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.
Issued By /� � Permittee Signature: C /
`C10 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.
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VrIA 00 'ED
Electrical Permit Applicatlsolli%' ,- FOR OFFICE USE ONLY
City of Tigard APR 2 2 DateB� �� Permit No.: '' / I s
q 13125 SW Hall Blvd., Tigard, OR 97223 P�D `� ■
: to Phone. 503.639.4171 Fax: 503.598.\( 0?11 v 1 nkO i •a. Other Permit:
f I G A R D Inspection Line* 503 639.4175 ��` DIN Date Ready/By ions. ® See Page 2 for
Internet www.tigard or.gov tegit Notified/Method Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below)
❑ Service or feeder 400 amps or more ❑ Building over three stones
❑ Demolition [ Other: )s Gl\ where the available fault current ❑ Marinas and boatyards
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations buildings
❑ Multi- family ❑ Master builder in Other: ' a f ) ❑ Fire pump ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION Cl Emergency system. larger separately derived system
❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "I -3 ",
Job no.: Job site address: ) ( 0 3 7 5 t 3 Li per BOOIr►e S C R or more occupancy.
❑ Six or more residential units ❑ Recreational vehicle parks.
City/State /ZIP: i � ^ SAS <� O R 6 17 i t ❑ Health -care facilities. ❑ Supply voltage for more than
J ❑ Haza locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: O, „ ❑ Service or feeder 600 amps or more
"`� S + FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single- or multi- family dwelling unit.
) (0031 bl,0 tAipe,t' gootl,eS Fax y 4-- 77; Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq ft or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family 75.00 2
Z. t II LI, ra i 11'(.ate A cab; n,ek S i S residential (with above sq ft.)
i 3 as or feeders installation, alteration, and/or relocation
200 amps or less 80 30 2
❑ PROPERTY OWNER I IS TENANT 201 amps to 400 amps 106.85 2
Name: n,(. e , ! , 0 � � 1 . r , a 4 cs 401 amps to 600 amps 160.60 2
`� p !l p / ,4 601 amps to 1,000 amps 240.60 2
Address: 16,n 41 6
( PP.r Oi�te,s r r e J
B ry Over 1,000 amps or volts 454.65 2
City/State/ZIP: 7, d O R C � ' Temporary services or feeders installation, alteration, and/or
r . relocation
Phone: ('SO3 ) 2 3 S CA C0 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 599 amps 133.75 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fcc for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fcc,
each branch circuit 6 65 2
Business name: Vancouver Sign Co B. Fee for branch circuits
c without service or feeder fee,
Contact name:
R.,, I CL sto ` 1Y first branch circuit 46.85 2
Address: 6 615 NE HWY 99 Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Vancouver WA 98665 Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( 36 0/ 6934773 Fax:: (3 6 0) 6932747 Reconnect only 66 85 2
E -mail: f 6116 &NIA iQ YL<.A . co m Pump or imgation circle 53 40 2
U CONTRACTOR Sign or outline lighting (z) 53.40 &( j,' '(� 2
Business name: Signal circud(s) or limited - l
Vancouver Sign Co energy panel, alteration, or
Address: 6 615 NE HWY 99 extension. Describe: Page 2 2
City/State /ZIP: Vancouver WA 98665 Each additional inspection over allowable in any of the above
Phone: ( 360 6 9 3 4 7 7 3 Fax: (3 6 0) 6932747 Per inspection 62 50
Investigation per hour (I hr min) 62.50
CCB Lie.: 63951 Electrica ic.: I Suprv. Lic.: 513_ Cl r, Industrial plant per hour 73.75
J' ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: 1 Subtotal tap e W
i eb Plan review (25% of permit fcc).
Print name: �, n ;� ! Date:
x t, 1_ ,._____ U State surcharge (8% of permit fee) f , f (�oL
Authorized signature: TOTAL PERMIT FEE: ( (C . In
Print name: A61,4 sZV Q y., Iy1 Date: 1 /
/aVo.g This permit application expires If a permit is not obtained within 180
days after it has been accepted as complete.
• Number of inspections allowed per permit
I\ Building \Pennus\ELC.PemstApp.doc 05/23/06 440- 4615T(I I /05 /COM/WEB
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CITY OF TIGARD T
BUILDING DIVISION PERMIT #: ELC20UB- 00235
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/28/2008
Phone: (503) 639 -4171 A
Inspection Requests (24 Hrs.): (503) 639 -4175 ...' "_
INSPECTION WORKSHEET FOR DATE: 5/19/2008 TIME: 7:00AM PAGE: 39
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD CLASS OF WORK:
SUBDIVISION: FANNO CREEK PLACE LOT #: TYPE OF USE:
PROJECT NAME: OREGON STATE BAR
DESCRIPTION: Installing two illuminated cabinet signs.
OWNER: AKERMAN, RICH/WATHEY, JAMES E, PHONE #:
CONTRACTOR: VANCOUVER SIGN COMPANY, INC PHONE #: 360
Inspection Request Scheduled For: Date: 5/19/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 070031 -01 360693 -4773 \_ Y
Corrections /Comments /Instructions: V` C Y O
A n ' Oa-W\ S V2._' 60 5 i l G-
V
h ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N NI Date: i.c,i Phone #: (503) 718- 1 -46
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