Permit CITY OF 1"IG'AR E LL-Ci °:f?CAE_ PERMIT
, ,.,
i,H�,f ., � 1• DEVELOPMENT SERVICES PERMIT #n ELC'� 1Z17:_;G
����� DATE ISSUED: 1/ ,� 7
13125 SW Hall Blvd., Tigard, OR 97223 ' (503) 639-4171
PARCEL: 271 10SCC- -40S0 i21
SITE ADDRi SS- - - 2 13500 SW PACIFIC HWY 1
SUBDIVISION....: ZONING :C - -G
,BLOCK...,......: LOT- ,s, <.. - JURISDICTION: T: ,
Project Description: ICI iRLL'X F'pINiS ;ours Signs ,
—RESIDENTIAL UNIT_ -_ - -._ .,.,.__ -. -TEMP SRVC /FEEDERS - --MISCELLANEOUS--
ISCF=LL1"!NEOUS -- -
1000 SF OR LESS- - - - - 0 0 - 200 :imp, - - - - - - - 0 PUMP/IRRISATION- . , . - 0
EACH ADD' L '500SF. - , ° M 201 '-' 400 anp. , - - .. - o 0 , SIGN /OUT LINE LTG- _ '; 4
LIMITED ENERGY...'..: 0 401'- 600 n R- , - - - - 0 SIGNAL /PANEL- - - - - - - . f
MANF- HM/ S•VC /FDR- . e 0 .601.1-amps-1006 v'o It s. u 0 MINOR LABEL (10)'—.:' .:' 07
-- - -- SERVICE /FEEDER----_- ----BRANCH C I , CU I TS-- '• - - --- ---- _ADD' L _ I NSF'GC T I ONS -• -_-
0 -•- 200 amp- - - , . , e. 0 W/ SERVICE OR FEEDER: 0 PER INSPECTION-.....: 0
slid. - -- 400 amp......: 0 i si_ W/O SRVC OR FDR- - 0 PER HOUR........—: 0
401 -• 600 amp......: 0 EA ADD'L BRNCI -f CIRGs 0 IN PLANT............: 0
0 .. -. 1000 aoi p- - - - : 0 --------------,----PLAN REVIEW SECTION--7-------------
1000+ arep /vol..b... -- -' 0 ) =4 RES UNJ - - - „ -, - ) 600'VOLT NOMINAL. - -
Reconnect only. - . - „ : 0 SVC /FDR ) = 225 AMPS..: . CLASS AREA/SPEC OCC-
STEIN SIGN type amount by date '•'ecpt
392 CROWN POINT HWY .- PRM . luo- k11i , JSD 11/04/97 57- -30064' .
C! 1RZ1E•j T S nR 97019 _ - - - ` (k S200 _71411_ 1.-1, /04 /9 l- 9,7- fl{ ,.:¢.971 — -
Phone: 4$e ,
Cant 1"aC:'.t U1^ a •--...._.._._._...-........ _.:__. :.__._�- _._-- --- ••- -• - --- ._.__._.___.
JIM STEIN STEIN SIGN COMPi=iN,', .:5 168.00 TOTAL. . •
398.10 CROWN POINT. HWY '
------7-- REQUIRED INSPECTIONS , '- -_ -_--
CORBETT OR 97019 Elect' I Final.
Phone' s 695-3220 ___��
This peroit is• issued subject to the regulations contained in the Tigard Municipal Code State of Oregon Specialty Codes and all other .
applicable laws. All or will be done in accordance with approved plans. This peroit mill expire if work is not started within 180
days of issuance, or if work is suspended for gore than 18i - days. ATTENTION: Oregon lass requires you to follow f! - e rules adopted by
the Oregon Utility notification Center. Those rules aye sus for in OAR 952 -001 -0010 through CAR 9524211-198 You nay obtain a copy
of these ;:e' .0e4 -
sued y: - '`-- ._.�. _.___._
---------------------7-----OWNER INSTALLATION ONLY----------- - - - - -- ------------
The installation is heino -madM on property I o■gn- which is no; intended for
sale,' lease, or nest- . ' . .
OWNER' S SIGNATURE: DATE: '
_.._ - - - CONTRACTOR INSTALLATION ONL.1''-.' -_
S I CGNA U'RE OF , SUPR, E.LEC' N m _,. _______ _ DATE a ____ _ . _
LICENSE NO o
+ +- 1-1-+••-if ± +- +-+- +••1- i- +$-1- +J•-r±± +ti- -1 -
4 -1-+ ++ +++ +-+ 1: 1-- +•-1-
1- +-f- + ++ F± +'F ± ±+++ + ++ + ++±-1• + ++ ++++ +-1. 4.4 - +++
Call 639-4175 by 7s001 p-,7!- for an inspect'ion needed the next business day
.r. ;. -i-i- --1-- 1...f. {..•-'r.h+--+r• +-+-1-» - ]-+- .1- +- i- ••i-1-•i-- I- - -t -+ i- •f- ±.1...f..-P-m -+± ± + + ++++++ f-'r +±+4-FA- 3- +-•{- -h + +• + -t -I- + +- ++++ +- +3 - i- ir+-++A-
•
CITY TIGARD Electrical Permit Application Plan Check # _,
13125 SW HALL BLVD. Recd B 1.
Date Rec'd AI/
TIGARD OR 97223 Date to P.E.
Phone (503) 639 -4171, x304 Print or Type Date to DST
Inspection (503) 639 -4175 Incomplete or illegible will not be accepted Permit # Lc 9 7-- o73?
Fax (503) 684 -7297 Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of inspections per permit allowed
Name (or name of business) _r-CL 60 /(TA I 676 Service included: Items Cost Sum
I
Address 0,5 s id PA c f ', C t /!,/ y � � 4a. Residential - per unit
t� 1000 sq. ft. or less $110.00 4
City /State /Zip f4�/ 0/�. < 7r ,2 Each additional 500 sq. ft. or
Commercial g Residential El portion thereof $25.00 1
Limited Energy $25.00
Each Manuf'd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of all current licenses) 4b. Services or Feeders
Electrical Contractor .'l/E S. yµ Installation, alteration, or relocation
200 amps or less $60.00 2
Address 3 ' f) C •ra rJ a' t 4.`' 201 amps to 400 amps $80.00 2
City 2B' I State 04, Zip 77 +/9 401 amps to 600 amps $120.00 2
Phone No. 3 - cf 5 - 3,9-0 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. Exp.Date
OR State CCB Reg. No. lv U Exp.Date a 23 - 9 Y 4c. Temporary Services or Feeders
COT Business Tax or Metro No: Exp.Date S- 9Y Installation, alteration, or relocation
200 amps or less $50.00 2
Signature of Supr. Elec'n 401 amps to 600 amps $75.00 2
Over 600 amps to 1000 volts,
License No 3S1 S.I 2 Exp.Date 10 /411 see "b" above.
Phone No oti S 3 Z-
4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address Each branch circ $5.00 2
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 2
The installation is being made on property I own which is not Each additional branch circuit $5.00 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irngation circle $40.00 2
Each sign or outline lighting 'y $40.00 /. La 2
3. Plan Review section (if required):* Signal circuit(s) or a limited energy
panel, alteration or extension $40.00 2
Minor Labels (10) $100.00
Please check appropriate item and enter fee in section 5B.
4 or more residential units in one structure 4f. Each additional inspection over
Service and feeder 225 amps or more the allowable in any of the above
System over 600 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00
as described in N.E.C. Chapter 5 In Plant $55.00
* Submit 2 sets of plans with application where any of the above apply. 5. Fees:
Not required for temporary construction services. 5a. Enter total of above fees $ ,
5% Surcharge (.05 X total fees) $
NOTICE Subtotal $
5b. Enter 25% of line 5a for .
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $ J
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY L
TIME AFTER WORK IS COMMENCED. ❑ Trust Account #
Total balance Due $
191DSTs \ELC96 APP Rev 9/96
16
2 -23
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: 0-- oZ `4' `7 t A.M. P.M. MST:
Location:
0 U) i ANC �L,
�u BUP:
Tenant: L n
(� x >�� Suite: Bldg: MEC:
Contractor: -?' J47 , C91??L-41. Phone: CATS 3c)-=+-O PLM:
� ` , I n Phone: ,, ] r ELC: q 7
✓/ iC/�! �N 1 l ELR:
�I i 0 7 _, • SIT:
BUILDING . LDG (con't) PL i ; 1 G MECHANICAL ELECTRICAJ) SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/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 roved Not Approved
FINAL FINAL FINAL FIN FINAL
.c-- 5/:, .)-7 A .., _s- .-
0 Call for reinspection 0 • spection fee of $ required before next inspection 0 Unable to inspect
Inspector: Date: — V1 L g O Page of