Permit 4
CITY OF T I G A R D ELECTRICAL PERMIT
PERMIT #: ELC2000 -00579
DEVELOPMENT SERVICES DATE ISSUED: 10/5/00
' - 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 1 S126C0 -01107
SITE ADDRESS: 09640 SW WASHINGTON SQUARE RD G -11
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of one 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:
PPR WASHINGTON SQUARE LLC PACIFIC ABLE SIGN CO
P.O.BOX 21545 2007 SE POWELL
SEATTLE, WA 98111 PORTLAND, OR 97202
Phone: Phone: 503 - 232 -6450
Reg #: LIC 134473
ELE 1112LMS
SUP 676SIG
FEES Required Inspections
Type By Date Amount Receipt Wall Cover
PRMT CTR 10/5/00 $53.50 2720000000( Elect'l Final
5PCT CTR 10/5/00 $4.28 2720000000(
Total $57.78
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- / A G E 7�� ISSUED B : C
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:
ONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: -) DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
10/04/00 WED 16:39 FAX 503 598 1960 CITY OF TIGARD ` IJ002
., A Electrical Permit Application
Date received: /O Permit no.:fG ti_OD 5
l l t : City of Tigard ProjectlappL no.: Expire date:
CiryofTigurd Address 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: I Receiptno.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT
O 1 & 2 family dwelling or accessory 0 Commercial/industrial U Multi - family ❑ Tenant improvement
0 New construction O Addition/alteration /replacement U Other: 0 Partial
JOB SITE INFORMATION .
Job address: kJ iiLi,: i
_ 11 ... - Bldg. no.G-// Suite no.:; j ( Tax map/tax lot/account no.:
Lot: Block: ' Subdiv ion:
Project name: I Description and location of work on premises:
Estimated date of completion/inspection:
(.:ONTRAC FOR :1PI'I.IG\IION • F1:1. SCIlI:I)LLL
Job no: _ Fee Max
Business name: 4 (� S4.e S option Q4' . (ea) Total no. leap ,
? e--(}e' r��`�j'►p &ani a&lI ch nadti-family per
Address: roge.
,,.}} , dwepingtralt.bu:bndsattachad�e.
City: F ri let h ei I State'/'{ I ZIP: q 7vp Z Servioetnduded:
Phone: I Fax: I E -mail: 1000 sq. it or less - 4
Each additional 500 sq. ft. or portion thereof
CCB no.: 3.141 3 Elec. bus. lie. no: `i5p // Limited
Cit /m lic. no.: e no residential - sie 2
Y � �o�d Limited energy, 2
{ —4, 0 Each manufactured home or modular dwelling
mgaature of supervising electrician (required) b ate Service andlorfeeder 2 /
to
Sup. elect name (per): Vl ver-tl t•r-N License no: -1425 Servlcesorfeeden— kedallation,
alteration or relontloo:
200 amps or less 2
Name (print): 201 amps to 400 amps 2
Mailing address: ant amps to 600 amps • 2
601 amps to 1000 amps 2
City: !State: jzIP: Over 1000 amps or volts 2
Phone: I Fax: 1E-mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary aaenICe$ or feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, orvptocatlorc
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600: . ., 2
ENGINEER Branch dreafts- new, eke:Vico, •
or extension per panel-
Name: A Fee for branch circuits with purchase of
Address: service or feeder fee. each branch circuit 2
City: I State: ! ZIP: B. Fee for brunch circuits without purchase
Phone: Fax: E 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 lacbsdedk ,
0 Service over 225 emps-comrmxial O Health-ane facility _ Each pump or irrigation circle 2
l] Service over 320 amps - rating of 1 &2 0 Hazardous location Each signor outline lighting • I 2
family dwellings O Building over 10,000 square feet four or Signal circvit(s) or limited energy panel.
O System over 600 volts nominal more residential units in one structure alteration, or extrusion' r - 2
O Building over three stories O Feeders, 400 amps or more rDesuiption:
O Occupant load over 99 persons CI Manufactured structures or RV pads Each additional Impedioo over the allowable to
any of the above:
0 Egresstightingplan 0 Other Per inspection I i I I
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Permit fee $ ..3....
Not an joriodietioas ere upt aedir cards. please call jurisdiction for more information Notice: This
permit permit application Plan review (at ! %) $
O Visa 0 MasterCard expires if a t is not obtained
Cradr card aorta: I / within 180 days after it has been State surcharge (8%) .... $ y i1 Zf -.
Name a cardholder as aboan at aeon card Flu accepted as complete. TOTAL $ ' f ig
S
Cardholder signature Amcor - 440 -4615 (6/00/COM)
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested / -1 /‘ AM PM BLD
Location 9,6 (1 S w 14145 Suite MEC
�/
Contact Person ✓ Ph 7 z -3 7&U PLM
Contractor 0( Ph SWR
BUILDING Tenant/Owner ELC �G� �'i �3)
Retaining Wall ELL. 'f 1 9
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof (J
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
• _ FAIL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Fi
S PART FAIL
E
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date / b //49 /� Inspector Other Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.