Permit a:d 1 CITY OF TIGARD ELECTRICAL PERMIT
.. DEVELOPMENT SERVICES PERMIT #: ELC98 -0042
4i � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: : 01 / 22 / 98
i �b� 8
PARCEL: 23115AB- 01900
SITE ADDRESS...:162O0 SW PACIFIC HWY #D
SUBDIVISION • ZONING:C —G
BLOCK • LOT • JURISDICTION: TIG
Project Description : Sign lighting for changing out of 4 signs, changing from
Payless to RiteAid.
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS : 0 0 — 200 amp • 0 PUMP /IRRIGATION • 0
EACH ADD'L 5O0SF...: 0 201 — 400 amp • 0 SIGN /OUT LINE LTG..: 4
LIMITED ENERGY • 0 401 — 600 amp • 0 SIGNAL /PANEL • 0
MANF. HM/ SVC /FDR..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (10)...: 0
- - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- -
0 — 200 amp : 0 W /SERVICE OR FEEDER: 0 PER INSPECTION • 0
201 — 400 amp : 0 1st W/0 SRVC OR FDR.: 0 PER HOUR • 0
401 — 600 amp • 0 EA ADD'L BRNCH CIRC: 0 IN PLANT • 0
601 — 1000 amp • 0 PLAN REVIEW SECTION
1000+ amp /volt • 0 > =4 RES UNITS • > 600 VOLT NOMINAL..:
Reconnect only : 0 SVC /FDR >= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: FEES
RITEAID type amount by date recpt
16200 SW PACIFIC HWY PRMT $ 160.00 DRA 01/15/98 98- 302541
SUITE D 5PCT $ 8.00 DRA 01/15/98 98- 302541
TIGARD OR 97224
Phone #:
Contractor:
BLAZE SIGNS OF OREGON $ 168.00 TOTAL
PO BOX 23910
REQUIRED INSPECTIONS
PORTLAND OR 97281 -3910 Wall Cover Elect'1 Final
Phone #: 639 -3262 Elect'1 Service
Reg #..: 000643
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001-00 OAR 952-001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (503)2 -1987.
Permittee Signature: 0 i l�— �r`.Sssued By: _
• i , , . . . . 4.. i , i k i _.
_ . . . . . ,
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 l
SIGNATURE OF SUPR. ELEC' N: DATE: / �a- -94"
LICENSE NO: 157 6/cc,
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
.3
CITY-OF TIGARD Electrical Permit Application Plan Check
13125 SW HALL BLVD. Rec'd By
r
Date Rec'd -
J l
TIGARD OR 97223
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print or Type Permit # ex
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: ]} 4. Complete Fee Schedule Below:
Name of Development A Li L 5 Number of Inspections per permit allowed
Name (or name of business) . i 1 \ R II f I b * 635S Service included: Items Cost Sum
Address (p &) 1 C f) P -tr 0 4a. Residential - per unit
1000 sq. ft. or less $110.00 4
City /State /Zip T16 A - i2b I DR 9'7 a o1 Each additional 500 sq. ft. or
Commercial p. Residential El portion thereof $25.00 1
Limited Energy $25.00
Each Manut'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 61.447 5I(9MS Installation, alteration, or relocation
Addre Pb 3D1C b i.ci lD 200 amps or less $60.00 2
201 amps to 400 amps $80.00 2
City f J State O 2 Zip 9 ' 7 X , 1 401 amps to 600 amps $120.00 2
Phone No. 4 3,44,9a 601 amps to 1000 amps $180.00 2
Job No. I 'B 1 'I Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No. A (p 3950 e- Exp.Date (2) �7 / a O Reconnect only $50.00 2
OR State CCB Reg. No. / 3 9 S Exp.Date .1Z/a7/ 06 4c. Temporary Services or Feeders
COT Business Tax or Metro No. al) 13 Exp.Date j1/l 9 Installation, alteration, or relocation
200 amps or less $50.00 2
201 amps to 400 amps 75.00 Signature of Supr. Elec'n 401 amps to 600 amps $100 00 2
J Ov 600 amps to 1000 volts,
License No. 157 S IG Exp.Date ID/ I / 9 C I see "b" above.
Phone No. Ip 3q -?i Q( a ru all
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 circuit $5.00 2
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee.
Firstibranch circuit $35.00 2
The installation is being made on property I own which is not Each additional branch circ $5.00 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00 le. 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: D
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ ---41?--
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 $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account # /616'..-
Total balance Due $
I: \DSTS \ELC96.APP Rev 9/96
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 11 // AM PM BLD
Location I (, c; C- 11 - Suite MEC
Contact Person Ph PLM
Contractor i¢7�� S Ph (0.3 9 - 3 Z4-L SwR
BUILDING TOwner �,ff ��C ELC ??" ��,
Retaining Wall ELR
Footing
Foundation Access: 1 1 FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab 9r- o q'Z, — 0_) SiCtc SIT
Post & Beam ?
Ext Sheath /Shear (1)® ag- rn.r-ey c •-e (disc
Int Sheath /Shear Cuts • arej �,��s fed) 0� j'A
Framing ��_� ► �� •
Insulation / `
Drywall Nailing .2 # -
Fire wall �P
Fire Sprinkler a�.L� � .Q� et,
Fire Alarm
Susp'd Ceiling — �-�� � t
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab • S - g 9 - fr‘-e--72
Top Out
Water Service
Sanitary Sewer
Rain Drains
01--Z
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
,ASS PART FAIL
ELECTRICAL)
Rough In
UG /Slab
Low Voltage
Fire Alarm
PART FAIL
SITE
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
Other Date P. Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.