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Permit CITY OF T ELECTRICAL PERMIT 'Ar t' DEVELOPMENT SERVICES PERMIT #: ELC98 -0748 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171 DATE ISSUED: i / i 8 / 98 PARCEL: 25115AB -01900 SITE ADDRESS...:16200 SW PACIFIC HWY #J1 SUBDIVISION ZONING:C —G BLOCK • LOT • JURISDICTION: TIG Project Description : Electrical service for installation of 3 perianent wall signs. - -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS 1000 SF OR LESS • 0 0 — 200 amp • 0 PUMP /IRRIGATION • 0 EACH ADD'L 500SF...: 0 201 — 400 amp • 0 SIGN /OUT LINE LTG..: 3 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-- - O — 200 amp : 0 W /SERVICE OR FEEDER: 0 PER INSPECTION • 0 201 — 400 amp ° 0 1st W/O 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 BANK OF THE WEST type amount by date recpt 16200 SW PACIFIC HWY PRMT $ 120.00 DEB 12/18/98 98- 311645 SUITE J -1 5PCT $ 6.00 DEB 12/18/98 98- 311645 TIGARD OR 97223 Phone #: Contractor: DWINELLS VISUAL SYSTEMS INC $ 186.00 TOTAL 1112 EAST NOB HILL BLVD REQUI RED INSPECTIONS YAKIMA WA 98901 Elect'l Service Phone #: 509-248-3772 Elect'1 Final Reg #..: 64411 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 sore 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 -001 trough MAR - 'A1 -1987. You lay obtain a copy of these rules or direct questions to OUNC by call•ng (503)246 -1987. Permittee Signature: : Issued By: aeam_16 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: /8 -45 LICENSE NO: gP-(/I S /l0 + +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day + ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + +4• + + + + ++ " Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. Tigard, OR 97223 Permit # E�9 ? -D 7 y� , �, Date Issued /a� /P /9�' ��� i Phone (503) 639 -4171 „:).14 V FAX (503) 684 -7297 CITY OF TIGARD TDD No. (503) 684 -2772 Inspection (503) 639 -4175 1. Job Address: 4. Complete Fee Schedule Below: Name of Development 11/ A ` Z W Ilv SQLNAIZIF Number of Inspections per permit allowed Address 1 ` 6 bO 9U.) Footc I pi c- WA `( S re Service included: Items Cost(ea) Sum City /State /Zip 1 &� g� - �� 4a. Residential - per unit l 1000 sq. ft. or less $110.00 4 Name (or name of business) - g 1K OF (A.3eST Each additional 500 sq. ft. or portion thereof $25.00 1 Commercial K1 Residential Ill Limited Energy $25.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $68.00 2 2a. Contractor installation only: J / 4b. Services or Feeders Electrical Contractor DU)) - t.�. I/' ISMI -SYST Installation, alteration, or relocation $60.00 2 200 amps or less Address I I t r • /J()8 0-1 -1 4_ BLUa 201 amps to 400 amps $80.00 2 N City P le-4 wi A- State ().41- Zip 'iJO/ 401 amps to 600 amps $120.00 2 601 amps to 1000 amps $180.00 Phone No. . Ott$ 3'7'7 Over 1000 amps or volts $340.00 2 Job NO. Reconnect only $50.00 2 contractor's license NO. 3 /DL LS /0/ /� j -4c. Temporary Services or Feeders Contractor's Board Reg. No. ' A I e2 , j/ Installation, alteration, or relocation 2 Signature of Supr. Elec'n 200 amps or less 2 License No. SI Phone No. SacJ pZ- 3! 4)-- 420011 amps amps to to 600 400 amps amps $50.00 $75.00 2 / V Over 600 amps to 1000 volts $100.00 . 2b. For owner installations: see "b" above. 4d. Branch Circuits Print Owner's Name New, alteration or extension per pane Address a) The fee for branch circuits with purchase of service or feeder fee. 2 City State Zip Each branch circuit $5.00 Phone No. b) The fee for branch circuits withou The installation is being made on property I own which is purchase of service or feeder fee. 2 Each additional branch circuit $5.00 not intended for sale, lease or rent. First branch circuit $ $5.00 Owner's Signature 4e. Miscellaneous (Service or feeder not included) 2 3. Plan Review section (if required): Each pump or Irrigation circle` $40.00 2 Each sign or outline lighting J \ $40.00 Signal circuit(s) or a limited energy 2 Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40.00 4 or more residential units in one structure Minor Labels (10) $100.00 Service and feeder 225 amps or more System over 600 volts nominal 4f. Each additional inspection over Classified area or structure containing special occupancy the allowable in any of the above a described in N.E.C. Chapter 5 Per inspection $35.00 Per hour $55.00 In Plant $55.00 Submit 2 sets of plans with application where any of the above apply. Not required for temporary construction services. 5. Fees: 5a. Enter total of above fees $ /020, rd NOTICE 5% Surcharge (.05 X total fees) $ l - PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $ A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ COMMENCED. wordkomdeNe,eo- ❑ Trust Account # prm.epp Balance Due $ /, 6, .07) CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 / BUP Date Requested .I L4 AM PM BLD Location / (i -.O Q 6 _c<_ Suite fl - ( MEC Contact Person Ph PLM ontra or Ph SWR o BUILDING Tenant/Owner %111r ► AA AA �� _ ��i 371 ' ELC n 0 7 T� Retaining Wall Footing Access: Foundation FPSSZDS Ftg Drain SGN Crawl Drain Inspection Notes: r Slab / F /..41 ' . ' / A l! SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Drywall on Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Cae) r 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 pgGSS PAK FAIL (E LECTRICAL Rough In UG /Slab Low Voltage Fire Alarm F k. PART FAIL 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 % ZqlQi Inspector - z Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.