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Permit (15) CITY OF TIGARD ELECTRICAL PERMIT � - COMMUNITY DEVELOPMENT Permit#: ELC2023-00318 TEGAj2,0 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 5/22/2023 Parcel: 1 S 134BC00300 Jurisdiction: Tigard Site address: 12282 SW SCHOLLS FERRY RD Project: Michi Japan Subdivision: None Lot: None Project Description: Sign lighting. Contractor: JERRY M YOUNGER Owner: FW OR-GREENWAY TOWN CENTER LLC 840 NE VILLAGE SQUIRE AVE PO BOX 790830 GRESHAM, OR 97030 SAN ANTONIO, TX 78279 PHONE: 503-380-4774 PHONE: FAX: 503-253-9407 FEES Quantity Description Date Amount 1 ea Sign or Outline Lighting 05/22/2023 $67.84 Specifics: 1 ea 12%State Surcharge- 05/22/2023 $8.14 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $75.98 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180 days. ATTENTION: Oregon law requires/•u to foil. the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 throuah OA -001-00 Jo/v•btai,:oov of the rules or direct questions to OUNC by calling 503. .1987 or 1.800.332.2344.Issued By: *4 Permittee Signature: � 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 the next available inspection date. 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. Electrical Permit Application ,�, ' City of Tigard sf -, IT Received u - Date/By: 4 / + t pC o -j /0J -- B d., 23 13125 h SW Hall.2 39 Tigard,OR 97219 n Review s'9a22 C/x/t� k 7 _ Phone: 503.718.2439 Fax: 503.598.1960 ' �) ,,Y,� Date/By: I't�fTr•"��, # (/ Inspection Line: 503.639.4175 Ready Date/By: Juris:9r / H See Page 2 for T I GA P.P. Notified/Method:Ci Supplemental Information Internet: www tigard-or gov 7;1 r F-f, i E'Oi WOR j1LD1 $ MSON:. ,,, ,, P M . ,I. ❑New construction ❑Addition/alteration/replacement Please check all that apply(submit Z sets of plans w/items checked): 0 Service or feeder 400 amps or more 0 Building over three stories. ❑ Demolition re5Other: fait i j erN where the available fault current 0 Marinas and boatyards. CAS*,GORY ,CONSI 'y l exceeds 10,000 amps at 150 volts or 0 Floating buildings. ❑ 1-and 2-family dwelling X Commercial/industrial IDAccessory building less to ground,or exceeds 14.000 0 Commercial-use agricultural amps for all other installations. buildings. ❑ Multi-family ❑Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION 1 IdIto11 0 Emergency system. larger separately derived 1 ❑Addition of new motor load of system. Job#: Job site address: tZ Z.ce z c IA) sChr, r Ltc 1 if 100HP or more. 0"A","E","1-2","1-3", ❑Six or more residential units. occupancy. City/State/ZIP:T i�G,I d 1 Gil�2?� 0 Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: Project name: ❑Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. l�i�( �Oint�� 600 volts nominal. I Cross street/directions to job site: setiES* ,,, y � 7 Description ( Qty. f Each 1 Total I * $ IA) IAA CT, __A U G New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1 ",-. „,',;IWACR o 0 �, �,..:: , `..-. - ;..,,, Limited energy,residential 1, l //'�� , � _4 (with above sq.ft.) 75.00 2 © Ul1 Q-[l c 1t H etitkj'tiLCI.t fin/ . Limited energy,multi-family ( residential(with above sq.ft.) 75.00 2 Renewable Energy 0 See Page 2 0 PROPERTY � - ,..;w 4h Services or feeders installation,alteration,and/or relocation Name: l'C LOn IMa g Vl4l1A S iQL2- V, L 200 amps or less 100.70 2 Address: _ },.' }/ - , 201 amps to 400 amps 133.56 2 1 3 5 I R S l W t'�"� pQ f'p 401 amps to 600 amps 200.34 2 City/State/ZIP: 0 ! 601 amps to 1,000 amps 301.04 2 �A.��O� UR- aI�'Og6 P P _ Phone: (gip-5) 41} ti� q Fax:( ) Over 1,000 amps or volts 552.26 2 \ Temporary services or feeders installation,alteration,and/or Email: relocation /A�Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 ri in-intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 Branch circuits—new,alteration,or extension,per panel APPLICANT • T (T ( • A.Fee for branch circuits with Business name: K TI np nn« lei j b- 1.L C above service or feeder fee, 7.42 2 each branch circuit Contact name: j.ciAt&4� Lam, B.Fee for branch circuits without V service or feeder fee,first 56.18 2 Each add'l branch circuit 7.42 2 Address: g 62( Sc Zot�l( gtid branch circuit City/State/ZIP: z(-'(.o„.ft.4 (9 C)y1.�(, L ! 1 1` Miscellaneous(service or feeder not included) Phone: (So3 ) ` ,c; _Cl qv v.F, Fax: :( ) Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email: a l4 c Litz_ Q fro]r (...ryl/\. Reconnect only 67.84 2 CONT AC OR ,, Pump or irrigation circle 67.84 2 Business name: 1 e 1/A m LA Sign or outline lighting 67.84 2 O Signal circuit(s)or limited-energy Address: 140 - V l t(t D" h g_ panel,alteration,or extension. 0 See Page 2 2 Each additional inspection over allowable in any of the above City/State/ZIP: G�tk,t /t A Li, LP I-O7 0 Additional inspection(1 hr min) 66.25/hr Phone:(5o3) ';i(a iti1tf Fax:( ) Investigation(1 hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lie.:1�g c Electrical Lic.:2,-7qq ►��Suprv.Lic.: Nibs,_ specifically listed('/2 hr min) ELEcT CAL PERI IT F1 Suprv.Electrician signature,required: Subtotal: Print name: ,,,.k RI' 0 I t j11 sib Date: 5111201,3 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized s'ap TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Date: �r` ! � days after it has been accepted as complete. Ill * Number of inspections allowed per permit. I:\Building\Permits\ELC_Pc .pp_ELR_ERE.doc ev 06/17/2015 440-461 T(Il/05/COM B