Loading...
Permit CITY OF TIGARD ELECTRICAL PERMIT S COMMUNITY DEVELOPMENT Permit#: ELC2014-00689 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/04/2014 Parcel: 1 S136C001600 Jurisdiction: Tigard Site address: 11674 SW PACIFIC HWY Project: Mattress Depot Subdivision: 2006-016 PARTITION PLAT Lot: 3 Project Description: Sign lighting for(1)illuminated wall sign. Contractor: SECURITY SIGNS INC Owner: DOUGHTY FAMILY TRUST 2424 SE HOLGATE BLVD BY DAVIS,C THOMAS PORTLAND,OR 97202 12220 SW FIRST ST BEAVERTON,OR 97005 PHONE: 503-546-7114 PHONE: FAX: 503-230-1861 FEES Quantity Description Date Amount 1 ea Sign or Outline Lighting 12/04/2014 $67.84 Specifics: 1 ea 12%State Surcharge- 12/04/2014 $8.14 Electrical Type of Use: COM 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 you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy•( moles or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: - Permittee Signature: /0 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' 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 Received ,/ /�/+0 City of Tigard Da�/B : / /)//y 4,./.7- Permit No.:�t—1- d`p„.. WG c�•III 13125 SW Hall Blvd.,Tigard,OR 97223 i Riew (/� g Phone: 503.718.2439 Fax: 503.598.1960 �/B : Other Permit: �AZ6/11—05a2.0 1 I�,;�1c 1 Inspection Line: 503.639.4175 �,/ D flat eeadyBy: mils: I See Page 2 for Internet: www.tigard-or.gov 11 2 ZC l4lotified/Method: (y Supplemental Information TYPE OF WORK �/(�� �/��Qf PLAN REVIEW New construction ❑Addition/alteration/replalYnO'1 1IERt 1 V Please check all that apply(submit 2 sets of plans w/items checked below): n���' On�R ❑Service or feeder 400 amps or more ❑Building over three stories. �(���❑ Demolition ❑Other: �� where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings. less to ground,or exceeds 14.000 ❑Commercial-use agricultural ❑ 1-and 2-family dwelling Commercial/industrial ❑Accessory building amps for all other installations. buildings. ❑ Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 75 KVA or ❑Emergency system. larger separately derived system. JOB SITE INFORMATION AND LOCATION ❑Addition of new motor load of ❑"A","E","I-2","I-3", Job no.: Job site address: MO'? ` IOOHP or more. occupancy. SV3 PAC 1 E(G 4t u')' ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP:'r'(G sy _'r , ©R q"7 ❑Health-care facilities. ❑Supply voltage for more than ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: I Project name:M 4.--- -mess Dea,r ❑Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: SW `"jel AVi✓ Description I Qtv. I Fee. I Total I * New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4 Ea.add.'500 sq.ft.or portion 33.92 1 Tax map/parcel no.: Limited energy,residential DESCRIPTION OF WORK (with above sq.ft.) 75.00 2 Limited energy,multi-family 7500 2 I 1 I 1 tA 1141 V"lt. d l ilt( SIO VI residential(with above sq.ft.) Services or feeders installation,alteration,and/or relocation 200 amps or less 100.70 2 4] PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2 Name: C., I g ' t�S �n vIc 401 amps to 600 amps 200.34 2 601 amps to 1.000 amps 301.04 2 Address: ( a ,?„O s w I St 5-tr-c t Over 1.000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or City/State/ZIP: 1 ! Ve,v' 12i2- G 700s relocation Phone:Fo3) (.1 C.1 4 _R Fax:( ) 200 amps or less 59.36 1 1 201 amps to 400 amps 125.08 2 Owner installation:This installation is being made on property that I own which is not intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2 Branch circuits-new,alteration,or extension,per panel Owner signature: Date: A.Fee for branch circuits with ® APPLICANT 1 gf CONTACT PERSON above service or feeder fee, 7 4� each branch circuit Business name: B.Fee for branch circuits without S -[its{1/Z t'(�( s (�(1S service or feeder fee,first 56.18 2 Contact name: / branch circuit m�-(ss� gyp Each add'I branch circuit 7.42 Address: aL at...4 SE +401 ,6i�,j l✓ gt✓UD Miscellaneous(service or feeder not included) _ Each manufactured or modular 67.84 2 City/State/ZIP: Fo('Z.r-e�r�r, Ot2. c Z.oa dwelling,service and/or feeder Phone: 603 at 1(a -'7( (4. Fax: : (503) a-30 (t� : t Reconnect only 67.84 2 MG) i SSGLC.SC.t .to r S(gt/1.5 •L�1/1 v Pump or irrigation lighting Ling I 67.84 t A 2 E-mail: d Sign or outline lighting 67.84 i 2 CONTRACTOR Signal circuit(s)or limited-energy Business name: S�--C�ri-- �� S tG rls panel,alteration,or extension. Page 2 2 Each additional inspection over allowable in any of the above Address: Additional inspection(I hr min) 66.25/hr City/State/ZIP: Investigation(1 hr min) 66.25/hr Industrial plant(1 hr min) 78.18/hr Phone:( ) I Fax:( ) Inspections for which no fee is 90.00/hr specifically listed('h hr min) CCB Lic.: I aEspCt. Electrical Lic.:aC ;40 1 uprv.Lie.:3$3s( ELECTRICAL PERMIT FEES _ Suprv.Electrician signature,required: Subtotal: �'�,vi — Plan review(25%of permit fee): Print name: l'l 4-- Li( rl Qom _ Date: I ( I G21 (L State surcharge(12%of permit fee): 7 i y TOTAL PERMIT FEE: ;/ 7 5% Authorized signature: All---"-- This permit application expires if a permit is not oltained within 180 Print name: t� f Date: i (, * days after it has been accepted as complete. ��L "r Wt� �� ( ( ( —f Number of inspections allowed per permit. 1:BuildingWermits\I:LC-PermitApp.doc 07/01/IU 440-4615T(I U05/COM/WEB