Permit (4) CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC1999 -00682
DEVELOPMENT SERVICE DATE ISSUED: 11/12/99
13125 SW Hall Blvd.. Tioard, OR 97223 (503
PARCEL: 2S103DD -00400
SITE ADDRESS: 13707 SW PACIFIC HWY 200
SUBDIVISION: " fr ZONING: C -G
BLOCK: LOT : 4 4 JURISDICTION: TIG
Project Description: Installation of one sign lighting. Job No. 20057
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:
WILSON'S TIGARD RETAIL CENTER BLAZE SIGNS OF OREGON
BY BOMCC ESCROW ADMINISTRATION PO BOX 23910
TX -2495 PORTLAND, OR 97281 -3910
DALLAS, TX 75201
Phone: Phone:
639 -3262
Reg #: SUP 524SIG
LIC 000643
ELE 26380CLS
FEES Required Inspections
Type ' By Date Amount Receipt
Elect'l Service
PRMT DEB 11/4/99 $42.75 99- 319553 • Elect'l Final
5PCT DEB 11/4/99 $3.42 99- 319553
Total $46.17
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 a. • • -= = le Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain •ies of these rule or direct questions to OUNC at (503)
246 -1987. -
PERMITTEE'S SIGNATURE . ISSUED BY: / / •
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
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OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: - DATE:
LICENSE NO: /57 S /Q•
Call 639 -4175 by 7:00pm for an inspection the next business day
t
CITY OF TIGARD Plan Check Electrical Permit Application A.
13125 SW HALL BLVD. Rec'd By 0 �
TI OR 97223 Date Rec'd - .
(-
Date to P.E.
Phone (503) 639 -4171, x304 .---
Date to DST
Inspection (503) 639 -4175 Print of Type Permit # `1 -0-1199 •
Fax (503) 598 -1960 Incomplete or illegible will not be accepted Called ( ---
1. Job Address: 4. Complete Fee Schedule Below: •
Name of Development Number of Inspections per permit allowed
Name (or name of business) C7L„, G),-pe .,.r Service included: Items Cost Sum Ni'
Address 1 01 S 1`7 u, /4,0 S „ :. oa 4a. Residential - per unit
Ci City/State/Zip 1000 sq. ft. or less $ 117.75 4
ty p T - 0 0_ -J.. - 1. 91 a D.3 Each additional 500 sq. ft. or
portion thereof $ 2615 1
Commercial ® Residential ❑ • Limited Energy $ 60.00
Each Manufd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2
(Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders
information for COT data base). Installation, alteration, or relocation
Electrical Contractor f ,,, 200 amps or less $ 64.25 2
Address 7 0 201 amps to 400 amps $ 85.50 2
� -0. D. 10
City 9o _.a -.�Q State (9-. n Zip 7 , a_ s- i 401 amps to 600 amps $ 128.50 2
U 6, q 601 amps to 1000 amps $ 192.50 2
Phone No. 5
3 (o Over 1000 amps or volts $ 363.75 2
Job No. ?.C5 G 5'7 Reconnect only $ 53.50 2
Elec. Cont. Lice. No.,l. "Sc' a <.L Exp.Date j -97 -Oa 4c. Temporary Services or Feeders
OR State CCB Reg. No. (r,fw_ E / Exp.Date a -37 - O v Installation, alteration, or relocation
COT Business Tax or Metro No. .O 1 3 Exp.Date / ` 1 - Oa 200 amps or less $ 53.50 2 0 .
201 amps to 400 amps $ 80.25 2
1,,,, � 401 amps to 600 amps $ 107.00 2
Signature of Supr. Elec'n ,,T ilL � Yf:
Over 600 amps to 1000 volts,
License No. I S S) G Exp.Date 1 - 1- 0 I
see "b" above.
Phone No. 6 3 `l - 3 2 - 'Orr 21 1 4d. Branch Circuits
New, alteration,or extension per panel
a) The fee for branch circuits
2b. For owner installations: with purchase of service or
feeder fee.
Print Owner's Name Each branch circuit $ 5.35 2
b) The fee for branch circuits
Address without purchase of service
City State Zip or feeder fee.
Phone No. First branch circuit $ 37.50
Each additional branch circuit $ 5.35
The installation is being made on property I own which is not 4e. Miscellaneous
intended for sale, lease or rent. (Service or feeder not included)
Each pump or irrigation circle $ 42.75
Owner's Signature Each sign or outline lighting / $ 42.75 ti 1 .1 S
Signal circuit(s) or a limited energy
• (if required):* panL alteration or extension $ 60.00
3. Plan Review section
( Minor Labels (10) $ 167:98-
Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over
4 or more residential units in one structure the allowable in any of the above
Service and feeder 225 amps or more Per inspection $ 50.00
Per hour $ 50.00
System over 600 volts nominal In Plant $ 59.00
Classified area or structure containing special occupancy as
described in N.E.C. Chapter 5 5. Fees:
5a. Enter total of above fees $ L/ I .7 E
* Submit 2 sets of plans with application where any of the above apply. rO'5°3 Surcharge (Ag X total fees) $ 74 LI 2
Not required for temporary construction services. Subtotal ' 0 $ $
5b. Enter 25% of line 5a for
NOTICE Plan Review if required (Sec. 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal . $
IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account # `
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ 146
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