Permit (5) •
CITY OF TIGARD '. ELECTRICAL PERMIT
PERMIT #. ELC99 0063
w iv i i i , DEVE RS ' DATE ISSUED: '02/05/99 Blvd., Tigard, °° .. 13125 SW PARCEL: 25103DD- 004P.10
SITE ADDRESS— . :13707 'SW PACIFIC HWY 4BLD 8
' SUBDIVISION... „ 0 •. �j ZONING 0 C...G
H . BLOCK..... ° LOT ° JURISDICTION: TIG •
Project Description 0 Electrical for new sign. . .
•- _.-- .RESIDENTIAL UNIT - - - -- -- -TEMP SRVC /FEEbERS•- . -. - - -. ....--•--....- MISCELLANEOUS-- - - -. --
1000 SF. OR LESS 0 0 • 0 -- 200 amp.. e .....,0 0 , PUMP /IRRIGATION 0
EACH ADD' L 500SF... 0 0 • 201 - .400 amp ° '0 SIGN /OUT LINE LTG.. 0 1 '
LIMITED .ENERGY .0 0 ' 401 - 610 amp ° 0 SIGNAL /PANEL ° 0
MANF. HM/ SVC /FDR.. 0 0 • 601 +amps -1000 volts 0 0 MINOR LABEL ( 10) ... 0 0
-
- -•- SERVICE /FEEDER - ---- - - - - -B RANCI -I CIRCUITS . -- -ADD' L_ INSPECTIONS--
,
'0 - 200 amp... ° 0 W /SERVICE OR FEEDER 0 PER INSPECT ION. .... 0 .0 •
201 -- 400 amp '° 0 1st W/O SRVC OR FDR. i' 0 PER HOUR . ° 0
401 - 600 amp......: 0 EA • ADD' L BRNCH CIRCO 0 IN PLANT° .......... 0 0
601 - 1000 amp 0 0 - -- •----- ..-- •----- - - - - -- -PLAN REVIEW SECTION---- ------
J000-1- amp/volt.....: 0 ) =4 RES UNITS° ° ......... 0 .. 1 600 VOLT NOMINAL.:
Reconnect 'only ° 0 SVC /FDR ) = 225 AMPS.,: CLASS AREA /SPEC OCC. 0
Owner: -- - - - - -- I =EES
CLUTCH WIZARD' type amount by date recpt
13707 SW , PACIFIC HWY PRMT , a 40.00 GEO 02/03/99 99-•312638
• SUITE 200 SPCT $ . 2.00 GEO 02/03/99 99 312638
1 1 r' ITV• L I\ 972; VI
Phone #e. .
Contractor: --- -- '
GRESHAM NEON & SIGNS $ 42000 'TOTAL • .
- 21551 SE STARK ST .
.. - -• REQUIRED INSPECTIONS ----- --• - -•
GRESHAM OR 970321 .
Phone # 666 -88� ]. _ -- __�
Reg' 4.. ° 72685
This peroit is issued subject to the regulations contained in the Tigard Municipal Code,' State of Oregon Specialty Godes and all other
applicable' laws. All work will be done in accordance with approved plans. This peroit will expire if work is not started within 180
days of issuance, or if work is suspended for core 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-m1-0010 through OAR 952 -001 -1987. You nay obtain a copy
of these rules or direct questions to OUNC by calling 15031246 -1987.
Permittee Signature: %a �Z �_ I.ss•ued By: . g --_-
•
------------ OWNER INSTALLATION ONLY ----------------------------
The installation is being made on property I on w.lhich is not intended for
sale, lease, or rent. .
OWNER'S S I GNATURE_ 0 _:.� -- .._ -_— _ DATE: _ _ _ -� ,
• -T---------------------------
. -
SIGNATURE OF SUPR. EL.Et ' N 0 /V f �__ DATE e . 5? '-
L I CENSE NO: _ 7 .... 7 ______ ________ __. -_
...... -h +- -1-1..--r +-k+ + +.•_4-. F +-1•r f +- I- i••• 4•+• F• +-I- ++-I- + + +-i•• + + 4• +-1--} i-- r•- F•+4-4-+++++- h+• i••- f-- 1-'.- +•{- +-i-i••-F• +•{-+•i-•{-++ .
Call 639• -4175 by 7000 p.m. for an inspection needed the next business day
+-I^ + ++ +-4•-h+ +•4•+-1--1-•4•-1-+- 1-+i. .... +-4• + +-1- +-4• +-t-...-F•+•9• I + ++ F Fi +- 1=+• h++++++ + +•{- +-4•-1- + + + + +i- +-F + + ++ +-I-+
CITY QF TIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD. Rec'd By
TIGARD OR 97223 Date Rec'd 19 3 --/9
Date to P.E.
Phone (503) 639 -4171, x304 Date to DST
Print or Type
Inspection (503) 639 -4175 Permit # r ��
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: w A 5o4i 77 1' ¢ t 6 1141 4. Complete Fee Schedule Below:
Name of Development �� 66 1g Al-r t3 Number of Inspections per permit allowed
Name (or name of business) Service included: Items Cost Sum
I
Address / '310 7 ,5') Y . / f1 C. /�� 4a. Residential - per unit
� 1000 sq ft. or less $110.00 4
City /State /Zip /' 0 C 9 ' • 71,9:1:3 Each additional 500 sq. ft. or
Commercial 121., Residential 1=1 Limited thereof $25.00 1
Limited Energy $25.00
Each Manuf 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 (.3 "e /jy 4,1/7 /1/S Installation, alteration, or relocation
Address / S SE' 200 amps or less $60.00 2
S 201 amps to 400 amps $80.00 2
City State wit Zip 7 70 D 401 amps to 600 amps $120.00 2
Phone No. - / 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 2
7V 9c�S Exp.Date /� - / - 9 Reconnect only $50.00 2
Elec. Cont. Lice. No.
OR State CCB Reg. No. 72 Exp.Date 4' _ 7 4c. Temporary Services or Feeders
COT Business Tax or Metro No. Exp.Date Installation, alteration, or relocation
/ /i1�i�i
/ 200 amps or less $50.00 2
Signature of Supr. Elec'n .�u�. - � 201 amps to 400 amps $75.00 2 -
!!! _ / 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. 6' Exp.Date le / - Fy see "b" above.
Phone No.
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.
First branch circuit $35.00 2
The installation is being made on property I own which is not Each additional branch circuit $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 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: Ai G
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ l
NOTICE Subtotal $ iF
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 # ____
Total balance Due $
I. \DSTS \ELC96 APP Rev 9/96