Permit (17) CITY OF TIGARD - -, ELECTRICAL PERMIT
PERMIT #: ELC2003 -00094
: l r� DEVELOPMENT SERVICES DATE ISSUED: 2125/03
`�' II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2 S 103 D D -0040 0
SITE ADDRESS: 13727 SW PACIFIC HWY 150
SUBDIVISION: ZONING. C -G
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of sign lighting for (2) wall signs.
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: 2
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
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 RAMSAY SIGNS
BY BOMCC ESCROW ADMN 9160 SE 74TH AVE
TX1 -2495 PORTLAND, OR 97206
DALLAS, TX 75201
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Phone: Phone: 777 -4555
Reg #: LIC 63422
ELE 26- 106CLS
FEES SUP 493SIG
Description Date Amount
Required Inspections
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[ELPRMT] ELC Permit 2/25/03 $106.80
[TAX] 8% State Tax 2/25/03 $8.54 Rough -in
Elect'l Final •
Total $115.34
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 mor- -- : i • = '- ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
fo • n OAR 952 - 001 -00 : through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246-6699 or
:00- 332 -2344. , / 'OP
Issued By: ,� % !. Permit Signature: ,�_�
/ OWNER INSTALLATION ONLY
The in . a ion is being m- .e on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
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CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
•✓ Electrical Permit Application
Date received: aSGg- Permit no.: E
, ` � i'l" City of Tigard Projectiappl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By I Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment • e:
Land use approval: cN .3 -t o r 50
TYPE OF PERT lIT
0 1 & 2 family dwelling or accessory pmmercial/industrial 0 Multi- family 0 Tenant improvement
0 New construction 0 Addition/alteration /replacement 0 Other: 0 Partial
JOB SITE INFORMATION
Job address: 1 3� � 'l S� 'B U t? , V& Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: B lock: Subdivision: VV
Project name: I Description and location of work on premises: t 9. ).h-\ ‘ S k q .I LL ,� r n .
Estimated date of completio inspection: �
CONTRACTOR APPLICATION FEE SCHEDULE
Job no: Fee Max
Business name: Slptn Description Qty. (ea) Total no. ins
New residential or multi- family per
Address: q l i pD S - 7 AV Q— dwelling unit. Includes attached garage.
City:` o(- cit •■_, I
State. I ZIP: 7 C )49 Serviceincluded:
Phonen1 )- LI &JJ I Fax:-777-02.2.01E-mail: 1000 sq. ft. or less 4
�D34 a a I lip ' ^ e I b C � Each additional rg 500 sq. ft. or portion thereof
CCB no.: Elec. bus. lie. no: L- Limited energy, residential 2
City /metro lie. no ' Limited energy, non- residential 2
j a S-7 3 Each manufactured home or modular dwelling
Si atu rvising electrician (required) Date Service and/or feeder 2
Sup. elect. name (print): - • S • • :.J License no: Servicesorfeeders installation,
j
alteration or relocation:
PROPERTY OWNER 200 amps or less 2
/ 201 amps to 400 amps 2
Name (print): 1. �(L�l� S �CvA1 1774-/C.
401 amps to 600 amps 2
Mailing address:4y &)�/(! � .`�'� y /9"j!-b i x/ ,V 1 amps to 1000 amps 2
City:`(', fj- 5 1 state-13 1 ZIP:76;90/ Over 1000 amps or volts 2
Phone: I Fax: I E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders
which is not intended for sale, lease, rent, or exchange according to installation, alteration, or relocation:
200 amps or less 2
20
ORS 447, 455, 479, 670, 701. 201 1 amps to 400 amps 2
Owner's signature: Date: 401 to 600 am s 2
Branch circuits - new, alteration;
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: • I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E -mail: Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
O Service over 225 amps-commercial . ❑ Health -care facility Each pump or irrigation circle 2 —
0 Service over 320 amps-rating ofl &2 U Hazardous location Each sign or outline lighting 2., 33,a /OW 2 -
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
O System over 600 volts nominal more residential units in one structure alteration, or extension' 2
O Building over three stories ❑ Feeders, 400 amps or more *Description:
O Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional Inspection over the allowable in any of the above:
0 Egress/lightingplan O Other. Per inspection I I 1
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ (D • $U
0 Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card amber: / / within 180 days after it has been State surcharge (8%) .... $ 5
Expires accepted as complete. TOTAL $
Name of cardholder as shown on credit card
$
Cardholder signature Amount 440-4615 (6/00/C'OM)
Electrical Permit Fees: Limited Energy Fees:
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items • Cost Total `, Check Type of Work Involved:
Residential - per unit •
1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40 1 ❑ Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular Garage Door Opener
Dwelling Service or Feeder $90.90 2
Services or Feeders ❑ Heating, Ventilation and Air Conditioning System' .
Installation, alteration, or relocation
200 amps or less $80.30 2 Vacuum Systems
201 amps to 400 amps $106.85 2
401 amps to 600 amps $160.60 2
601 amps to 1000 amps - $240.60 2 ❑ Other
. Over 1000 amps or volts $454.65 2 •
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each system $75.00
200 amps or less $66.85 2 (SEE OAR 918-260-260)
201 amps to 400 amps $100.30 . 2
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401 amps to 600 amps $133.75 2 Check Type of Work Involved:
Over 600 amps to 1000 volts, ❑
see "b" above. Audio and Stereo Systems
Branch Circuits . ❑ Bo iler Controls
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New, alteration or extension per panel
a) The fee for branch circuits
with purchase of service or ❑ Clock Systems
feeder fee.
Each branch circuit $6.65 - • 2I ❑ - Data Telecommunication Installation
b) The fee for branch circuits
without purchase of service ❑ Fire Alarm Installation
or feeder fee. '
First branch circuit . $46.85
Each additional branch circuit $6.65 ❑ HVAC
Miscellaneous ❑ Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40 Intercom and Paging Systems
Each sign or outline lighting • a $53.40 1 nip
Signal circuit(s) or a limited energy El panel, alteration or extension $75.00 Landscape Irrigation Control •
Minor Labels (10) $125.00' ❑
Medical
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Each additional Inspection over
the allowable in any of the above Calls
Per inspection $62.50 El
Per hour $62.50
In Plant $73.75 ❑ Outdoor Landscape Lighting
F ees: - 17j Protective Signaling
Enter total of above fees $ 1 062 Ist. 0 Other
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8% State Surcharge $ 8,(1 Number of Systems
25% Plan Review Fee
See Plan Review" section on $ * No licenses are required. Licenses are required for all other installations
front of application.
Fees:
Total Balance Due $ 1 ISM Enter total of above fees $
❑ Trust Account # 8% State Surcharge $ •
Total Balance Due $
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i:'dsts\forms\elc- fees.doc 10/09/00
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