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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2006 - 00343 ,----- eil DEVELOPMENT d., Tigard, OR 97223 503 - 639 - 4171 DATE ISSUED: 6/20/2006 PARCEL: 2S102BD -02000 SITE ADDRESS: 12885 SW PACIFIC HWY ZONING: C -G SUBDIVISION: NORTH TIGARDVILLE ADDITION LOT : 038 JURISDICTION: TIG Project Description: (4) sign lighting. 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: 4 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: MENG HANNAN CONST. MEYER SIGN CO OF OREGON 9301 SE STANLEY AVE. 15205 SW 74TH AVE PORTLAND, OR 97222 TIGARD, OR 97223 Phone: 503 - 761 -5290 Contact #: PRI 503 - 620 -8200 FAX 503 - 620 -7074 FEES Description Date Amount Reg #: ELE 20- 190CLS [ELPRMT] ELC Permit 6/20/2006 $213.60 LIC 64014 [TAX] 8% State Surcharge 6/20/2006 $17.08 Total $230.68 REQUIRED ITEMS AND REPORTS 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 in 180 days of issuance - if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the 0 -• • Utility Notification Ce ter. Those are set forth in OAR 952 - 001 - 0010 through OAR 952 - 001 - 0100. You may obtain copies of these rules or o s t ques • • - ..t 50 - 246 or 1- 800 - 332 -2344. Issued By: Permittee Signature: 11111111 � OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or r: • . 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 an inspection that business day. 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. 2-0060 -oo 9q - la)-doh , - :Electrical Permit A . , lication i j L f -- . � � I', r i 0 a r a,g . u I t ;Ip k t 1 0it 0i;i I *l OS1 ON I l e .v , w r ,] ''.,X. 01 City of Tigard �� . Date/By: � L a � . Permit No. G ado& o O3q y 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie Phone: 503.639.4171 Fax: 503.598.f1960 i \ 2006 ni *�;A ,/ I" Daze/B Other Permit. r. J U i VI � ,;. � . ; � ,i D aze Read /B 1 ® See Page 2 for Inspection Line: 503.639.4175 ; _. .. ' __ Ready /By: g Internet: www.tigard - or.gov Notified/Method: l Supplemental Information i`i - '1/ A hw■ i Nli 'uA _ 1/4-111 'y/� O,F W ORt T[ m' pr\ PLAN, EVIEW . .1.- ■ S(1 P V.G , i , ( 1 M ? a_ - t r.: - ° Y • ° ' ' ' ' Please check all that a I i on , IL �Addition/al /re pp y 0 New construction 1:1 Demolition ID Other: ['Service over 225 amps, comm'l ['Hazardous location ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential ❑ 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure 1:1 Multi - family ❑Master builder ❑ Other: ['Building over three stories ['Feeders, 400 amps or more DOccupant load over 99 persons ['Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park G s- J-20 r/C /47 ❑Health -care facility ['Other: � Q Job no.: Job site address: flees Submit 2 sets of plans with any of the above. City /State/ZIFer 4 JD ©�ec The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: I Project name. /..GO T71 FEE* SCHEDULE T Description I Qty. I Fee. I Total 1 Cross street/directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: I Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 I Limited energy, residential 75.00 2 Tax map /parcel no.: Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular ie. 6fc a S ...� l / J 09-4 E a f . �- f dwelling, service and/or feeder 90.90 _ 2 Services or feeders installation, alteration, and/or relocation hi 200 amps or less 80.30 2 411. CA..) 1. ,. L © lit _ , 9 -- -r P ❑ PROPERTY OWN ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: A/, eli 4 Alz/4 - �,G / ,S7 19 C-77 04.1 601 amps to 1,000 amps 240.60 2 Address: 93e1 �X S ty Over 1,000 amps or volts 454.65 2 ` Reconnect only 66.85 2 City/State/ZIP: b. /65 972. Z Z Temporary services or feeders installation, alteration, and /or Phone: t:1 ) 76 5-7,9 o 1 Fax: 6 7 / 4 / relocation 200 amps or less 66.85 1 Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel ❑ . APPLI C ANT n ow , f f' �A . ❑ CONTACT PERSON A. Fee for branch circuits with / service or feeder fee, each branch circuit 6.65 2 Business name: / ej ,v � pUST � Contact name: ©l f11 1-0 B. Fee for branch circuits without service or feeder fee, first branch circuit 46.85 2 Address: � ?o .. 5". �r jJ L Each add'I branch circuit 6.65 2 City /State/ZIP: On�'� �i, 0 2 2 - 2 Miscellaneous (service or feeder not included) Phone: �3 � . Z �7Q I Fax: : 6 i ¢9 / Z Pump or irrigation circle 2 Sign or outline lighting 53.40 2, E - mail: Signal circuit(s) or limited / CONTRA R energy panel, alteration, or extension. Describe: Page 2 2 S "2„,..0 � Business name: /� �� y(� 6 (02a Address: / 0 .. cif SW , Each additional inspection over allowable in any of the above Per inspection 62.50 City /State/_ZIIP: 1 J L A-740 ef�' F 7 - 1.... - L-- Investigation per hour (1 hr min) 62.50 Phone (fslj, (J p Z 0 I Fax: kra3) 62 207 Industrial plant per hour 73.75 f(// ELECTRICAL PERMIT FEES* CCB Lic.: 6 T 01 ef'' I Electrical A,,,.. Suprv. Lic.: Slg s-6,6 Subtotal a z * 60 Suprv. Electri • signature, uired: / / / r Plan review (25% of permit fee) J Print name: / o tl �� c D State surcharge (8% of permit fee) 7. fl� A'` .2o_p TOTAL PERMIT FEE a 30, ea Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board •' Number of inspections per permit allowed. / 616 I:\ Building \Permits\ELC - PermitApp.doc 12/30/05 440- 4615T(10/02/COM/WEB Electrical Permit Application - City of Tigard - Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined .. $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* El Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY. Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and, Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1:\ Building \Pennlis\ELC- PermitApp.doe 12/30/05