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Permit CITY OF TIGARD ELECTRICAL PERMIT V PERMIT #: ELC2006 - 00345 t1 DEVELOPMENT 1 d., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/21/2006 Hall PARCEL: 2S102BD - 02000 SITE ADDRESS: 12885 SW PACIFIC HWY ZONING: C -G SUBDIVISION: NORTH TIGARDVILLE ADDITION LOT : 038 JURISDICTION: TIG Project Description: (2) branch circuits for new canopy 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: 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: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 1 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. BOYLES ELECTRIC, INC. 9301 SE STANLEY AVE. P.O. BOX 1227 PORTLAND, OR 97222 BORING, OR 97009 Phone: 503 - 761 -5290 Contact #: PRI 503 - 668 -7440 FEES Description Date Amount Reg #: ELE 3 -465C [ELPRMT] ELC Permit 6/21/2006 $53.50 LIC 137002 [TAX] 8% State Surcharge 6/21/2006 $4.28 SUP 3404S . Total $57.78 REQUIRED ITEMS AND REPORTS This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699 or 1- 800 - 332 -2344. Issued By: " ° / Permittee Signature: OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. 2LAkD oc, f Application _ F Receive , Electrical _ Elec Permit i�oK -O 4E,<<tiE;o- v l`Y0? r ;<x � w, / ) � ^/ tricat ` / Date City �' V b /l /t PermitNo.���✓�, City of Tigard r Planning Approval i � Sign �� A � ? Date/By: Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 Date/By: Permit No.: Phone: 503- 639 -4171 Fax: 031-59:8,•.1..436 Post- Review Land Use //ar.,Jk�i. l % Date/By: ,.- • Case No,: Internet: www,ci,tigard.or,us -. - ii i ,� r' i , Contact J ® See Page 2 for 24 -hour Inspection Request:(-;36S-14 4 I V 13� . , . pp SLUM Name/Method: Supplemental ` -. t 0.'m q) - ° y r�. 3 t x, �. w�' °=•r r$.' "i" f : r - r . -iR ; �{•.:.,. Y.'. �. 3 . �� � ..x �,.. y +.- ,� �'•E ��"""� -' ,- 9 � r!`. -°� � ' :'3`nu.eti 7' ° .�rG_s, :� ?'. v atC " 3 F?-. d, A'. 1 •v?t.i.1'`n..�3.1��nti:s:z���m e`Qar.dirT- fi � ` "� a :}?+.,` p ❑ New construction ❑ Demolition ❑ Service over 225 amps- ^ ❑ Health -care facility commercial ❑ Hazardous location .. .Addition/alteration/re.lacement ❑ Other: ❑ Service over 320 amps -rating of ❑ Building over 10,000 square feet, ENNEAW ; ��'yli' ` ©��M��.',��"�IEfiRa ;,�. tik °'t "= 1 & 2 family dwellings four or more residential units in ❑ 1 & 2- Family dwelling EJ Commercial/Industrial ❑ System over 600 volts nominal one structure n ❑ Building over three stories ❑ Feeders, 400 amps or more ❑ Accessory Building ❑ Multi-Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park ❑ Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other: ;5 a r 8 -INF. P • ash LL `fl„ --` ,�. Submit sets of plans with any of the above. � J The above are not a.. bcable to tem.ora construction service. Job site address: a F- K S W PA►e.0 e. " = , ' :, 045‘0)11 Xa e l 1 ' 7 , ' • Suite #: Bldg. /Apt. #: Number of inspections per permit allowed Pro'ectName: G , 1 Description Qty Fee(ea.) Total 1 Cross street/Directions to job site: New residential - single or multi- family per dwelling unit. Includes attached garage. Service included: (�/ / d A I P 5 4- 1000 sq. ft. or less 145.15 4 Each additional 500 sq. ft. or portion thereof 33.40 1 Subdivision: I Lot #: Limited energy, residential 75.00 2 Limited energy, non residential 75.00 2 Tax ma . / • arcel #: Each manufactured home or modular dwelling • 3 .� :; 9 service and/or feeder 90.90 2 Services or feeders - installation, j eAAJ C rAi �d � 4{. S 15 >tJS �- I n alteration or relocation: 200 amps or less 80.30 2 - n 201 amps to 400 amps. 106.85 2 -e. a. C d A `c Al �) 401 amps to 600 amps 160.60 2 ��7 ;® •PIYU d - ■ _ t. : [ ;r1 =mm' 601 amps to 1000 amps 240,60 2 Over 1000 amps or volts 454.65 2 Name: Reconnect only 66.85 2 Address: Temporary services or feeders - installation, alteration, or relocation: City /State /Zip: 200 amps or less 66.85 1 Phone: Fax: 201 amps to 400 amps 100.30 2 1".a.",\:' d 1 ` R E � N al It a t x,��� �,h 401 to 600 amps 133.75 2 1. . , >® � ",. A � °� - ' Branch circuits - new, alteration, or Name: extension per panel: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 6.65 ' 2 ' City /State /Zip: B. Fee for branch circuits without purchase of / r L 8 S service or feeder fee, first branch circuit 4 6.85 7 2 Phone: I Fax: Each additional branch circuit / 6.65 6 `S 2 E-mail: Misc.(Service or feeder not included): �g .•sr c14 F, w r Each pump or irrigation circle 53.40 2 ' '-L '= "` d a y ' ©1 •� 3 t Each sign or outline lighting 53.40 2 Job No: Signal circuit(s) or a limited energy panel, alteration, or extension Page 2 2 Business Name: . l. __ A - _ Description: Address: Pn 6 a / a 2') City /State /Zip: 8 rp ,.a . ' Q 9 Each additional inspection over the allowable in any of the above: �2 / a r Per inspection hour (min. per hour (min. 1 hour) 62.50 Phone: ,563 66% 7ti 4 0 ax: Sc J o6v 6 (.J Investigation fee: �. CCB Lic. #: 13)6O - Lic. #: 2 y 6 S C other. y la 'C- � ^`rL'T,e,:W,.l G*P°� 4 t'I Supervising electricia, v 3 , .45 � Subtotal $ si' ature re • uir- d: ,, — -d�!, _ Plan Review (25% of Permit Fee) $ Print Name: dle.°1 4 i b • L*a #: y0 t(S State Surcharge (8% of Permit Fee) $ cf afr— TOTAL PERMIT FEE $ S 72X Authorized Notice: This permit application expires if a permit is not obtained within Signature: Date: 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. (Please print name) is \Dsts \Permit Forms \ ElcPermitApp.doc 01/03 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all systems $75.00 Check Type of Work Involved: 0 Audio and Stereo Systems O Burglar Alarm Garage Door Opener El Heating, Ventilation and Air Conditioning System Vacuum Systems O Other COMMERCIAL WORK ONLY: Fee for each system. $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: O Audio and Stereo Systems 0 Boiler Controls 0 Clock Systems O Data Telecommunication Installation 0 Fire Alarm Installation n HVAC Ei Instrumentation El Intercom and Paging Systems Landscape Irrigation Control Medical 0 Nurse Calls Outdoor Landscape Lighting Protective Signaling Other Number of Systems * No licenses are required. Licenses are required for all other installations i:\Dsts\Permit Forms \ElcPermitAppPg2.doc 01/03