Permit �/e' //✓ C\ ./7//0
at CITY OF TUGARD ELECTRICAL PERMIT
' , a . COMMUNITY DEVELOPMENT 4 Permit #: ELC2010 00186
. Date Issued: 04/21/2010
';Tiri1lRD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S102CB02600
Jurisdiction: Tigard
Site address: 13066 SW PACIFIC HWY
Subdivision: Lot: 0
Project: Sanches Taquaria
Project Description: (1) branch circuit for neon sign (copy change only) 5/7/2010: ADD (1) 100 amp service and (2)
branch circuits. -
Owner: FEES
WALTER, ANGELA D Quantity Description Date Amount
2863 RIVERWALK LP
EUGENE, OR 97401 1 crt Branch Circuits 04/21/2010 $56.18
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 04/21/2010 $6.74
Electrical
Contractor: 67 da Electrical Permit 05/07/2010 $66.78
DICKINSONS ELECTRIC 8 da 12% State Surcharge - 05/07/2010 $8.02
8449 SW BARBUR BLVD Electrical
PORTLAND, OR 97217
PHONE: 503 - 246 -3550
FAX: 503- 213 -6049
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $137.72
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those_, rules are -et forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 o c r. == '" • /
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' 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.
,`7�' CITY OF TIGARD ELECTRICAL PERMIT
i COMMUNITY DEVELOPMENT Permit #: ELC2010 -00186
0 , . Date Issued: 04/21/2010
T I CARD, 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S102CB02600
Jurisdiction: Tigard
Site address: 13066 SW PACIFIC HWY
Subdivision: Lot: 0
Project: Sanches Taquaria
Project Description: (1) branch circuit for neon sign (copy change only)
Owner: FEES
WALTER, ANGELA D Quantity Description Date Amount
2863 RIVERWALK LP
EUGENE, OR 97401 1 crt Branch Circuits 04/21/2010 $56.18
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 04/21/2010 $6.74
Electrical
Contractor:
DICKINSONS ELECTRIC
8449 SW BARBUR BLVD
PORTLAND, OR 97217
PHONE: 503 - 246 -3550
FAX: 503 - 213 -6049
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $62.92
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 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- 001 -0010 through OAR 952 -001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1 0.332.2344.
Issued By: t _ "" 4 �/� rr_� Permittee Signature: - "`�G '
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' 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.
Electrical Permit Applicati(REcpivED FOR OFFICE USE ONLY
Il - City of Tigard n 2 Received /i Date /By: 7 a / /0 WAY Permit No.ELC ' OHO C ��
•
q 13125 SW Hall Blvd., Tigard. OR 9722APR 2 1 2010 Plan Revie
Phone: 503.639.4171 Fax: 503.598.1960 Date /By: Other Permit:
T I G A R D Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready /By: luris: fd See Page 2 for
Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: !:I ( Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition 0 Other:
where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial - use agricultural
❑ I- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A "', "E ", "I -2 ", "1 -3 ",
Job no.: Job site address: 13066 sw Pacific Hwy IOOHP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard, Or 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project (lame: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Frewing Description 1 Qty. 1 Fee. 1 Total 1 "
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
67.84 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi-family 67.84 2
Sanches Restaurant / ,9&.0 i,2/ f residential (with above sq. ft.)
��,,, \ Services or feeders installation, alteration, and /or relocation
Power to Neon sign ( i p y C/�-Nrr� 1 /9 200 amps or less 100.70 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name:
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and /or
City /State /ZIP: relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange. according to ORS 447. 449. 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee 7.42 2
each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, first I 56.18 56.18 2
Contact name: branch circuit
Each add'I branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67 84
dwelling, service and/or feeder 2
Phone: ( ) Fax: : ( )
Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail:
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited - energy
Business name: Dickinsons Electric panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 8449 sw Barbur Blvd Additional inspection (1 hr min) 66.25/ hr
City /State /ZIP: Portland, Or 97219 Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 246 - 3550 r . Fax: (503) 213 - 6049 Inspections for which no fee is
90.00/ hr
specifically listed (%2 hr min)
CB Lic.: 65534 Electrical Lie.: 26 140c Suprv. .: 3100s Iva
ELECTRICAL PERMIT FEES
,5))14,,,,C �-- ':! % Subtotal: 56.18
Suprv. Electrician signature, required: L - 1� , ,. /"�—� Z Plan review (25% of permit fee):
`,- V 6 .
Print name: Larry Dickinson Date: 4/21/10 State surcharge (12 %ofpermit fee): 6.74
TOTAL PERMIT FEE: 62.92
Authorized signature: (� 3��- This p ermit application expires if a permit is not obtained within 180
v
t/ 0-- days after it has been accepted as complete.
Print name: Larry Dickinson Date: 4/21/10 * Number of inspections allowed per permit.
1. \ Building \ Permits \ELC - PermitApp.doc 10/01/09 440- 4615T(1 I /05 /COM/WEB