Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2009 -00206
Date Issued: 05/08/2009
T i GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S112DD00900
Jurisdiction: Tigard
Site address: 15680 SW UPPER BOONES FERRY RD
Subdivision: Lot: 0
Project: Speakeasy Bar and Grill
Project Description: Sign /sign outline lighting for (2) signs.
Owner: FEES
BHGAH TIGARD LLC Quantity Description Date Amount
BY BHG HOTELS, PO BOX 1670
WILSONVILLE, OR 97070 2 ea Sign or Outline Lighting 05/08/2009 $106 80
PHONE. 1 ea 12% State Surcharge - 05/08/2009 $12.82
Electrical
Contractor:
EDS SIGNS
10965 COMMERCE CIRCLE, SUITE A
WILSONVILLE, OR 97070
PHONE: 503 - 582 -8400
FAX:
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $119.62
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 rf 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 1.800.332 2344.
Issued By: 6 .t L 1 1\ Q A 1 Perm ittee Signature: Q 09
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.
_ 5 - 'lelsttrical Permit Applicatio RECEIVED - - 1 C)1t O.'l_,
Received ,,p
City of Tigard Date/By S' I • V 9 ■d z i Permit No t ' t o 2 . 0020 C
•
r 13125 SW Hall Blvd., Tigard, OR 972M1Y 0 7 2009 Plan Review
' C ' Phone 503 639 4171 Fax. 503 598.1960 D Other Permit
TIGARD Inspection Line. 503.639.4175 CITY OF TIGARD Date Ready/By Juns ® See Page 2 for
Internet www.tigard -or.gov Notified/Method ( C � Supplemental Information
BUILDING DIVISION
TYPE OF WORK PLAN REVIEW
51 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 stones
❑ Demolition ❑ 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
❑ 1 - and 2- family dwelling z 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 "1 2 ", "1 - ",
I 00HP or more occupancy
Job no.: Job site address: /5 6t) p/34 -k ,C /vi.S ❑ Six or more residential units ❑ Recreational vehicle parks
City/State/ZIP: iiik (�SGUFGO c7 - 9 7035' ❑ Health -care facilities ❑ Supply voltage for more t
t� ❑ Hazardous locations 600 volts nominal.
Suite/bldg. /apt. no.: Project name 5A .E 4s y ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single - or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145 15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq ft.)
Hiftr Limited energy, multi - family 75.00 2
L U /� n ,516./L/S (Z) residential (with above sq ft )
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
at PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
k City/State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 I
Owner installation: This installation is being made on property that I 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 599 amps 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2
n / each branch circuit
Business name: EJ)S . 5 / &/ �-+ 13 Fee for branch circuits
without service or feeder fee, 46.85 2
Contact name: � o '11 7 i3ki r 4 L,t'G first branch circuit
Address: 1096.19- 6a) Com/r,ERc ( /lt? sr/ Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: tt 0 LLE p 9 Each manufactured or modular
� fC 77�T� Eh ftd dl
90.90 2
„TV _ g ycc Fax: ( . 3 5 ' - g. Reconnect dwelling, ne t on y 66 85 2
and/or feeder
Phone: (
t�3) ) 91/ Reconnect only
E -mail: I'•S(� {3 , Eb S N(L) t co/7i Pump or imgation circle 53.40 2
CONTRACTOR Sign or outline lighting .2_, 53 40 /06, g 2
Business name: /-- 3J 6. I GA/ Signal panel, er or limited -
energy panel, alteration, or
Address: /00:16,6— SW �mm r_ a, 1e. S r - 4 , extension Describe. Page 2 2
City /State /Z IP: /..) I t..7o /LO CF. 97070 Each additional inspection over allowable in any of the above
/ Per inspection 62.50
Phone: (c03) jig - , ,? _ 6 Fax: ( b , 3 ) .5 8 a - fild Investigation per hour (1 hr min) 62.50
CCB Lie.: /2 es la Electrical Lic.: c. 5 5 - Suprv. Lic.: J ' 5/6 Industrial plant per hour 73.75
Suprv. Electrician signature, re uire ELECTRICAL PERMIT FEES
Su
P g 9 Vq wi Subtotal /Q 4 . ?6
Print name: A' iP�2 z Q AA/ _,p / ( (/'- Date: Plan review (25% of permit fee):
State surcharge (12% of permit fee). Az , ea,
Authorized signature: e � 7 l / ii/ TOTAL PERMIT FEE: // 6
,t This permit application expires if a permit is not obtained within I :^
Print name: 4-A � / 'J ! / , / y,/, J ), Date: days after it has been accepted as complete. ,ii r
d • Number of inspections allowed per permit SY
11BuiidineermusU.:LC- PermitA p doe 05/23 /06 440.4615T( I t /OS /COMJWEB
�.
, Eiect>;lricaA Permit Applicati tY � OE is E uS1 ()N1A'''
City of 'Tigard Received 4
�
y t `J Date/By _.— __.._.. rm
Peen it Nt ,: u c l ,�.��r„
.q 13125 SW itall Blvd.. Tigard, OR 97223 {UOV 0 2009 flan Review L.�.ue�
hl ' a Phone: 503.639.4171 Fax: 503.598.196t)) Date /By - -- Other Permit: - - -
ti1.CARD
Inspection Line: 503.639.4175 Dale Ready/By: Juris. 91 See Page 2 for
F ... ,.: ,itA Internet: www.ligard- or.gov CITY OF TIGARD Notificd/M - -- Supplemental Information
TYPE Ol laPIK Iv!o)Viv - PLAN
— — — ` - --` - - - Please check all that apply (submit 2 sets of plans w /items checked below):
0 New construction ►.1 Addi (ion /alterttion.replaccnient
❑ Service or feeder 400 amps or more ❑ Building over three stories.
0 DCmohtiOil 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 a &icultural
0 i - and 2-family dwelling ® Commercial /industrial 0 Accessory building amps for all other iusudlations, buildings.
❑ Multi - family 0 Master builder 0 Other: ❑ Fire pump. Cl Installation of 75 K\'A or
•- -------- - -^- -- ❑ Emergency system. larger heparately derived system.
JOB SI'i'E INFORMATION AND LOCATION" • 0 Addition of new motor load of
Job no.: 75314 .lab site address: 1 SW SEQUOIA PKWY t ?OIIP or more. occuparrcy.
— —�_ — ❑ Six or more residential units. ❑ Recreational vehicle parks.
Clly /StateIZIP: TiCAl20 OR /C9.55' ❑ Bealth -care facilities. ❑ Supply voltage for more than
❑ If varduus locations. 600 volts nominal.
ye
'd no.: d Project name: BMOGO?,PORT1414,4 1114r({� ❑ Service or feeder 600 amps or more.
_ —_
- -._ ._ - FEE SCHEDULE
Cross street /directions to job site: De t • ®11113231111 °
_.__-- __._ - -_ -_ ._ - _----- - -__ -- -- - • - - - -- New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq, R. or less 168.54 4
-_ - -- --- -. -_..- _ -- - - -...- - - - - -- - -_- _----- ....__- __......._.._ La. add'l S00 sq. ft or portion 33.92 l
Tax map/parcel no - -- Limited energy, residential 67.84 2
DESCRIPTION OF WORK (with above sq. ft.) ---- - -. -_
- -- - -- -
----------- Limited energy. multi- Gunily 67.84 2
X -RAY SUITE residential (with above sq. n.) __
-- -_ - -- ___...____-.._______. ---. - - - - - -- Services or feeders installation, alteration, and/or relocation
- -- -- st - - ---
___..-- ..._. __ -_-_..- _._._._._____ --.._.___..__ _.____- _-.______ ________.__ 200 amps or less 2 100.70 201.40 2
PROPERTY OWNER .� -I- TENANT -_ -- 201 amps to 400 amps - t 13356 133.56 'T
Name: 401 tunps to 600 amps_ -_ -___ 200.34 2
— - _--- -- - -_ - -- -- - -- - -.._ -- - 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City /State /ZIP: 'Temporary services or feeders installation, alteration, and /or
-- _.._---- - - -- -- -. -. -- -- - -- __- .- ___- -____ relocation
Phone: ( ) 1 Fax: ( ) 200 amps or less -- 59.36 1
Owner installation: T his installation is being made on property thai l own which is not 201 amps to 400 traps - i2S.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
signature: Branch circuits - new, alteration, or extension, per panel _
Owner si
U' - -..... ._ ---- -_ .__...____- --_ D ate:--- .___. __ - A. Fee for branch circuits with
❑ APPLICANT 1 0 CONTACT PERSON above service or feeder fee. 12 7.42 89.04 2
- -- - -- each branch circuit
Business name: 13. Fee for branch circuits
- nithola service or feeder 1'a,
Contact natne: 56.18 2
first branch circuit
-
Address: each addl branch Circuit 7.42 2
-_- - - - -- - Miscellaneous (service or feeder not included)
City/ State /ZIP: Each manufactured or modular
67.84 2
-- - - dwelling, service and/or feeder
Phone: ( ) j Fax: : ( ) Reconnect only 67.84 2
E -mail: Pump or irrigation circle 67.84 2
CON'T'RACTOR Sign or outline lighting 67.84_ -
Signal cireuit(s) or limited-
2
Business name: OREGON ELECTRIC GROUP
energy panel, alteration, or
Address: 1709 SE 3" AVE extension. Describe: Page 2 2
__ City /State /ZiP: PORTLAND ) OR 97214 Each additional inspection over allowable In any of the above
- - Per inspection 66.25
Phone: (503) 234 -9900 Fax: (503) 535 - 2763 htvestigation per hour (I hr min) 66.25
CCB i,ic.: 203 Electrical Lic.: 26 - 95C Suprv. Lic.: 4549S Industrial plant per hour 78.18
C.. - ELECTRICAL PERMIT FEES
Suprv. Electrician signature, require v Subtotal: 424.00 —
Print name RICHARD MCELLiO'1 "T - Date: 11-10 -09 -_ Plan review (25 % ofpermit fee): - -
-- - _ State surcharge (12% of permit fee): 50.88
Authorized signature: � __ 1 & TO'T'AL PERMIT Flit : 474.88
This permit application expires if a permit is not obtained width n IRO
Print name: RICHARD MCELLIOT•I' Date: 11 -10 -09 days after it has been accepted as complete.
-' — _ - - -- — ° Number of inspections allowed per permit.
t`. Building \remtits'OLC- PennitApp.doe 10'01109 Rid/ t- ,fit �1{t5'C(1M∎w LB o ac