Permit "° ELECTRICAL PERMIT
1 11 CITY OF TIGARD
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° PERMIT #: ELC2008 -00067
. COMMUNITY DEVELOPMENT DATE ISSUED: 2/7/2008
TIGARD- 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S 136AD -04000
SITE ADDRESS: 11525 SW PACIFIC HWY ZONING: C - G
SUBDIVISION: PACIFIC TERRACE LOT : 007 JURISDICTION: TIG
PROJECT: FAST SIGNS
Project Description: moving two machines. (2) branch circuits.
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: SIGNAUPANEL:
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: 0 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:
SMITH, EDITA M P B ELECTRIC INC
833 NW 170TH DR 1108 SE DOGWOOD LN
BEAVERTON, OR 97006 OAK GROVE, OR 97267
Phone: Contact #: PRI (503)786 -4499
FAX 503 - 786 -6005
• FEES
Description Date Amount Reg #: ELE 3 -428C
(ELPRMT] ELC Permit 2/7/2008 $53.50 LIC 85896
(TAX] 12% State Surchar 2/7/2008 $6.42 SUP 4541 S
Total $59.92 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for
more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued B� ` ` Permittee Signature: . t=> /G�
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
i1ectrncaI Permit App a4 1r ct E 0 ' —, --
)I 1 i 1 1 C`11� 11 :, j
f , City of Tigard ..' '� remit 5G
tNo., C —g o 7
j '' ',', ,'
et 1312$ SW 14a11 Blvd„ Til;aud, O1�- • hen Review / �; � ' • �—
r Phone: 503,639,0171 Flue: 503C5�60 Dot.: Other Permit: i! __ - 1
' inspection Line: 503.639,417$ Onto' •ady/By: side: :- sec Pogo 2 for
, i t t tis Noticed/meta: SupplementalInformation
i, e, 1 Internal: www,tigltrd- or, • T ' +TpeC , , ' -'' PLAN REVTEW
J New construction ' ,, Oil: inn /altcrattott/replacement Mane chock all that eppfy (euGmtk 3 mitt ofplans wliamn chocked below):
ID Service or feedcr 400 amps co more 0 Bui/dlnR Overt= stories,
■ Demolition IC Other: Owe the available fault qualm Cn Madna4 and boatyards.
CATEGORY OF CONST'RVCTTON extooth 10.000 amps at 150 vplta or ❑ 31otning buildings.
Lamm around, or a+taeeds 14,000 ❑ Comtserciel•tec agricultural
0 1- and 2-family dwelling 7 Commercial /industrial ❑ Accessory building amps for all other installations. buildings,
0 Multi- family • Master builder ❑ Other; OFim pump. 0 installation of 7S KVA or
Q Emergency system. larger separately derived system.
JOB SXTt INFORMATION ANA LOCATION ION ID Addition of new motor load of IF.2 "A" "S". "1-2 "1.3 ",
lob no_: Job site address: 10010 or more, ooa,ptncy.
f) r7 S f) / 'r t..J. C3Sia ep mar„ reciQsntihl units. ❑ Roerendantu vehicle pants.
City /StatcIZ1I: 7 0k3enith -care Osollitloa. ❑Supply voltage Fermate Man
► -._ (0 Hazardous lnoedone, 600 voila nominal,
Suitelbldg, /apt no.: Project name: m Service or feeder 600 ion .. or mare.
.•. 7- - FEE SC EDULE
Cross strcbt/directions to job site: 4 S I III= SPuPIIlMIE_G?!MIc„I'IIIII •
New T . doatild Single- or multi- family dwelling unit,
Naiades attitehad • arage.
Subdivision: Got no.: 1,000 sq. it. or less MIK� 4
Tux trap/parcel no.: Ea, add'I 500 sq, R. or portion In 33.40 1
1,irn ter. energy, residential 75.00 2
DESCRIPTION Of WORK INA a . . , ft
Limited corm, multi- faruilq III 75.00 111. Z
API `� tvsidential with atm e• it
40 4 Services or feeders Kindle , n alteration. ana • or relocation
200 em • or less IIM 80,30 2
CI PROPERTY OWNER Q TENANT 201 .s 400 amps MI 106,85 NNW 2
Nestle: 401 amps to 600 sops gm 160.60 2
601 amps ro 1,000 am � 111111 240.60 2
Address: _ Over 1,000 amps or volts - 454.65 MO 2
City/State/VP: Temporary services or feeders 2netttllatton, nitEration, aloe /or
relocation
Phone: ( )
Fax: ( ) 200 amps or Iona — 66.85 _ 1
Owner installation: This installation is being; made 4n property that 1 Own which is not 201 am• to 400 amps 100,30 2
intended fir sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 are • s to 599 ampq MIIIM111111=1 2
Owner signature! Date: Broach er • .:� . extoasc ., L,...;.,„1, eel
L Q i sh a r . branch or Writ pp
2
0 APPLICANT CONTACT PERSON ab service or feeder lac.
- t 't��
Business name; ....,.:_ , l branch circuit
D. Fee for branch aiteane
COTtlact name: without se vivo Or ibader foe, 46.85 1-1-----„,„9 2
first branch circuit
Address' Each Will circuit WO 6.65 2
I atlaaeoes service or feeder not include
gulch err
C(ty /Soaoc/ZIP: ch manufactured Or MOW NI
.. dy silt .. service and /err feeder 90.90 2
Phone: ( ) Fax :: ( )
Tutconncct oaf — 66.65 2
E _ Pum • or irri _shoe circle I= 53.40 2
CONTRACTOR Si ; n or ont}ine Iitdul ,. in 53.40 2
Business name: Signal otrat►it(o) or lirnited
/- / r r FGT� /r' / � energy panel, alteration, or
Address: , + , extension, Amelia:
2
may , an. / J
City /State /ZIP � ys10d � 7 Each additional ine . dolt over allowable In an of the above
Per it. ..cctlon IIIII 62,50
Phone: ( ) ays 1 6,- 1-276,1 Fax:( ) 1nvcsti: atiOn par hour 1 hr min) 11111 62.50 ENE
CCB L.ic.: .�� - - Electrical Lk _ ,, b Suprv. Lie A5 Industrial l+taltt per hour =KM
f i • /, ELECTRICAL P'E1i f7 PEES
Suprv. ci :# s , . to, required: _ Subtotal: lir 1Z'
Print name 7? D Plan review 25% of p¢imittbc
Authorized Signature; IIIIIIIIMEMEMEll 5. /7--
nit sunlit applle , nn nouns if a permh heat obtained within 184
Print name: Date: days miter it has boon accepted as complete.
" Number of inopeottona ntlowed por pcemit.
lAbaitaingkrermluartcRmnitAp ,don eartimr 44O461s3
5 --- T 0 0 V31 500998LCOS XVd Cb :TZ 9002 /90 /Z0