Permit Ir t
CITY OF TIGARD PERMIT
.,':,,., ,. ‘;: : COMMUNITY DEVELOPMENT Permit #: ELC2010 00271
{' Date Issued: 06/08/2010
T 1 GX.RD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
,,',...:.‘,.:d;:,.:-•- t ,K Parcel: 2S102BD00100
Jurisdiction: Tigard
Site address: 12645 SW PACIFIC HWY
Subdivision: Lot: 0
Project: St. Anthony School
Project Description: Sign lighting for freestanding sign.
Owner: FEES
ROMAN CATHOLIC ARCHBISHOP OF Quantity Description Date Amount
PORTLAND IN OREGON, 2838 E BURNSIDE
PORTLAND, OR 97214 1 ea Sign or Outline Lighting 06/08/2010 $67.84
PHONE: 1 ea 12% State Surcharge - 06/08/2010 $8.14
Electrical
Contractor:
MEYER SIGN CO OF OREGON
15205 SW 74TH AVE
TIGARD, OR 97224 •
PHONE: 503 - 620 -8200
FAX: 503- 620 -7074
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $75.98
Required Items and Reports (Conditions)
This permit is issue. 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 i - ordance with approved •tans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. • ENTION: Oregon law •uires you to follow the rules adopted by the Oregon Utility Notification Center. Those • - are set forth in OAR
952 -0' -0010 through OAR 952 -0• -0100. u obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.3
Is . ued By: /, �r _ A L � � L _ ( Permittee Signature: - ft. ''' . til��� ■
r \ OWNER INSTALLATION ONLY 1
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.
i ni.
Electrical Permit Applicat a ;1 � FOR OFFICE USE ONLY
City of Tigard ' IN O $ 2010 Received / Date /B ( • .Q (Q Permit No.: £' O/Q — a7 /
13125 SW Hall Blvd., Tigard, OR 97 2 Plan Review
' Phone: 503.639.4171 Fax: 503. (� , j Date /B : Other Permit:
TIGARD
Inspection Line: 503.639.4175 "• 'J t T: 1 LJ Date Ready /By: tuns: RI See Page 2 for
Internet: www.tigard - or.gov Eitp,.D i\ (' n'ii;- lycO Notified/Method: 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 ® Other: Sign 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 ® 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.
El A Addition of new motor load of ❑ "A ", "E ", "I - ", "I - ",
Job no.: Job site address: 99.1 �W' 'nicicc'n / �! 100HP or more. occupancy.
/c,14 �/ J �� I a ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard, OR 97223 7 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: St. Anthony Church & Scho ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: cross st. - Pacific Hwy. 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 I
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 67.84 2
Limited energy, multi- family 67.84 2
Install (1) freestanding sign with electronic reader board residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 100.70 2
® PROPERTY OWNER r TENANT 201 amps to 400 amps 133.56 2
1 ^ Name: St. Anthony Church & School 401 amps to 600 amps 200.34 2
V , 601 amps to 1,000 amps 301.04 2
iJ Address: (Same as above) Over 1,000 amps or volts 552.26 2
t`.... Temporary services or feeders installation, alteration, and /or
City /State /ZIP: relocation
Phone: (503)855 -3211 Fax: ( ) 200 amps or less 59.36 I
201 amps to 400 amps 125.08 2
t Owner installation: This installation is being made on property that 1 own which is not
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: (Same as contractor) B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: Steve Murphy branch circuit
Each add'I branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: /State /ZIP: Each manufactured or modular 67.84 2
Y dwelling, service and/or feeder
Fax: Reconnect only 67.84 2
Phone: ( ) ( ) Pump or irrigation circle 67.84 2
E - mail:
Sign or outline lighting 1 67.84 67.84 2
CONTRACTOR Signal circuit(s) or limited- energy
Business name: Meyer Sign Co. of Oregon, Inc. panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 15205 SW 74 Ave. Additional inspection (1 hr min) 66.25/ hr
City /State /ZIP: Tigard, OR 97224 Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: 503 620 -8200 F ax: (503) 620 -7074 Ins for which no fee is
Phone: ( 503) ( ) 90.00 / hr
specifically listed ('/ hr min)
CCB Lic.: 64014 Electrical Lic.: 20- 190CLS Suprv. Lic.: 566SIG ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: ./ Subtotal: 67.84
Pl an review (25% of permit fee):
Print name: Phil Reynold Date: 6 - - State surcharge (12% of permit fee): 8.14
L) TOTAL PERMIT FEE: 75.98
Authorized signature: � < —... `- �`— _ -
y This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Steve Murphy Date: 6 - - * Number of inspections allowed per permit.
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