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Permit ; a CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELC2008 00219 DATE ISSUED: 4/17/2008 TIGARD' 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S1 12 DD -00800 SITE ADDRESS: 15670 SW UPPER BOONES FERRY RD ZONING: C -G SUBDIVISION: LOT : JURISDICTION: TIG PROJECT: CHEVRON Project Description: (4) sign Iightings 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: 4 LIMITED ENERGY: 401 - 600 amp: SIGNALJPANEL: 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: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 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: RYAN, JOANNE C + RAMSAY SIGNS SMITH, BOB L 9160 SE 74TH AVE BY FRED DRYSDALE INC PORTLAND, OR 97206 LAKE OSWEGO, OR 97035 Phone: Contact #: PRI 777 - 4555 FEES Description Date Amount Reg #: ELE 26- 106CLS [ELPRMT] ELC Permit 4/17/2008 $213.60 LIC 63422 [TAX] 12% State Surchar 4/17/2008 $25.63 SUP 493SIG Total $239.23 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 -0 ough 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. Issue Permittee Signature: '2,--(7; 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. Electrical Perm Applicatio 1 r r Ho i o 1 N ON W � ,; r a ' x M . r �.° : '-' City of Tigard Date/ft ^ I7 �d Permit No.: C Q�O�9 q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ,h . '' 8 . * : Other Permit Phone: 503.639.4171 Fax: 503.598.1960 Date/B IICAEZD� Inspection Line: 503.639.4175 Date Ready By: UM ® See Page 2 for L s Internet: www.tigard - or.gov 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: 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. ❑ Addition of new motor load of ❑ "A ", "E ", "l - ", "I - ", Job no.: Job site address: 1 5 70 Sc � (/ �/�Pij" F Six or or more. occupancy. / 7 OK voi 1❑ Six or more residential units. ❑ Recreational vehicle parks. ' .4— City /State /ZIP: "' 7 .62____ ❑ Health -care facilities. ❑ Supply voltage for more than • ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: C _,L.um„„--t ,5 ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description 1 Qtv. 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 145.15 4 Ea. add'I 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.) Limited energy, multi - family 75.00 2 residential (with above sq. ft.) Services or feeders installation, alteration, and /or relocatio 200 amps or less 80.30 2 2 ��� OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 Name: 0/� w `?/� 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: 3' /41.67- 41. r Over 1,000 amps or volts 454.65 2 City /State /ZIP: Temporary services or feeders installation, alteration, and /or relocation Phone: ( ) I Fax: ( ) 200 amps or less 66.85 I Owner installation: This installation is being made on property that 1 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 Owner signature: Da te: Branch circuits - new, alteration. or extension, per panel g A. Fee for branch circuits with u►' APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee, 6.65 2 aw n each branch circuit Business name: B Fee for branch circuits WIN_ f \<\-Q./( xithout service or feeder fee, Contact name: y Jf� u first branch circuit 46.85 2 Address: al 1 (400 .r 7 L/ V Each add'l branch circuit 6.65 2 G Miscellaneous (service or feeder not included) City /State /ZIP: pa/l, 4 © � J ` - Each manufactured or modular 90.90 2 dwelling, service and/or feeder Phone: (S ? 11_ s 35 T Fax:: ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting L/ 53.40 Z /3 ( 6 Signal circuit(s) or limited - Business name: / ate 6 1 m j L {� energy panel, alteration, or Address: / extension. Describe: Page 2 2 City /State /ZIP: Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: ( ) I Fax: ( ) Investigation per hour (1 hr min) 62.50 CCB Lic.:6 L /Z.2 1 Electrical Lic.: Z6-/06' Cq Suprv. Lic.: L/9 5.276, Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES / Suprv. Electrician signature, required: Subtotal: _ /5 .LPD Print name: i t< i P 5 .e ✓ Date: / 1 1 / 6L, Plan review (25% of permit fee): State surcharge (12% of permit fee): .rj, (4 Authorized signature: _ ~_ ` ' 4� tr��_ TOTAL PERMIT FEE: aj�( • o1 This permit application expires if a permit is not obtained within 180 Print name: �j -- V Z 14/ / a ( p I' Date: y I i 7 / b days after it has been accepted as complete. / ( * Number of inspections allowed per permit. ItBuilding\Permits\ELC. PermitApp.doc 05/23/06 440 -4615T(t t /05/COM /WEB