Permit r ' ' CITY OF TIGAR® ELECTRICAL PERMIT
I
PERMIT #: ELC2007-00872
1 , COMMUNITY DEVELOPMENT DATE ISSUED: 12/31/2007
T16■[iD_ 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S112AD 01100
SITE ADDRESS: 06600 SW BONITA RD ZONING: I - P
SUBDIVISION: PAUL SCHATZ FURNITURE LOT : 001 JURISDICTION: TIG
PROJECT: PAUL SCHATZ
Project Description: (1) sign lighting for freestanding sign.
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: 1
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:
PACIFIC REALTY ASSOCIATES SECURITY SIGNS INC
15350 SW SEQUOIA PKWY #300 -WMI 2424 SE HOLGATE BLVD
PORTLAND, OR 97224 PORTLAND, OR 97214
Phone: Contact #: PRI 503 - 546 -7114
FAX 503 - 230 -1861
FEES
Description Date Amount Reg #: ELE 26- 560CLS
IELPRMTI ELC Permit 12/31/200' $53.40 LIC 122809
(TAXI 8% State Surcharge 12/31/200' $4.27 SUP 383 SIG
Total $57.67 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 wi n 180 days of issuance, or if work is
suspended Kr . - •s. •TTENTION: Oregon law requires you to follow rules ado y the Oregon Utility Notification Center.
Those rul s are set forth iri •.AR 952 .1 -0010 through OAR 952 -001 -0100. You may obtain f•optes -of-t es- rules or direct questions to OUNC at
503.246. 699 • r 1.800.33 .23
Issued E%/: G ■ � � Permittee SignaWif �� �".. �� /gw' 4A—_----
OWNER INSTALLATION ONLY
1 i .
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 Permit Application " " °
, ' i t►IZ c 1 tc t u�t t�
�l Received /� e�/ 7 F�eC�00 (X
City of Tigard � Date /B : Permit No.
13125 SW Hall Blvd., Tigard, •(' ' � Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Il t h DateB : Other Permit:
Inspection Line: 503.639.4175 c 1 I i = Date Read /13 orr ® See Page 2 for
Pa
[[ 1 2007 .4,1:4:,'1_;'; y y: g
Internet: www.ci.tigard.or.us DEE Notified/Method: Supplemental Information
uti 'UFT T 0. PLAN REVIEW
❑ New construction iiilithIMI.r: - ,t ti r placement Please check all that apply:
❑ Demolition ❑Other: ['Service ['Hazardous over 225 amps, com'l Hazardous location
❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling I] Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories ❑ Feeders, 400 amps or more
❑ Multi- family 0 Master builder ❑Other:
DOccupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park
• Job no.: Job site address: �/]°Q� ❑ Health care fa cility ❑Other:
—` `'"' ���' Submit 2 sets of plans with any of the above.
City/State /ZIP: The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project nam'. . 0 . ' .... FEE* SCHEDULE
4 _ tat _ l t _4 / . tesertpttoo Qty. Fee. Total **
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.:. Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.:
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
dwelling, service and /or feeder 90.90 2
M OIN ' t "'1 Services or feeders installation, alteration, and /or relocation
me Do1 200 amps or less 80.30 2
jig PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: Aet- / c i e_ f /! 601 amps to 1,000 amps 240.60 2
Address: / Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 1
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 600 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
❑ APPLICANT
1 ❑ CONTACT PERSON . A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: Secu rty Signs branch circuit
B. Fee for branch circuits
Contact name: Melissa Hayden without service or feeder fee,
2 424 SE Holgate Blvd first branch circuit 46.85 2
Address: Each add'l branch circuit 6.65 2
City/State /ZIP: Portland, OR 97202 Miscellaneous (service or feeder not included)
Phone: ( 503) 546 7114 Fax: : ( 503 )230 1861
Pump or irrigation
tl ig e i g circle 53.40 � 2
Sign or outline lighting 53.40 533.7
E -mail: Melissa @Secuir Sl s.com Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: Security Signs
Address: 2424 SE Holgate Blvd Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State /ZIP: Portland, OR 97202 Investigation per hour (1 hr min) 62.50
Phone: ( 503 ) 546 7114 Fax: ( 503 )2301861 Industrial plant per hour 73.75
- ELECTRICAL PERMIT FEES*
CCB Lic.:122809 Electrical Lic.:2ff52OCLS Suprv. Lic.:383 SIG Subtotal 53 , e/D
suprv. Electrician signature, required: Plan review (25 %ofpermit fee) ---(2,
Print name: Date: State surcharge (8% of permit fee) 1 1' A 7
Marc Lin Ulst TOTAL PERMIT FEE 67, 6 7
Authorized signature: This permit application expires if a permit Is not obtained within 180
Melissa Hayden days after it has been accepted as complete
Print name: Y Date: Fee methodology set by Tri- County Building Industry Service Board
a° Number of inspections per permit allowed.
is \Building emlits \ELC- PermitApp.doc 12/03 4404615T110/02/COM /WEB