Permit c,�
e Lc .
::- CITY OF TIGARD q'•7 ELECTRICAL F'ERMI7
r� r'IIIA DEVELOPMENT SERVICES PERMIT #: ELC97- -0488 14 1' DATE ISSUED: 08/06/97
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171
PARCEL: 1S136DB -02600
SITE ADDRESS...:11201 SW 72ND AVE
SUBDIVISION • ZONING:C -G
BLOCK..........: LOT JURISDICTION: TIG
Project Description : Electrical for freestanding sign re: SEN97- 0084/BUP97 -0303
-- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS-- - ---
3.000 SF OR LESS....: 0 0 - 200 amp • 0 PUMP /IRRIGATION : 0
EACH ADD'L 500SF...: 0 201 - 400 amp • 0 SIGN /OUT LINE LTG..: 1
LIMITED ENERGY.....: 0 401 - 600 amp.......: 0 SIGNAL /PANEL.......: 0
MANF. HM/ SVC /FDR..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (10)...: 0
- - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS - - - - -- -- -ADD'L INSPECTIONS--- -
0 - 200 amp • 0 W /SERVICE OR FEEDER: 0 PER INSPECTION • 0
201 - 400 amp : 0 1st W/0 SRVC OR FDR.: 0 PER HOUR : 0
401 - 600 amp • 0 EA ADD'L BRNCH CIRC: 0 IN PLANT : 0
601 - 1000 amp • 0 -- - - --- -PLAN REVIEW SECTION -------- - - - - -•
1000+ amp /volt • 0 > =4 RES UNITS........: ) 600 VOLT NOMINAL..:
Reconnect only...,.: 0 SVC /FDR > - 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: -- -. FEES --
MCDONAL DS CORPORATION type amount by date recpt
5000 SW MEADOWS ROAD, SUITE 230 PRMT $ 40.00 JSD 07/18/97 97- 297307
LAKE OSWEGO OR 07035 SPCT $ 2.00 JSD 07/18/97 97- 297307
Phone #:
Contractor: -- -- - ---
YOUNG ELECTRIC SIGN CO $ 42.00 TOTAL
416 EAST 41ST ST
-- - - -• -- REQUIRED INSPECTIONS -- - - - ---
BOISE ID 83714 Elect'1 Final
Phone #:
Reg #..: 000693
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 —x`•10 through OAR 952-001-1987. You may obtain a copy
of these rules or direct questions to'.OUNC by calling (503)246 -1987.
i iii ii Kr
Perm ittee Signature: _ — \T Issued By: �� __
-- • — 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: ,_ ,T_____ _
++++++++++++++++++++++++++++++++++++++++++++++++ + ++ + + + + + + ++ ++ + ++ + + + + + + ++ + + ++ + ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + ++ + + + + + +++ + ++
tC1T1�'OF TIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD.
Rec'd By ���� J
TIGARD OR 97223 Date Rec'd n / S
Date to P.E. /
Phone (503) 639 -4171, x304 Print or Type Date to DST
Inspection (503) 639 -4175 Incomplete or illegible will not be accepted Permit # c9 f --°c �'
Fax (503) 684 -7297 Called <S i? 97 74 - » 1. Job Address: 4. Complete Fee Schedule Below: Gj'"'`
Name of Development /10Z)J741.1)S Number of Inspections per permit allowed
Name (or name of business) Service included: Items Cost Sum
2..0 •? �
Address 1 1 O 1 a 4a. Residential - per unit
`7� /��f 1000 sq. ft. or less $110.00 4
!
City /State/Zip 7G . O �' Each additional 500 sq. ft. or
Commercial Residential El Limited thereof $25.00 1
Limited Energy $25.00
Each Manuf d Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor installation only:
(Attach copy of a l l urrent licen�se�_ss) 4b. Services or Feeders
Electrical Contractor %1 df .C�"f�CT1><c. .S jn AP. Installation, alteration, or relocation
Addr S 200 amps or Tess $60.00 2
201 amps to 400 amps $80.00 2
City State Zip 401 amps to 600 amps $120.00 2
Phone No. • 91 7 601 amps to 1000 amps $180.00 2
Job No. Over 1000 amps or volts $340.00 2
Elec. Cont. Lice. No.37•51GGSExp.Date Reconnect only $50.00 2
OR State CCB Reg. No.t' ! Exp.Date /r ( -4 7 4c. Temporary Services or Feeders
COT Business Tax or Metro No. CI6O4 Exp.Date ) f -1 - 47 Installation, alteration, or relocation
200 amps or less $50.00 2 -
2
Signature of Supr. Elec'n --A--- AIL*
401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License No. Exp.Date see "b" above.
Phone No.
4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
/A---. purchase of service or
� Print Owner's Name feeder fee.
Address Each branch circuit $5.00 2
-
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 2
The installation is being made on property I own which is not Each additional branch circuit $5.00 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle $40.00 2
Each sign or outline lighting l $40.00 2
3. Plan Review section (if required):* N /A- Signal circuit(s) or a limited energy
panel, alteration or extension $40.00 2
Minor Labels (10) $100.00
Please check appropriate item and enter fee in section 5B.
4 or more residential units in one structure 4f. Each additional Inspection over
Service and feeder 225 amps or more the allowable in any of the above
System over 600 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00
as described in N.E.C. Chapter 5 In Plant $55.00
* Submit 2 sets of plans with application where any of the above apply. 5. Fees:
Not required for temporary construction services. 5a. Enter total of above fees $ /
5% Surcharge (.05 X total fees) $ .
NOTICE • Subtotal $
5b. Enter 25% of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if required (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $ --,V
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account #
$
Total balance Due
I: \DSTS \ELC96.APP Rev 9/96