Permit CITY OF TIGARD ELECTRICAL PERMIT
111 11. 8 C OMMUNITY DEVELOPMENT P ermit #: ELC2011 -00143
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/18/2011
Parcel: 1 S136DC04400
Jurisdiction: Tigard
Site address: 11945 SW 70TH AVE
Project: TVF & R Subdivision: DARTMOUTH SQUARE Lot: 30
Project Description: Installation of (2) sign lightings
Contractor: SECURITY SIGNS INC Owner: TUALATIN VALLEY FIRE & RESCUE
2424 SE HOLGATE BLVD 11945 SW 70TH AVE
PORTLAND, OR 97202 TIGARD, OR 97223
PHONE: 503 - 546 -7114 PHONE:
FAX: 503 - 230 -1861
FEES
Quantity Description Date Amount
2 ea Sign or Outline Lighting 03/18/2011 $135.68
Specifics: 1 ea 12% State Surcharge - 03/18/2011 $16.28
Electrical
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $151.96
Required Items and Reports (Conditions)
This permit is issued 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 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 the 180
days. ATT ION: Ore law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001- 10 through OAR 95 -0 0 9 You may obtain a copy of the rules or direct questions to OUNC by c - ' • 93.232.1987 or 1.800.332.2344. —
Issued y: P ermittee Signatu�•.
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' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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 AnDlication 1,)l. OITI( r: 1 -'- (t`1.,
Ci ty of Tigard • ' Jr f hen ' //- f ,3
Batd/BY; ' Permit No.;
13I SW Sall 131vd., I7 8ard, OR 97223 Received /
p)� Review
� Phones: 503.639.4171 Pax: 503.596.1960 Date/By: Other Permit:
T t .` 1: Lt Inspection Line: 503.639,4175 Date Ready/By. lofts. la See Page 2 for
Internet: www.tigard ez,gov Notified/Method: — Supplemental Information
E od?WO11K .
❑ New construction CI Addition/alteration/replacement Please check all that at (submit a sets of plans wltterns checked below):
171 Demolition ❑ Other: ❑ Service or feeder 400 amps or more In Building over three stories.
where the available fault current ❑ Marinas and boatyards.
RY OF CONSTRUCTION exceeds 10,000 as at ISO volts or ❑ Floating buildings,
and 2-family dwelling ® (`PminCrC1 lass to ground, or exceeds 14,000 ❑ Comuuxoial -use agricultural
❑ l
Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Ire pump. ❑ Installation of 73 KVA or
❑ E ay system larger separately derived system.
' Jdd3 13°E nvl t# °14 ,411) Ll 'A�TI°N
:.. _ Q of new motor load of ❑ "A ", "B ". "1.2'•, `•1.3 ^,
Job no.: Job site address: + 1946 , /�''L� 1001iP or more. occupancy
` C �.0 �l tr CI six or more residential units. Q Recreational vehicle parks.
City/ State /ZIP: ❑ Health -care facilities, ❑ Supply voltage for more than
. 0 Hazardous locations, 600 volts nominal.
Suite/bldg. /apt. no.: 1 Project name: 1.--'\/ F .. ❑ Service or feeder 600 amps or more.
', VI&E 'S
'
Cross street/directions to job site: Description 1 Qt I F ( Total " I r,,,,
New residential single- or multi - family dwelling unit. -
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'I 500 sq. R. or portion 33.92 ' 1
Tax rnap/pexcel no.: Limited energy, residential
witty above s R. 67.54 2
DESCRIPTION' pin WO { q• ) ..
t Limited energy, multi - family 67.84 2
residential (with above so. ft.)
---- -- -- - Services or feeders installation, alteration, and/or relocation
*Mount Only* 200 amps or less 100.70 2
^
0 ;IIROpERTrpvirNEst ' - . I j D TRI+r 201 amps to 400 amps . 133.56 2
Name: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
-
Qty /State/7.IF: Temporary services or feeder; installation, alteration, and/or
_ relocation
Phone: ( ) f Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not - 401 amps to 399 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits - new. alteration, or extension, per panel .
Owner signature: Date: _ A. Fee for branch circuits with
above service or feeder fee
Te ': I CONTACT P2�1i6ON , ! 7.42 2
each branch Circuit
Business name: Security Signs B. Fee for branch circuits without .
service or feeder fee, first 56.18 2
Contact name: Melissa Hayden branch circuit _
Hach add'l branch circuit 7.42 2
Address: 2424 SE Holgate Blvd Miscellaneous (service or feeder not included)
Each manufactured or modular
City /State/ZIP: Portland, OR 97202 dwelling, service and/or feeder 67.84 2
Phone: (503) 546.7114 I
Pair: : (503) 230.1861 Reconnect only 67.84 2
Pump or irrigation circle 67.64 2
uritySigns.com Sign or outline lighting 4_ 67.84 13,'� le 8 _ 2
E-mail: McIaE ,. ec : CONTRALTO* .. .. Signal circuit(s) or limited :energy
Business name: Security Signs panel, alteration, or extension. Page 2 _ 2
Each additional inspection over allowable in any of the above
Address: 2424 SE Holgate Blvd Additional inspection (1 err min) 66.25/hr ,
Investigation (1 hr min) 66.25/ hr
City /State/ZIP: Portland, OR 97202 -
Industrial plant (1 hr min) 78.15/ hr
Phone: (503) 546.7114 1 Fax: (503) 230.1861 Inspections for which no fee is 90.00/ hr
specifically listed (h hr min)
CCB Lic.: 122809 Electrical Lie.: 26560CLS Suprv. Lie.: 383SIG F''' !RIC iL, PER JI'I S
Subtotal: / ,i....'
.5 6 g
Suprv. Electrician signature, required: Plan review (25% of pemiit fee):
Print name: Marc Linguist Date: State surcharge (12% of permit fee); /(p. x$ _
_--- - TOTAL PERMIT FEE: / 5/.74
Authorized signature: This permit application expires W e permit is not obtained within 180
Print name: Melissa Ha Date: days after it has been accepted as complete.
Hay Number of inspections allowed per permit.
l Aauildinguemitsmtc- permitApp.doc 10101/09 440-4615T(11 /05/coMfWEB
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