Permit ,, CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00430
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/02/2011
Parcel: 1 S126CA00100
Jurisdiction: Tigard
Site address: 9225 SW HALL BLVD F
Project: Ideal Image Subdivision: FAIRVIEW PLACE CONDO Lot: 20
Project Description: Sigh lighting if (1) wall sign.
Contractor: MEYER SIGN CO OF OREGON Owner: GREENBURG CORNERS LLC
15205 SW 74TH AVE BY MENASHE, R BARRY
TIGARD, OR 97224 621 SW ALDER, SUITE 605
PORTLAND, OR 97205
PHONE: 503 - 620 -8200 PHONE:
FAX: 503 - 620 -7074
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 08/02/2011 $67.84
Specifics:
1 ea 12% State Surcharge - 08/02/2011 $8.14
Electrical
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $75.98
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 accor e with - • •roved •lans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTEN N: Oregon la r ires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -001 thro gh OAR 952 -00 1090. Y. ay obtain a copy of the rules or direct questions to OUNC by calling 503.23 .1987 or 1.800.332.2344.
Issued y: 4 -AA . 1 Permittee Signature:
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.
i t — 000 .)
Electrical Permit Application wfflsbgsmiag,Eo.aaNmaotnoFFwvnsooromwsmomsmssEmmmag
minonnowughgwzopsagwgamasemopg.=omegsmgmgmk.aggmwzsw
pirip City of Tigard Received
Date'13v. ' fi k- 11/ Permit No : ete 5
p D: ," 13125 SW Hall Blvd.. Tigard, OR 97223 Plan Review
.104 1 "All Phone: 503.718.2439 Fax: 503.598.1960 Da teiliv: Other Permit
rititik0 Inspection Line: 503.639.4175 Date Read3:/By. Juris El See Page 2 For
ttntthattiattto inicrnet: .w\v‘v.112ard-or. goy
Notified/Method: Supplemental Information
„
Typic.oFAVORI: ,
„ .
. ° , : ',. , '. - - -,.--,--' ."'PLA.r.ti -1 121NIEW - ',, — . • —
-,. -- - • „ • , . . ,
• •:, — - •,-.. • ..-....- .• . - , ..,,
0 New construction „ErAdditionlalteration/replacement . Please-check all ihai apply (submit 2.sms or plans w:licins checked below)
El Service or feeder -100 amps or more 0 Building o‘er three stories
0 Demolition LI Other: where the available 000 current 0 Marinas .and boatyards
. CATKCORV.OF -' , -- • - • ' . :' exceeds 10,000 tulips at 150 volts 'or 0 Floating buildings
less to ground. or exceeds 14.000 0 Commercial-use agtieultural
Ill I- and 2-Itiolv dwelling Con al ID Accessory building amps for all other installations buildings
El Multi-family I=1 Masten 0 Other: 0 Fire pump, 0 Installation of 75 KVA or
. 0 Emeigener system larger separately derived SySteln
/1./0.; iNFoiii4Fic.?N 'Arsib ' ,, , , . -, ,
0 Addition of nen means load or 0 "A "E". "1-2
--- 100HP or more. necnoancY
Job no.:
Job site address: 2 .2 s c c_k ( ( 0 uc 4 0 sis,or more
residential units. 0 Rem:allow vehicle parks
C it y/Stateril I': 71,6ALCL.L/2) 011cultlbcare.theilities 1=1 Supply Nonage for near than
Dl lardalous locations. 600 volts nominal
Suite/bldg./apt. no.: Pricer name: 2-yr_AL., tet,v36E 0 Service or feeder 600 maps or more.
- ..2):
Cross street/directions to job site: A2/1 Description I Qq. I Fee. I Total I •
New residential single- or multi-family dwelling unit.
• lacludes attached garage.
Subdivision: 1.ot•no.: 1.000 sq. Ft. or less I 68.54 4
Ey. ydcFI 500' sq. It or p00101) 33.92
T 1
ax map/parcel no.: Liniitcdeneray. residential
75.00 2
'-' . ; • ''' "; ' :''''' - fiV Wo'iii - ": , ' — '----' ' ' ' '" '-'°'-, '' (with above st1.
Limited energy, multi-fannly
,
C.I ) '''( c (--(1/\Z-et\ ( y'ii, 4. u....c17` i residential (with above sq. it.) 75 00 2
Services or feeders installation,;alteration.,and/or relocation
200 amps °Hess 100 70 2
'Timm:10:y 9wNE114. -.,, 'I' _ - ., : ll .:):EjS,"*F.: ; .' ' ' ::' i;: 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200 34 2
Name: "4-7? 601 amps to 1,000 amps 301.04 2
,---
Address: aL 2 / c. (,....(....,• j -1 ( /3 (./C( . ove,, 1,000 amps in volts 552.26 2
I Temporary services or feeders installation, alteration. and/or
City/State/ZIP: (Trrit124) OR i
, relocation
Phone: ( ) &r .... Fax: ( . A 200 amps or less 5936
201 amps 10 400 amps
125,08 I
K 1
I 2
Owner installation: Thislitstallation isbeing made on properly that ,I own which is not
401 amps lo 599 amps 168.54 r2
intended for sale. lease. rent 'or e..ehange. 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
iral'AP2PliaNT: ' '. ,' ' : ' l ' " :. - 4=reotiiiA'a . :14:ii■F r : "!' above service or feeder fee.
7.42 2
each branch circuit
1 Business name: ac 19 V 5 H. Feefor branch circuits ti
i
service orfeeder fee. first
56.18 2
Contact name: COG_ ( Cu..,..k. -7... branch circuit
Each addl.t branch circuit 7.42 2
Address: ( ------1,0 S z`L( ti - 1 u ii,. A Miscellaneous (service or feeder not included)
Each inanutheturechir modular
C. i ty/St ate/7.11' : 1 o p e.:7 ---- -2, 61 dwelling, service and/or feeder 67.84 2
Phone: (‘ ?6D, ..-- . 06 Fax: l 9 62.6 - 7-e 7 7 - L c Reconnect only 67 84 2
. Pump orirrigation circle 67,84 2
E-mail: ? -:- ) c (0 5 i., — 1 . 5 -. /A . c,c,,cc _ si lighting 67:84 1p 7.1/4 2
.„.. „ „ , , , , ,. ,
. CONT , „ R, ' -- - ' - • ' '
' . ,. crO • " ' Signal circuit(s) or limited-energy
Business name:
panel. alteration, or extension Page 2 2
-.
..----
Each additional inspection over allowable in any of the above
Address: \ ±" A 4
, , la Additional inspection (I hr min) 66.251 hr
Investigation (I hr min) 66.25/ ltr
Cit
Industrial plant (1 hr min) 78 18; hr ....._.
Phone: ( ) Fax: ( ) Inspections for which no fee is
90.00/ hr
specifically listed (5 hr min)
CCI3 Lie.: CL- 0 (Lk Electrical Lic '7
7- 0 6( e„--,5 1-ic.: ,4:4() f- C '- ' - „EILICTRICAI.::PERMIT:FEES7 --
-) l.
Subtotal: 6 7. y4
Suprv. Electrician signature. required: -
Plan review (25% of permit fee): —_-_—
Print name: t Date: 2- ( State surcharge (12% 01' permit fee): S*. /I1
Ai
'I'OI'AL PERMIT FEE: --7
Thi application s--. 9 ei
Authorized signature: s permit appliion expires if a permit is not obtained nithin 180
days after it has been accepted as complete.
P _
rint name: Date; - ' ..- - Number of inspections allowed per pet inn
. •
1 , Ittelding‘Porunisq:LC.PCIancApp doe 07 01 to 445 5T(11.05 C0(11 WI/ti