Permit ELECTRICAL PERMIT
1 _-:
III Yq CITY OF TIGARD
t _ .`_ COMMUNITY DEVELOPMENT Permit #: ELC2009-00250
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 639 4171 Date Issued: 05/29/2009
Parcel: 251018801400
Jurisdiction: TIGARD
Site address: 12150 SW GARDEN PL, BLDG# 3
Subdivision: PARK 217 Lot: 0
Project: Harris WorkSystems
Project Description: Installation of one sign outline /lighting
Owner: FEES
WALTON CWOR PARK BC 8 LLC Quantity Description Date Amount
BY TTA/EPROPERTYTAX DEPT 325, PO BOX
4900 1 ea Sign or Outline Lighting 05/29/2009 $53.40
PHONE 1 ea 12% State Surcharge - 05/29/2009 $6 41
Electrical
Contractor:
MEYER SIGN CO , OF OREGON INC
15205 SW 74TH AVENUE
TIGARD, OR 97224
PHONE. 503 - 620 -8200
FAX
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $59 81
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 oth - pplicable law At 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 • •rk is suspended for more the 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 -0010 through OAR 952- 001 -0100 You may obtain a copy of the rules or direct questions to OUNC by calling 503 246 6699 0 1 800 332 2344
Issued By: Permittee Signature: �� - -- `� .
OWNER INSTALLATION ONLY ` 1
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 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.
IPp.-) <:() - 0 13 f 0 3
Electrical Permit Applicatio>I ECEIVED FOR OFFICE USE ONLY
City of Tigard Received
Date/By. l..4 Permit No 11 ?d� 00
13125 SW Hall Blvd., Tigard, OR 9722 Plan Review
.
Phone. 503 639 4171 Fax: 503.598.1960 AY 2 9 2009
Date/By. Other Permit
T GARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready /By, lures 0 See Page 2 for
Internet. www.tigard -or.gov BUILDING DIVISION Notified /Method• 1 1 C7) Supplemental information
�.? �' : n om. ',,.
TYPE - I±` WORK ; k _ <.. � - y ''1 = w.
❑ 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: Sign where the available fault current ❑ Mannas and boatyards
'`'u' s ,`CATECRY'`AF '
IN ,;;v'- exceeds 10,000 amps at 150 volts or 1:1 Floating buildings
• -" . su^ %. -. " -" ` ° O ON t "' ° ' ''• " " " ' , Na 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
,,.,. _ _ , ,,, U; ❑ Emergency system larger separately derived system
i' -i :1(5B S 1TE' INPOR itorI AhID-�L IO N; < ; z ,,, - A ❑ Addition of new motor load of ❑ "A ", "E ", "1- 2 ", "I -3 ",
Job no.: Job site address: 12150 SW Gordon PI. lootlP or more occupancy
❑ Six or more residential units ❑ Recreational vehicle parks
City /State /ZIP: Tigard, OR 97223 ❑ Health -care facilities ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal
Suite /bldg. /apt. no.: Project name: Harris Worksystems ❑ Service or feeder 600 amps or more
�s c .. , `'`FEE SCHEDULE 'rF' ' ,.;r ' `
Cross street/directions to job site: Park 217 Description I Qry. I Fee. I Total
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
� y ;; t, 75 00 2
'' t n F , DESGT2 OP 'WO ;, , , : ,,, 4, ' _ ' , ., (with above sq ft )
Limited energy, multi- family 75 00 2
Install (1) elec wall sign residential (with above sq ft )
Services or feeders installation, alteration, and /or relocation
200 amps or less 80 30 2
I , 1 P ` ,,,, ,,;, • ` %TENA " i , ,
< � , , „ , „ 2 01 amps to 400 amps 1 06.85 2
,,.,,, ���, .. .. .'.'«,' . lam:?. „ .., . <
Name GVA Kidder Matthews 401 amps to 600 amps 160 60 2
601 amps to 1,000 amps 240.60 2
Address: One SW Columbia St., Ste. 950 Over 1,000 amps or volts 454.65 2
City /State /ZIP: Portland, OR 97258 Temporary services or feeders installation, alteration, and /or
relocation
Phone: (503)221 -9900 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 599 amps 133 75 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A Fee for branch circuits with
t ` APPLI �ANT°t ' r” ® ° C0i TACT PERSON - ` above service or feeder fee
;'',--.® :, k:' < R.. «r xa. 6.65 2
each branch circuit
Business name: (Same as Contractor) B Fee for branch circuits
Contact name: without service or feeder fee, 46 85 2
first branch circuit
Address: Each add'I branch circuit 6 65 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular 90 90 2
dwelling, service and /or feeder
Phone: ( ) Fax: : ( ) Reconnect only 66 85 2
E -mail: Pump or irrigation circle 53 40 2
°" e ' " 's a: '° °' Sign or outline lighting 1 53.40 2
�'��, '��:;..���;�,.��.��:: .?�'..�,y.....CONTRAC�'TOR >�., - �t� "'': � t.: a,.. ,. ,>
Signal circuit(s) or limited -
Business name: Meyer Sign Co. of Oregon, Inc.
energy panel, alteration, or
Address: 15205 SW 74 Ave. extension. Describe. Page 2 2
City/State /ZIP: Tigard, OR 97224 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 620 -8200 Fax: (503) 620 -7074 Investigation per hour (1 hr min) 62.50
CCB Lie.: 64014 Electrical Lic.: 20 -190CL Suprv. Lic.: 566SIG Industrial plant per hour 73 75
:'
'; ' ; .,' %' '',` °EI;ECTRICAI PERMIT FEES'„ ' = . `;, i
/ Suprv. Electrician signature, required: Subtotal. 53.40
Print name: Phil Reynolds Date: 5 -28 -09 Plan review (25% of permit fee)
State surcharge (12% of permit fee) 6.41
Authorized signature: �����, — 1,......, TOTAL PERMIT FEE 59.81
This permit application expires if a permit is not obtained within 180
Print name: Steve Murphy Date: 5 -28 -09 days after it has been accepted as complete.
' Number of inspections allowed per permit
1 \Building \Permits\ELC -Perm iApp doc 05/23/06 440 - 461ST( I 1 /05 /COM /WEB