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Permit 7 CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2011 -00626 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/08/2011 Parcel: 25101 DA00102 Jurisdiction: Tigard Site address: 13221 SW 68TH PKWY 100 Project: Precoa Subdivision: VARNS ACRES Lot: 9 Project Description: (1) sign lighting. Contractor: HANNAH SIGN SYSTEMS LLC Owner: GK TRIANGLE CORPORATE PARK III L 1660 SW BERTHA BLVD BY THOMSON REUTERS INC PORTLAND, OR 97219 ATTN: MEGAN DOWLING PO BOX 130174 CARLSBAD, CA 92013 PHONE: 503 - 946 -8373 PHONE: FAX: 503 - 206 -4900 FEES Quantity Description Date Amount 1 ea Sign or Outline Lighting 11/04/2011 $67.84 Specifics: 1 ea 12% State Surcharge - 11/04/2011 $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 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. 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 -0090. You may obtain a c•. • I - ct questions to OUNC by calling 503,232.1987 or 1.800.332.2344„ Issued B S' Permittee Signature: � G�� ��_ V.i.•. 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. s- ItiZo 1 I -OO Electrical Permit Applicatio FOR OFFICE USE ONLY Received ©�,/ C A 4,4,4z3 �' ' 14 City of Tigard Re Date/B // Permit No.: G V 13125 SW Hall Blvd., Tigard, OR 97214 V 0 4 2011 Plan Review Other Permit: Phone: 503.7182439 Fax: 503.598.1 Date/B TIGARD Inspection Line: 503.639 4175 Date Ready/By: .turfs: ® See Page 2 for Internet: www.tigard- or.gov CITE' OF TIGARD Notified /Method: Supplemental Information BUILDING DIVISION TYPE OF WORK PLAN REVIEW RI 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: where the available fault current ❑ Marinas and boatyards. CAT EGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling E Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder LI Other: El Fire pump. ❑ Installation of 75 KVA or JOB • SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "l -2 ", "l -3 ", Job no.: Job site address: /3224 f cJ 6E3111 a�,/ w, occupancy. T 0 o or r more or more. ore residential units. ❑ R ecr eational vehicle parks. City /State /ZIP: (1402_, D 12. 22-1 ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: J, DD Project name: i .,p . — t A ❑ Service or feeder 600 amps or more. job site: FEE SCHEDULE Cross street/directions to J Description I Qty. I Fee. I Total I New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Ea. add'l 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential DESCRIPTION OF WORK (with above sq. ft.) 75.00 2 Limited energy, multi - family Si (4.1 C1 tr residential (with above sq. ft.) 75.00 2 Services or feeders installation, alteration, and /or relocation 200 amps or less 100.70 2 PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 Name: ' i) l ij�D1 a �Z'� 601 amps to 1,000 amps 301.04 2 Address: 136-,o S,,, 5114 ph.IG Over 1,000 amps or volts 552.26 2 City /State /ZIP: �C7(Z RA�� b Z. 1/ Za ( Temporary services or feeders installation, alteration, and /or relocation Phone: (O 2.4 y —2 7 0 ---- Fax: ( ) 200 amps or less 59.36 1 201 amps to 400 amps 125.08 2 OV►'nei`i ist911ation: This installation is being made on property that I own which is not - intended forsale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with j& APPLICANT ❑ CONTACT PERSON above service or feeder fee, 7.42 2 each branch circuit Business name: ]� C 1 / B. Fee for branch circuits without ' '" ^ f"� 3 < <�" J Y S service or feeder fee, first 56.18 2 Contact name: 2 ) )_ Ap a L branch circuit Each add'I branch circuit 7.42 2 Address: I t c 5 i. ... ) 13 a2.,t -311 ,3L ft) Miscellaneous (service or feeder not included) Each manufactured or modular City /State /ZIP: 67.84 2 d1))t 0 2_ 5 -7 Z t c1 dwelling, service and/or feeder Phone: (S ) F t� Reconnect only 67.84 2 `L337 (� �) ��� y� Pump or irrigation circle 67.84 2 E bil4z. I _ C 410NFktt S t t4 .4 Wein t, t:,ptvr Sign or outline lighting l 67.84 (p7.8 2 CONTRACTOR Signal circuit(s) or limited- energy panel, alteration, or extension. Page 2 2 Business name: Spme A-S " Each additional inspection over allowable in any of the above Address: Additional inspection (1 hr min) 66.25/ hr City /State /ZIP: Investigation (1 hr min) 66.25/ hr Industrial plant(1 hr min) 78.18/ hr Phone: ( ) Fax: ( ) Inspections for which no fee is 90.00/ hr specifically listed (Y2 hr min) CCB Lie.: 1 & Electrical Lie.: LLS t Suprv. Lie. (v7 •SI ELECTRICAL PERMIT FEES \ Subtotal: 41 /• �T Suprv. Electrician signature, required: /d , ✓ ) --� Plan review (25% of permit fee): � . �� rvv Print name: l'T �f' Date: State surcharge (12% of permit fee): g • /7 TOTAL PERMIT FEE: 775 9 g Authorized signature:' This permit application expires if a permit is not obtained within 180 Print name: l J L: e- L�� is Date: I I / l days after it has been accepted as complete. L l ` Number of inspections allowed per permit. I:\ Building \Permits\ELC- PermitApp.doc 07/01/10 440 46t5T(1 I /05 /COM/WEB