Permit CI TY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00713
j;'rcl DEVELOPMENT SERVICES DATE ISSUED: 11/8/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S135BC - 00100
SITE ADDRESS: 10775 SW GREENBURG RD
ZONING: C -
SUBDIVISION:
BLOCK: LOT : JURISDICTION: TIG
Project Description: Installation of (4) sign lightings.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: 4
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
TOSCO CORP CASCADE SIGNS + NEON
PROPERTY TAX DEPT -DC17 KINNEE SIGNS INC
PO BOX 52085 2166 WAYSIDE TERR NE
PHOENIZ, AZ 85072 SALEM, OR 97303
Phone: 503 - 620 -8747 Phone: 503 - 378 -0012
Reg #: LIC 64416
ELE 36 -2CLS
FEES SUP 659SIG
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 11/8/2004 $213.60
[TAX] 8% State Surcharge 11/8/2004 $17.09 Rough -in
Elect'I Final
Total $230.69
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. 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 rules adopted by the Oregon Utility Notification Center. Those
rules are - orth in a R 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct ques'ons to OUNC at (503)
246 -06s • or 1 -800- 332 - 2344.
Issu • By: Vu 2,y Permit Signatur; ..- A 11I �
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:
Call 639 -4175 by 7:00pm for an inspection the next business day
•
Electrical Permit Application . ..
FOR OFFICE USE ONLY - . ,',:,.,, ,,
,.., .
City of Tigard - Received
Date/By: &Air Permit No.: Eta ) 44) 'e 7/
13125 SW Hall Blvd., Tigard, OR 97223 plan Review
Phone: 503.639.4171 Fax: 503.598.1960 A,
44 40164 Date/B : Other Permit:
1V
Inspection Line: 503.639.4175 Date Ready/By: El See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: 1, Supplemental Supplemental Information
Wr fUfre'it71tg, toregi%wdfaz"!0A3-7: !4, =A4RI:t3ottm.xtmq ?. :,,, '
0 ,, i'Firlinlis14,14:;:71e:'-nlE.- ., 'emz e,-„' ,--
New construction 'Addition/alteration/replacement Please check all that apply:
EService over 225 amps, comm'l OHazardous location
El Demolition El Other:
0
S ervice over 320 amps - rating ElBuildng over 10,000 sq. ft,
;kZeAIVIZSIMJAWIF: EOVOKOZEIIEYAIIITIMIIZ of 1- and 2-family dwellings 4 or more new residential
El 1 and 2 dwelling J6,Cornmerciallindustrial El Accessory building ESystem over 600 volts nominal units in one structure
OBuilding over three stories OFeeders, 400 amps or more
LI Multi ['Master builder ID Other:
00ccupant load over 99 persons EManufactured structures or
InaaagtaN9tW 0 Egress/lighting plan RV park
ClOther: •
Job no.: Job site address: 1 01 7S - SI N ; 6 k osio k d s o ub H mi ea t ith 2 : _c f
i plans with any of the above.
City/State/ZIP: - 110) OV.... The above are not applicable to temporary construction service.
i• • • ' T AMTAPIT'1714:44tt:**§bil•ElitiEtal;':';` . 'i'• :- - - :.' • - ..'
Suite/bldg./apt. no.: Project nameCAvtora.1..)1, t ''-'''' ' "- " --'''''-'-- -------"- '..'"-' - • - - - •• - ,,,,
Description Qty. Fee. Total
Cross street/directions to job site: CAD_ KM 06 ealead....e SI-A New residential single or multi dwelling unit.
Includes attached garage.
4 GALUAk CA11 .01 1,000 sq. ft. or less 145.15 4
Subdivision: , ----------, Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
-. Limited energy, residential 75.00 2
Tax map/parcel no.: . -
Limited energy, non-residential 75.00 2
_MANIMUSWO,. .R.W#i Each manufactured or modular
. VV\i ) klP6' - ‘ <I" _a_A---ry dwelling, service and/or feeder 90.90
Services or feeders installation, alteration, and/or relocation 2
1----° S a S 40 ei 1 StA;V\S3 I
csj 200 amps or less 80.30 2
105n1 - 1± - .i Oilitoiariti AT; :, 33433:31, 003 koi-BrofRomos
401 201 amps to 600 400 amps 106.85 2
amps to amps
160.60 2
Name: 76, _ 61,2 4.. x:),
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
. Reconnect only 66.85 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: (52) - , .) 6,1 €74' 7 I 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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
qi ift il
ee
A
, ?: - -1.'" .. *•1§9V&ze :- "' trk l A Fee for branch circuits with
l'': .M q,MINANIMittvitm WitV igxg-T,..-PaitlF;,,' A.
.. , .
service or feeder fee, each
6.65 2
Business name: .
branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
46.85 2
each branch circuit
Address:
Each add'I branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 4. 53.40 2
Phone: ( ) Fax: : ( ) Sign or outline lighting . 53.40 a
E Iry Signal circuit(s) or limited-
aittaan energy panel, alteration, or
extension. Describe: Page 2 2
Business name: c c ' ct - N.1 e
-
Address: VO 60)( Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: Sai2s JAA CYK cf7,303 Investigation per hour (t hr nun) 62.50
c- I
Phone: (50) 3-ig- -o 0) 2_ Fax: SOS) 3 ( 1 - '8 1 S-4 Industrial plant per hour 73.75
V
*-AaVal3figiwoiv,,„,'„,„,...1_,:.,:,,„„„„..A, ,,,,,,„„„_,,,__,A,-
CCB Lic.: ( 1 Electrical Lie.: 3( Suprv. Lie.: ( c s 16 Subtotal A 5.
-
Suprv. Electrician signature, required: i 464,,14
-.,_, _ Plan review (25% of permit fee)
Print name: LIS'', • K °\J • Date: i t (LW State surcharge (8% of permit fee) /7, 0 ?
, TOTAL PERMIT FEE As (0?
0 •
Authorized signature: g / 4 x
px ___(4AA,t_s2_,e___ This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
/ •
Print name: / J cvt K_IAKIL--E- Date: I ),s104 * Fee methodology set by Tri-County Building Industry Service Board
** Number of inspections per permit allowed.
i.kBuildingWermits \ELC-PermitApp.doc 12/03 440-46IST(10/02/COM/WEB
Electrical Permit Application - City of Tigard . •
Page 2 - Supplemental Information,.
LIMITED ENERGY PERMIT FEES:
R 700 *NT i O: ONLY 1 x X°'°``
� �m��._s . __�.. �_,�;,:�., ate.
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
n Burglar Alarm
❑ Garage Door Opener*
n Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
n Other:
,1 767
Fee for each commercial system $75.00
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
n Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
n Fire Alarm Installation
n HVAC
❑ Instrumentation
- ❑ Intercom and Paging Systems
n L andscape Irrigation Control*
❑ Medical
❑ N urse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
n Other
Q'
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
i:' Building \PermIts\ELC- PermitApp.doc 04/03