Permit CITY OF TIGARD ELECTRICAL PERMIT
111 COMMUNITY DEVELOPMENT Permit #: ELC2012 -00095
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/16/2012
Parcel: 2S 102AC00700
Jurisdiction: Tigard
Site address: 12540 SW MAIN ST 120
Project: Benjamin Moore Subdivision: BURNHAM TRACT Lot: 1
Project Description: Sign lighting.
Contractor: GARRETT SIGN COMPANY Owner: DOLAN & CO LLC
811 HARNEY STREET BY FLORENCE T DOLAN
VANCOUVER, WA 98660 4523 NE DAVIS ST
PORTLAND, OR 97213
PHONE: 360- 693 -9081 PHONE:
FAX: 360- 693 -5948
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting . 02/09/2012 $67.84
Specifics:
1 ea 12% State Surcharge - 02/09/2012 $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 copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344,
Issued By: 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.
Electrical Permit ApplicaRECEIVE i FOR OFFICE t si: ONLY
City of 'Tigard Receivc
DsteBv: j'r r ��, . -
a 13125 SW Hall Blvd Tigard, OR 97223 FEB 0 9 2012 flan Review
Phone: 503.718.2439 Fax: 503.598.1 c960 Dato'Bv: Other Permit:
1.I (IA It D Inspection Line: 503.639.4175 Data Ready/By: 65 See Page 2 for
Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method: FAIPAP Supplemental Information
1�' {k 9 Its L wqM T PLi[L'
TX1 + +A , „
E New construction ❑ Addition /alteration/replacement Please check all that apply (submit 2 sets of plans wiiteros checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
❑ Floating buildings.
..�,TEGO1)t r 4> "" CV exceeds 10,000 amps aedl 14 a c agricultural
1Ca or
Ftoa
less
ground, or exec s , ? 0 Commercial-use agricu ural
❑ 1 and 2-family dwelling [S] Commercial /industrial ❑ Accessory building amps "far all other installations, buildings.
❑ Multi-family 0 Master builder ❑ Other: ire pump. ❑ Installation of 75 KVA or
Q Fmorg?nncy syxtcm. larger separately derived system.
JO13 51TB. .0;:l Ii O A,T1"O1i r' „. ❑ Addition of new motor load of LJ 'A.", E" `12',"1 -3 ",
Job no.: Job site address: 12540 SW Main St 1001IP or more occupancy.
0 Six or more residential units. ❑ Recreational vehicle parka.
City/State/ZIP: Tigard, OR 97223 El health-care facilities. ' 0 Supply voltage for snore than
0 hazardous locations 600 volts nominal
Suite/bldg. /apt. no.: 120 'Project name: Benjamin Moore ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: SW Main St. & SW Burnham St. Description ! Qty. I flee. ( Total
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. orluss 168;54 4
Tax map/parcel na.: En. addl. 500 sq. 1
ll. or portion 33.92 V
` :! 13 t 4 11 1. F ''t I 4 Lit( energy, sqg
,,.. _ ,,,,�,.,..,, .. %�,�., � . � na (with above residential 75 txl 2
Limited energy, multifamily 75:00 2
Install: (1) new illuminated fascia sign residential (with above sq. H.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 100.70 2
'' j I'ltei. R'1`Y OWNER TENANT, ? • / 201 amps to 400 amps 133.56' 2
Name: Benjamin Moore 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04
Address: 12540 SW Main St., Suite 120 Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
CitylState/ZlP: Tigard, OR 97223 re
Phone: (360)687 -2603 Fax: ( ) 2 awli or l ess 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 599 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 signtature: Date: A. Foe for branch circuits with 1
_ -� A PPI,I CitN . G ,4"1. P ;P t1M,l7 above service or f der fee,
,. � y . , ., , ., � - . , , �' each branch circuit 7:42` 2
Business name: Garrett Sign Co., Inc. B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: Joe Taylor branch circuit
Each add 'I branch circuit 7.42 2
Address: 811 Harney St. Miscellaneous (service or feeder not included)
City/State/ZIP: Vancouver, WA 98660 Each manufactured tarmodular 67.84 2
y , dwelling; service and/or feeder
Phone: (360) 693-9081 Fax: : (360) 693 -5948 Recounect'only 67.84 2
Pump or irrigation circle 67.84 2
E joet @garrettsign.com Sign or outline lighting 1 67.84 6,7,E 2
°iQ Cri?c31?
S gh
„� Si ciltuit(s) or limited-energy
Business name: Garrett Sign Co., Inc. panel, alteltttion, or extension. Page 2 2
Each additional Inspection over allowable in any of the above
Address: 811 Harney St. Additional inspection (1 hr min) 66.25/ hr
City/State/ZIP: Vancouver, WA 98660
Investigation (Ibrznur) 66.25/ hr
Industrial plant (1 hr min) 78.18 / hr
Phone: (360) 693 -9081 Fax: 360 69 - 5948 Inspections for which no fee is 90.00111r
s (Yi hr min)
CCB Lic.: 66826.. --4 / :Electrical Lic. :. Suprv. Lie.; 700SIG £ # y F , 4 , TRTI 10.1..'PERMIT FEES
/I / , i A _ I �t
i ' Subtotal: 6.7 . .
Suprv. Electrician signature, required: Plan review (25% permit fee): t0
t P _
i Print name: Michael Simpson Date: 02/01 /12 State surcharge (12% of permit fee):
- _ T t TAI. PFRIvIIT.FEE - 3Yy --
Authorized signature: This permit application expires if a permit is not obtained widrin 180
Print name: Joe Taylor Date: 02/01/12 " days after it has been accepted as complete.
y Number of inspections allowed per permit.
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