Permit J
_ CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT
P ermit #: ELC2009 -00343
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/13/2009
Parcel: 2S110AA00500
Jurisdiction: Tigard
Site address: 10580 SW MCDONALD ST 101
Subdivision: Lot: 0
Project: Odgen Building
Project Description: Sign outling lighting for (1) sign.
Owner: FEES
OGDEN DISCLAIMER TRUST Quantity Description Date Amount
BY MARY JOAN OGDEN TR, 24030 AIRPORT
RD NE 1 ea Sign or Outline Lighting 07/13/2009 $53.40
PHONE: 1 ea 12% State Surcharge - 07/13/2009 $6.41
Electrical
Contractor:
MEYER SIGN CO OF OREGON INC
15205 SW 74TH AVE
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 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. T • - le are set forth in OAR
952 -001 -0010 through O • - 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.'+x0.33 !234 • ,
Issued By: OA 11 1• i _ , I i4 Perm ittee 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 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.
Electrical Permit Application REGit
City of Tigard Date/By:
No.: F' T 2 � , 003.13
13125 SW Hall Blvd., Tigard, OR 97223 JUL 1 3 2008
Plan Review n t2 0 O° , col /
1,
II M Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: , v
T I GA RD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready /By: Juris: la See Page 2 for
Internet: www.tigard - or.gov Notified/Method: T ( C-•) Supplemental Information
8JJILDING DIVISION /
..- TY O F Wi 1 K , . LAN R VIEW
❑ New construction El Addition /alterationlacement 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 El - ether: L where the available fault current ❑ Marinas and boatyards.
CATEGORY 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 Commercial /industrial El Accessory building amps for all other installations. buildings.
El Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑Emergency system. larger separately derived system.
�' � LOCATION' ❑ Addition of new motor load of ❑ "A" "E»
Job no.: Job site address: 1 ,lti N ' e .I)Gty2z1 Id ,s77 S ix or or more. occupancy.
a5 C + ❑S ix or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: f r � �` ❑ Health -care facilities. ❑ Supply voltage for more than
— / r/ 7 Z Z ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: cen,_D / L -0 ei � ❑ Service or feeder 600 amps or more. •
/ / Y ) Gp.L FEE SCHEDULE
Cross street/directions to job site: �(,(; / �� d De s cription I Qty. y. I Fee. I Total I '
�^ . ) /VS /1 _ New residential single- or multi - family dwelling unit.
e d� j , �,f� Includes attached garage.
�"
Subdivision: Lot no.:
1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited residential
mited energy,
,n lit 4 O E
F WO ` '` (with above sq. ft.) 75.00 2
�j� ,// / . " Limited energy, multi - family 75.00 2
��1t.Z+ a �� a C �C r 11/ tom/►K.0 L residential (with above sq. ft.)
S e rvices or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
,,, I ("PROPERTx O It„ 0 ' 1,`A 201 amps to 400 amps 106.85 2
Name: -, an.3,� /2-pc 401 amps to 600 amps 160.60 2
�� 11 601 amps to 1,000 amps 240.60 2
Address: /000/ <) 6- I T cL Over 1,000 amps or volts 454.65 2
City/State /ZIP: .�tj - 1-1,,,,,, t 4 ) "77 2 3 Temporary services or feeders installation, alteration, and /or
relocation
Phone: (1-03) 3 t) -41 0 6 , 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
{ PtiICA+1 T; r ON *+ PERSON _ • above service or feeder fee, 6.65 2
each branch circuit
Business " ame: ,i'divihr O 1 ad C B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) I Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
2 CONTItACTtR Sign or outline lighting / 53.40 9, VD 2
Signal circuit(s) or limited -
Business name: ito C :- 6 < a i2. L7 energy panel, alteration, or
Address: i 7 ��`` , extension. Describe: Page 2 2
SoZ d :St-v r //Lc
City/State/ZIP: ! l 6 ot2 �'7 22.. V Each additional inspection over allowable in any of the above
/ i ` J J Per inspection 62.50
Phone: ( 3) 1 p20 g 2ov I Fax: (So 6 2 - D - 707( Investigation per hour (1 hr min) 62.50
CCB Lic.: &Oft/ Electrical Lic.: 20�t7oet Suprv. Lic.:3�6,l /� Industrial plant per hour 73.75
6 (7,,.. Suprv. Electrician signature, required: _ ELECTRICAL PERMbt ' F
�t ( ES
Plan review (25% of permit fee). /
Print name: �! Q t,�/�� Date: 743 State surcharge (12% of permit fee): 6, 4 Authorized signatur ■ ' . TOTAL PERMIT FEE: 5 7
This permit application expires if a permit is not obtained within 180
Print name: 0 ) j 4 71 q,
C� ALA`' `�' `t ( Date: / 13 / days after it has been accepted as complete.
• Number of inspections allowed per permit.
1.\Building\Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(I1 /05 /COM/WEB