Permit CITY OF T ELECTRICAL PERMIT
, i� DEVELOPMENT SERVICES PERMIT #: ELC99 -0028
� � 13125 SW Hall Blvd., Tigard, OR 97223(503) 639 -4171 DATE ISSUED: 01/13/99
PARCEL: 2S102CC -00500
SITE ADDRESS...:13500 SW PACIFIC HWY #54
SUBDIVISION • ZONING:C -G
BLOCK • LOT . JURISDICTION: TIG
Project Descript : Installation of sign lighting for wall sign.
- -- RESIDENTIAL UNIT - - -- -- -TEMP SRVC /FEEDERS - - -- MISCELLANEOUS
1000 SF OR LESS • 0 0 - 200 amp • 0 PUMP /IRRIGATION • 0
EACH ADD'L 500SF...: 0 201 - 400 amp • 0 SIGN /OUT LINE LTG..: 1
LIMITED ENERGY 0 401 - 600 amp • 0 SIGNAL /PANEL • 0
MANF. HM/ SVC /FDR..: 0 601 +amps -1000 volts.: 0 MINOR LABEL (10)...: 0
- - -- SERVICE /FEEDER - - -- - - -- BRANCH CIRCUITS -- -ADD'L INSPECTIONS-- -
0 - 200 amp • 0 W /SERVICE OR FEEDER: 0 PER INSPECTION.....: 0
201 - 400 amp • 0 1st W/O SRVC OR FDR.: 0 PER HOUR • 0
401 - 600 amp • 0 EA ADD'L BRNCH CIRC: 0 IN PLANT • 0
601 - 1000 amp • 0 PLAN REVIEW SECTION
1000+ amp /volt • 0 > =4 RES UNITS > 600 VOLT NOMINAL..:
Reconnect only • 0 SVC /FDR )= 225 AMPS..: CLASS AREA /SPEC OCC.:
Owner: FEES
COMPANION PET CLINIC type amount by date recpt
13500 SW PACIFIC HWY PRMT $ 40.00 DEB 01/13/99 99- 312134
STE 54 SPCT $ 2.00 DEB 01/13/99 99- 312134
TIGARD OR 97223
Phone #:
Contractor:
SALEM SIGN CO INC $ 42.00 TOTAL
1825 FRONT ST
REQUIRED INSPECTIONS
SALEM OR 97303 Elect'1 Service
Phone #: 503 -371 -6362 Elect'1 Final
Reg #..: 000652
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon 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 resuires you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -001 hrough ''; 952 -001 -1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (503)246 -1987.
Permittee Signature: ^1144 Issued B • �.
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: Asp &p.i1 -1( e23\ 0 — DATE: / - 19
LICENSE NO: 394
+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + ++ + + + + + + + ++
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Permit # 'L C 9 9 " D °c/g
� �r ��� 1
� Date Issued / SS
,�
Phone (503) 639 -4171
FAX (503) 684 -7297
CITY OF TIGARD TDD No. (503) 684 -2772
Inspection (503) 639 -4175
1. Job Address: , 4. Complete Fee Schedule Below:
Name of Develo ment A l 0 0, 1 I a 01111,.16 Number of Inspections per permit allowed
Address i) S A r I1J • 140 1. . *54 Service included: Items Cost(ea) Sum
IIir / n
City /State /Zip 1 ( \(,1,` D 1 I `'L 4a. Residential - per unit
i 9 I ` 1000 sq. ft. or less $110.00 4
Name (or na a if business) ti , , �� L
r CIRO Each additional 500 sq. ft. or
portion thereof $25.00
Commercial �N Residential ❑ Limited Energy $25.00 1
Each Manufd Home or Modular
Dwelling Service or Feeder $68.00 2
2a. Contractor in allation only:
4b. Services or Feeders
Installation, alteration, or relocation
Electrical tra or _ `` 7� 200 amps or less $60.00 2
Addres . �� r %�,i�„ g' ,) I' 201 amps to 400 amps $80.00 2
City /RNA State / Zip MN/ ^ 401 amps to 600 amps $120.00 2
601 amps to 1000 amps $180.00 2
Phone No. IBM # , Over 1000 amps or volts $340.00 2
Job NO. L, Reconnect only $50.00 2
Contractor's license NO. L =; `-' 4c. Temporary Services or Feeders
Contractor's Board Reg. No. �%��� Installation, alteration, or relocation
Signature of S pr. Elec' _�/ M.W.141117 200 amps or less 2
License No.� Slft•1 201 amps to 400 amps $50.00
�jl✓ Phone • . 1�1a 401 amps to 600 amps $75.00 2
Over 600 amps to 1000 volts $100.00
2b. For owner installations: see „ b"above.
4d. Branch Circuits
Print Owner's Name New, alteration or extension per pane
Address a) The fee for branch circuits with
purchase of service or feeder fee. 2
City State Zip Each branch circuit $5.00
Phone No. b) The fee for branch circuits withou
The installation is being made on property I own which is purchase of service or feeder fee. 2
First branch circuit $35.00
not intended for sale, lease or rent.
Each additional branch circuit $5.00
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00E-
Signal circuit(s) or a limited energy 2
Please check appropriate item and enter fee in section 5B. panel, alteration or extension $40.00
4 or more residential units in one structure Minor Labels (10) $100.00
Service and feeder 225 amps or more
System over 600 volts nominal 4f. Each additional inspection over
Classified area or structure containing special occupancy the allowable in any of the above
as described in N.E.C. Chapter 5 Per inspection $35.00
Per hour $55.00
In Plant $55.00
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees: /[]�
5a. Enter total of above fees $ 'T V
NOTICE 5% Surcharge (.05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal �'
$
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25% of line A for
ilk
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ MA
COMMENCED. w rd∎wmdMe4o- ❑ Trust Account #
$
prm.app
Balance Due $ g..----