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Permit CITY OF TIGARD ELECTRICAL PERMIT 1 4 2 .. COMMUNITY DEVELOPMENT Permit #: ELC2012 -00321 TIG'AR.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/29/2012 Parcel: 1 S136DB00600 Jurisdiction: Tigard Site address: 11635 SW PACIFIC HWY Project: Taco Bell Subdivision: AZOIC TERRACE Lot: 1 Project Description: TI Contractor: MEYER SIGN CO OF OREGON Owner: ZAPP FAMILY REVOCABLE LIVING TRU TYSON 15205 SW 74TH AVE BY TBC #016600 TIGARD, OR 97224 PO BOX 35370 LOUISVILLE, KY 40232 PHONE: 503 - 620 -8200 PHONE. FAX: 503 - 620 -7074 FEES Quantity Description Date Amount 1 ea Sign or Outline Lighting 05/29/2012 $67.84 Specifics: 1 ea 12% State Surcharge - 05/29/2012 $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 l5. - 001 -00'0. You may •btain a copy of the rules or direct questions to OUNC by calling 503 or 1.800.332.2344 vN Issued By: :.,Iia I —/ ` I Permittee Signature: 14-ePuC�`T.27 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. • e46,,e Electrical Permit Application 1 � ` G3 � � y I tllc (MACE I. t tit: (.1 N1,1 Cl City' of Tigard ,v. • Rccei.d rr 13125 SW Hall Blvd„ Tigard, 4R 97223 DatelB OA I r' e�_ Permit No.: -'�° �(a. 0034 ' . Phone: S03.718.2439 Fax; 503.398.1960 M AY 24 2012 PlatRrvirw n ,!M /a' 0005-4 `� p.m,: _ Other Nnrmit; g a r 1 , , i , t ,, Inspection Line: 503.639,4175 Darr RredyBy f co Internet: www.ti and -or, ov CITY OF G "= 't I &cePage l roe ffi 11 CITY La ��•l� ,� j Notified/Method! . .. Supplemental Information . „ 'Q1 - 0 New construction ddition/alteration/replaccment Mean cheek all that apply (submit a ants of plans w /items chocked below): Ci Serviec or tenter 400 amps or mom Q Building over three stories. ❑ Demolition Oth who* the available fault current ❑ Marinas and boatyards. exceeds 10,000 amps at 130 volts or El Floating buildings. ❑ I and 2 - famil dwcllin less to ground. or cxcseds 14.000 0 Cumme ial -use agricultural Y g commercial/industt-ial ❑ ACCCSyory building amps for all other installations. buildings. ❑ Multi - family 0 Master builder ❑ Other: © F'irn pump. D Installation of 75 KVA or ❑ Emergency ysem, hatter se JOIi'..w E,r R to '.AN'.LOCAAm ION., st 1 pa+atelydnrivcdsystem, ❑ Addition, of on motor load of 0 " A " , " 1 3 " , " 1 - 2 " , " 1 - 3 " , Job no.: Job site address: . r ,^ , 10011P or more. occupancy. / �r' r ID Six or more residential units. CI Recreational vehicle perks. City/State/ZIP: �, (�� � , 5 © Health-care fasililias, ❑ Supply voltage for more than, b�' J ❑ Hazardous locations, 600 volts nominal. Suite/bldg./apt. no.: ,y Project name: v�-- �, 1 j BE, f J � - a Service or feeder 600 amps or more. • Cross street/direction�s tto job Site: �' Ei' 8 1JL • necrin . _ Qt 1 Nee- '.. Total 1 New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: 1 Lot no.: 1,000 sq. ft. or less 168.54 4 fax map /parcel no.: Ea, add'i 500 sq. It or portion 33,92 1 Limited energy, residential 75.00 2 CR)FRlUO N. aF 'wp with above Sq, ll.) / T — Limited energy. multi - family 75,00 2 ✓t residentir (with above sq. R.) _ ' —" Services or feeders installation, alteration and/or relocation 200 amps or lass 100.70 2 ❑ PA OPE.RTv OW ER . ' ' F li,[1J --- 20I amps to 400 amps 133,56 2 Name: 401 amps t0 600 amps 200.34 2 � _ 601 amps to 1,000 amps 301.04 2 (4/ Address: ( 3 4c. /. - e . 2 * Over 1,000 amps or volts 552.26 2 _ _ City /State/L1P: - Temporary services or feeders Installation, alteration, and /or N ) 7 relonitiott Phone: ( ) �{ /, tax ( 200 amps or leas $9,36 I 400 Owner installation: This installation is being made on property that 1 own which is not 201 amps to 599 amps 125.08 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701, 401 amps to 599 amps 168.54 2 Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with AI►C" ;ICAN1 '..D. CONTACT PERSON' each branch circuit above service or feeder fee, 7.42 2 Business name: , l ' B. Fee for branch circuits without service or feeder ten, first 56.18 2 _ Contact name: 'if brunch circuit r� , ("1,, � — Each add'I branch circuit 7.42 2 Address: C Miscellaneous (service or feeder not included) City /State /ZIP: •�trt Each mg service or modular r � 2. � - ' dwelling, serv and/or feeder 67,84 P' • e: ( .a ja Reconnect only 67,84 2 - yr ,rlT � Pump or irrigation circle 67.84 ? �/I 4.i ..s._ 0 Sign or outline lighting f 67.84 2 CON RACT0$ F Signal cireuit(s) or limited- energy t Business name: ., Panel, alteration or extension. Page 2 2 Each additional inspection over allowable in nay of the above Tess: Additional inspection (I hr min) 66.25/ hr City/State/L1P: Investigation (l hr min) 66.25/ lir - Industrial plant (1 hr min) 78,18 / hr Phone: ( ) Fax: ( ) Inspections for which no fen is s�ecificeilYlir d(!�htmin 90,00/ hr CCB Lie,: t, o i Electricoi , : „ -4 6 S upr L'• 20-010 C .� ur;Ke�>� ,>P rcaERlei _ Suprv. Electrician signature, required: / , / ' / Subl otaL Print name: ` L flue review (25% of permit fee): r ..ar � C Date Stott surcharge (12% of permit fee): fi Authorized signature: / TOTAL PERMIT FEE: 75.9 ? This ermit a p p '— tar r p pplication ex ires I f a permit is ant obtained within ISO Print name: f' � days "tar it has boon ateapted as complelr. r 17 aIe'�J�� ! f • Number o f inspections allowed per permit. l: 1 BuJding 4 Permir,9tLC•PormitApp,doe 07/01/1.0 44 t /US / /COM/WEB Z0 /t0 39 d NJIS 63A3W 17LOLOZ9E09 05:17t ZtOZ /bZ /50