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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC1999 -00509 DEVELOPMENT {B r SERVICES ) 639-4171 DATE ISSUED: 8/18/99 - 13125 PARCEL: 1 S134BC -00101 SITE ADDRESS: 12144 SW SCHOLLS FERRY RD SUBDIVISION: ZONING: C -G BLOCK: LOT : JURISDICTION: TIG Project Description: Four signs 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: • • STEVE CAPILOUTO LEGACY SIGN CO 1200 N HARBOR BLVD 5316 NE 38TH AVE ANAHEIM, CA 92803 PORTLAND, OR 97211 Phone: 714 - 491 -4363 Phone: 503 -481 -0906 Reg #: LIC 135192 SUP 640SIG ELE 26- 127CLS FEES Required Inspections Type By Date Amount Receipt Elect'I Service PRMT BON 8/10/99 $171.00 99- 317533 Elect'l Final 5PCT BON 8/10/99 $11.97 99- 317533 Total $182.97 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. ; ENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -4 ' through OAR . 2 -00 -0080. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -1987. t r Permit Signature: _ ',A * Issued By: OWN' R INSTALLATION ONLY The installation is being m • e on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY c?)-----/C---.429 SIGNATURE OF SUPR. ELEC'N: ®" '"' DATE: G i LICENSE NO: �-10 S Call 639 -4175 by 7:00pm for an inspection the next business day CITY OF TIGARD Electrical Permit Application Rec'd By 13125W HALL BLVD. Recd By IF', Date Rec'd i t, - I 0 TIGARD OR 97223 Date to P.E. Phone (503) 6394171, x304 Date to DST Inspection (503) 639 -4175 Print of Type Permit # Fax (503) 598 - 1960 Incomplete or illegible will not be accepted Called - 5 1. Job Address: C Ceerwa P Ia-Za 4. Complete Fee Schedule Below: 1 Name of Development 1 \ S 5f'. 1 724 Number of Inspections per permit allowed Name (or name f I ss) CA rVS U 4V . 7a4 Service included: Items Cost Sum Address S . W. 56\00 S T I' /► W . 4a. Residential - per unit City /State /Zip �i ark ©a 1000 sq. ft. or less $ 117.75 4 l Each additional 500 sq. ft. or portion thereof $ 26.25 1 Commercial Residential ❑ Limited Energy $ 60.00 Each Manned Home or Modular 2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2 (Prior to permit issuance, applicants must provide contractor license 4b. Services or Feeders information for COT data base). Installation, alteration, or relocation Electrical Contractor I- epkacy 5 i9 n GD . 200 amps or less $ 64.25 2 Address S 4, c - . 201 amps to 400 amps $ 85.50 2 City took ■ ■ State O • Zip 9 `7, Ii- 401 amps to 600 amps $ 128.50 2 601 amps to 1000 amps $ 192.50 2 Phone No. 50) £13 I - OR :4 Over 1000 amps or volts $ 363.75 2 Job No. O 65 7 Reconnect only $ 53.50 2 Elec. Cont. Lice. No. cl £ 1 2 7Gh xp.Date 1()- I - 77 s 4c. Temporary Services or Feeders OR State CCB Reg. No. 1 3 s i 9 2 Exp.Date 5 7-01 Installation, alteration, or relocation COT Business Tax or Metro No. 5941 i Exp.Date 4- I- cc 200 amps or less $ 53.50 2 201 amps to 400 amps $ 80.25 2 % ?�/l � A G�� % � /""_ Over t amps to amps $ 107.00 2 ALL/ Signature of Supr. Elec'n Over 600 amps to amps volts, see "b" above. License No. (4 S Exp.Date JO I - /90Y as Branch Circuits Phone No. 5 � 4 81 -0906 New, alteration or extension per panel a) The fee for branch circuits 2b. For owner installations: with purchase of service or feeder fee. 1 ' ; • • er's Name - 1 - ' , in u�0 Each branch circuit $ 5.35 2 Address . dill► i - f N� b) The fee for branch circuits � ` -- ' - �'' ' ' without purchase of service City A a • C Zip 9a10� or feeder fee. Phone ► .. Rii _ First branch circuit $ 37.50 Each additional branch circuit $ 5.35 The installation is being made on property I own which is not 4e. Miscellaneous intended for sale, lease or rent. (Service or feeder not included) Each pump or irrigation circle $ 42.75 Owner's Signature Each sign or outline lighting $ 42.75 / 7/, OC) Signal circuit(s) or a limited energy 3. Plan Review section (if required):* * panel, alteration or extension $ 60.00 f re id �. Q � Minor Labels (10) $ 107.00 Please check appropriate item and enter fee in section 5B. 4f. Each additional inspection over 4 or more residential units in one structure the allowable in any of the above Service and feeder 225 amps or more Per inspection $ 50.00 Per hour $ 50.00 System over 600 volts nominal In Plant $ 59.00 Classified area or structure containing special occupancy as described in N.E.C. Chapter 5 5. Fees: CO 5a. Enter total of above fees $ / 'V' * Submit 2 sets of plans with application where any of the above apply. 'I AID i Surcharge (.05 X total fees) $ // • Y 7 Not required for temporary construction services. Subtotal $ 5b. Enter 25% of line 5a for NOTICE Plan Review if required (Sec. 3) $ PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account # Q AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ / Q oo �• / 7 i:\dsts\forrns\electric.doc 10/08/1999 Activities for Case #: ELC1999 -00509 10:40:52 AM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes ELCC001 Application received 08/10/1999 DRA RECD No Hold BON 08/18/1999 ELCC003 Permit created 08/18/1999 BON DONE No Hold BON 08/18/1999 ELCC730 Elect'I Service 08/18/1999 08/18/1999 No Hold BON 08/18/1999 ELCC799 Elect'l Final 08/18/1999 08/18/1999 10/04/1999 CD PASS No Hold AKJ 10/05/1999 ELCC500 (F)Issue permit 08/18/1999 BON DONE No,Hold DST 08/18/1999 ELCC800 Case Finaled 10/05/1999 AKJ DONE No Hold AKJ 10/05/1999 • • Page 1 of 1 •