Permit V
CITY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
Iii DEVELOPMENT SERVICES PERMIT #: ELR2004 -00301
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/21/2004
SITE ADDRESS: 12288 SW SCHOLLS FERRY RD PARCEL: 1S134BC -00300
SUBDIVISION: GREENWAY TOWN CENTER ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
Project Description: Installation of (2) signs.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: SIGNS X
TOTAL # OF SYSTEMS: 2
Owner: Contractor:
BPP RETAIL LLC SIGN MASTERS INC
BY BURNHAM PACIFIC PROPERTIES 5105 SW 45TH AVE
ATTN: JOHN WATERS PORTLAND, OR 97221
SAN DIEGO, CA 92101
Phone: Phone: 503 245 - 5056
Reg #: ELE 26- 1051CLS
SUP 410SIG
LIC 77928
FEES Required Inspections
Description Date Amount Low Voltage Inspection
[ELPRMT] ELR Permit 9/21/2004 $150.00 Elect'I Final
[TAX] 8% State Surcharl 9/21/2004 $12.00
Total $162.00
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. ATTENTION: Oregon law requires
you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699.
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:
CONT ACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N DATE: 9/Z10`>
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
ElectricA Permit A 8tvey F o R ()Hi( l: I; r ()Ni..)
� g
Cl C>f Ti and R RDateeceivlBy: 1 : 2_ Permit No.: a I
.) � ��' �, wy oo .�
13125 SW Hall Blvd., Tigard, OR 97223 _ i Plan Resew r
Phone: 503.639.4171 Fax: 503.598 2 1 2 O 0 X * ii , Date/By: Other Permit V 6 k , u po y - J as�
Inspection Line: 503.639.4175 l v r t 1 Wit V =!�� "' j Date Ready/By: runs: ® See Page 2 for
Internet: www.ci.tigard.or.us . Notified/Method: 1 Supplemental Information
6'4' l' ' PLAN REVIEW
New construction 11 Addition /alteration/replacement Please check all that apply:
❑Demolition ❑Other: ❑Service over 225 amps, comm'l ['Hazardous location
❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1 and 2 family dwellings 4 or more new residential
❑ 1 and 2 family dwelling jkCommercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
['Building over three stories ❑Feeders, 400 amps or more
❑ Multi- family 0 Master builder 0 Other: ❑Occupant load over 99 persons :Manufactured structures or
JOB SITE INFORMATION AND LOCATION ['Egress/lighting plan RV park
❑Health care facility I:Other
Job no.: Job site address: 12'1( fC S (J SCtrotszE FgggY above.
A)
Submit 2 sets of plans with any of the above.
City/State/ZIP: o 97 .2' The above are not applicable to temporary construction service.
FEE* SCHEDULE
Suite/bldg. /apt no.: Project name: cbcp vs - ilk-a: G'2s�
Description I
a Qty. I Few I Total I ••
Cross street/directions to job site: (f.f_i_e -• L,r q -y , Vt, New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
Tt � /� dwelling, service and/or feeder 90.90 2
2L? 1 ST�_ G) Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 I
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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
p3 APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: 5 (6 MA -rEe JC branch circuit
, 1_ �^ B. Fee for branch circuits
Contact name: Ns, $2._e1,1 $2._e1,1 ;� .- Q) j without service or feeder fee, 46.85 2
_ each branch circuit
(�
Address: 5 l J Si 4 -h- iS - 2 .0 1 Each add'l branch circuit 6.65 2
1
City/ State/ZIP: - p G (� Z Z Miscellaneous (service or feeder not included)
(G t, �G1 I �� J „ Pump or irrigation circle 53.40 2
Phone: (5J 3) - -Al-S - -- �rJ� Fax: : (533) Z45 SO:3 Z Sign or outline lighting 53.40 2
E -mail: tt c r tl'\6lS - f r ^S 'V\ C � N c+t i,1 • C JIM Signal circuit(s) or limited -
ay e
energy panel, alteration, or
extension. Describe: 4, Page 2 2
Business name: G W lk Ci r p t U
Address: � Each additional inspection over allowable in any of the above
Per inspection 62.50
City / State/ZIP: Investigation per hour (1 hr min) 62.50
Phone: ( ) Fax: ( ) Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: - 1 1q 2,i Electrical Lic.: A-103 Suprv. Lic.: 5 2cf SAIL Subtotal Jrj„ w
Suprv. Electrician signature, required: Gc2__ /��Z Plan review (25% of permit fee)
f
JtY
State surcharge (8% of permit fee) u
/
Print name: ( 2.4\e _. 61 (2_ Date: 9/410y " '
/ TOTAL PERMIT FEE / 6 _ 0
Authorized signature : // � This permit application expires if a permit is not obtained within 180
� 4
� -" days after it has been accepted as complete
• Fee method
Print name: � + Date: /Ic./ methodology set by Tri County Building Industry Service Board
t •• Number of inspections per vomit allowed.