Permit •
CITY OF TIGARD ELECTRICAL PERMIT
• COMMUNITY DEVELOPMENT Permit # ELC2012 -00535
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Date Issued 09/17/2012
Parcel 1 S135BC01100
Jurisdiction Tigard
Site address 11105 SW GREENBURG RD
Project Express Furniture Subdivision HILLSBORO Lot PTS 1 -2
Project Description Installation of (2) sign lightings
Contractor MEYER SIGN CO OF OREGON Owner GREENBURG SPACE CENTER LLC
15205 SW 74TH AVE 21360 NW AMBERWOOD DR
TIGARD, OR 97224 HILLSBORO, OR 97124
PHONE 503 - 620 -8200 PHONE
FAX 503 - 620 -7074
FEES
Quantity Description Date Amount
2 ea Sign or Outline Lighting 09/17/2012 $135 68
Specifics
1 ea 12% State Surcharge - 09/17/2012 $16 28
Electrical
Type of Use COM
Class of Work ALT
Type of Const
Occupancy Grp
Total $151 96
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 do in accordan • th 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
day ATTENTION Oregon -w re• •s you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
95 001 -0010 through OAR 952 -1' -1090 Y • may obtain a copy of the rules or direct questions to OUNC by calling 503 987 or 1 800 332 2344 Q
/ ,4� y / y�. �
Is ed By / / s�� 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
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
XII
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard ;13v ��i7 i Permit No ac 53S
; � n 13125 SW Hall Blvd Phone 503 718 2439 Fax 503 598 1960 Date/ By
Tigard OR 97223 Plan Resiess y
13v Other Permit � bAl0p 1 DO/s
T 1 G A R D Inspection Line 503 639 4175 Date Ready /13s turn RI See Page 2 for
Internet www ugard - gov Notified /Method Supplemental Information
TYPE OF WORK PLAN REVIEW
El New construction E- Addition /alteration /replacement Please check all that apply (submit 2 sets of plans ss /Hems checked beloss )
❑ Sers ice or feeder 400 amps or more ❑ Building user three stories
❑ Demolition ❑ Other k1 here the asailable fault current ❑ Marinas and boatyards
CATEGORY OF CONSTRUCTION exceeds 10 000 amps at ISO sohs or ❑ floating buildings
less to ground or exceeds 14 000 ❑ Commercial -use agricultural
❑ I - and 2- family dwelling B Commercial /industrial ❑ Accessory building amps lor all other installations buildings
❑ Multi - family ❑ Maslei builder ❑ Other ❑ fire pump ❑ Installation ol 75 KVA of
1013 SITE INFORMATION AND LOCATION ❑ Lniergenc) system larger separately denscd system
❑ Addition of ncu motor load ol ❑ A L 1 -2 1 -
1 00HP or more occupancy
Job no Job site address 110 SW 41266.1 e ,(,., ez ❑ Six or more residential units ❑ Recreational sehicle parks
City /State /ZIP Ti G, Arid) F Op_ ❑ Health -care facilities ❑ Supply s oltage for more than
❑ Havardous locations 600 sops nominal
Suite /bldg /apt no Protect name Ex f'ites S R.42 flx.e.e ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/dilutions to job site Ts Ef4AAki nescnpnon I On I Fee I mcitni I •
New residential single- or multi -family dwelling unit.
Includes attached garage.
Subdivision Lot no 1 000 sq ft or less 168 54 4
Ea add 1 500 sq ft or porno!' 33 92 1
Tax map /parcel no Limited energy residential
sq ft 75 00 2
DESCRIPTION OF WORK ( with above q )
Limited energy multi- family 75 00
2
I'xi SIE�i c2) .5 16 P4 Cod a/ 6 .474J S sq residential (with above s fl )
Services or feeders installation, alteration, and/or relocation
200 amps or less 100 70 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133 56 2
Name 401 amps to 600 amps 200 34 2
601 amps to 1 000 amps 101 04 2
Address Oser 1 000 amps or volts 552 26 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP relocation
Phone ( ) Fax ( ) 200 amps or less 59 36 1
201 amps to 400 amps 125 08 2
Owner installation: This installation is being made on property that I own which is not
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 ii nth
As APPLICANT in- CONTACT PERSON abose service or feeder fee 7 4 o
each branch circuit
Business name 114E t SIG, NI Co. 0E- O Q _ B Fee for branch circuits it nhuut
service or feeder fee first 56 18 2
Contact name 12.05 LA ALTL . L . branch circuit
Each add I branch circuit 7 42 2
Address I SZOJ Svc - l 4' A ✓e Miscellaneous (service or feeder not included)
City/State/ZIP I 4 Ot 9 } 22 J-
Each manufactured or modular 67 84 2
( �� dwelling service and/or feeder
Phone (S03) G2O &200 Fax (S03) FjZO - 9-O"34 Reconnect only 6784 2
Pump or irrigation circle 67 84 2
E - mail eo gO_JIA Eit61-5 Re 4 co ,CoM
Sign or outline lighting Z 6 7 84 I 3 flog 2
CONTRACTOR Signal circuu(s) or limited- energy
Business name panel alteration or extension Page 2 _ 2
�� � ��� Each additional inspection over allowable in any of the abov
Address Additional inspection (I hr nun) 66 25/ hr
City /State /ZIP Insesugauon (I hr nun) 66 25/ hr
Industrial plant (I hr min) 78 18/ hr
Phone ( ) Fax ( ) Inspections for which no fee is 90 00/ hr
specifically listed ('/ hr min)
CCB Lie - 01'f Electrical Lie 20 - 1 O LLS Supry Lic S2Cl 516 ELECTRICAL PERMIT FEES
C Subtotal X35. G8
Supry Electrician signatwe requited 1 n_ 4 /0/,/,4 Plan review (25% of permit fee)
Prnit name 31.4 /SOS Date 1/14 112_ State surcharge (12% of permit fee) IV 2 Sr
n TOTAL PERMIT FEF f SI , C,
Authorized signature w k-- l -_C Y this permit application expires if a permit is not obtained %siihin ISO rij
—\ dass after it has been accepted as complete
hint name R{ j � M� L t-- L p Date / /l4 ii Z Number of inspections allossed per permit
t \Building \I4rmn, \I IC punmApp dos 117/01/10 441146151111 /115 /C 1)xi /wl it