Permit CITY OF TI G A R D ELECTRICAL PERMIT
PERMIT #: ELC1999 -00236
•I , DEVELOPMENT SERVICES DATE ISSUED: 4/19/99
r ' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 25101 DC -03900
SITE ADDRESS: 07150 SW SANDBURG ST
SUBDIVISION: SALEM FREEWAY SUBDIVISION ZONING: C -P
BLOCK: LOT : 004 JURISDICTION: TIG
Project Description: Electrical permit for a sign
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: 1
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:
PROGRESSIVE CASUALTY INSURANCE RAMSAY SIGNS
6300 WILSON MILLS RD 9160 SE 74TH AVE
MAYFIELD VILLAGE, OH 44143 PORTLAND, OR 97206
Phone: Phone: 777 -4555
Reg #: SUP 157SIG
LIC 00063422
FEES Required Inspections
Type By Date Amount Receipt Elect'l Service
PRMT BON 4/19/99 $40.00 99- 314464 Elect'l Final
5PCT BON 4/19/99 $2.00 99- 314464
Total $42.00 •
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 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
Permit Signature: 01A (l �r�— Issued By:
V�
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: � � ll (441" (V912 DATE:
LICENSE NO: `\
Call 639 -4175 by 7:00pm for an inspection the next business day
CITY OF TIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD. Rec'd By (--
Date Rec'd - /3 �
TIGARD OR 97223 Date to P E.
Phone (503) 639 -4171, x304 Date to DST
Inspection (503) 639 -4175 Print or Type Permit # f .. L�( °I `?R -ODZ?
Fax (503) 598 -1960 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed
Name (or name of business) 17�.r,Lss,s t V 109 Service included: Items Cost Sum
Address 7 ISM SIN lP a P al, 4a. Residential - per unit
1000 sq. ft. or less $110 00 4
City /State /Zip'11bPA -¢ D O-- 9 Each additional 500 sq ft or
g- / portion thereof $25 00 1
Commercial Residential ❑ Limited Energy $25.00
Each Manufd Home or Modular
Dwelling Service or Feeder $68 00 2
2a. Contractor installation only:
(Attach copy of all current licenses) 4b. Services or Feeders
Installation, alteration, or relocation
Electrical Contractor " .4 Y S- il� S
200 amps or less $60.00 2 -
Address i(60 S 201 amps to 400 amps $80.00 2
City 7b nl,! State 02 Zip 1 401 ampsto600amps $120.00 2
Phone No. - 7 M7 4-i,575-6- 601 amps to 1000 amps - $180.00 2
Job No. - LS I c5 Over 1000 am or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. 24 f o(p ti ./0/ Exp.Date / ct9
OR State CCB Reg. No. i p •v - / 2 1 - - Exp.Date I - I ' ' t 4c. Temporary Services or Feeders
COT Business Tax or Metro No. Exp.Date Installation, alteration, or relocation
200 amps or less $50.00 2
/ 201 amps to 400 amps $75.00 2
Signature of Supr. Elec'n .. _ . , . _ . ,�, . ____% r,, • 401 amps to 600 amps $100.00 2
f Over 600 amps to 1000 volts,
License No. ...3,5 - - 5/4 Exp.Date 1. r2._ o - see "b" above.
Phone No. 4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address Each branch circuit - $5.00 2
b) The fee for branch circuits
City State Zip without purchase of
Phone No. service or feeder fee.
First branch circuit - $35 00 2
Each additional branch circuit - $5 00 2
The installation is being made on property I own which is not
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owner's Signature Each pump or irrigation circle $40.00 2
__i_ Each sign or outline lighting $40 00 2
3. Plan Review section (if required):*
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 $35.00
System over 600 volts nominal Per hour - $55.00
Classified area or structure containing special occupancy In Plant $55.00
as described in N.E C. Chapter 5
5. Fees:
* Submit 2 sets of plans with application where any of the above apply. 5a. Enter total of above fees $ 46 0 6
Not required for temporary construction services. 5% Surcharge (05 X total fees) $
Subtotal $
NOTICE 5b. Enter 25% of line 5a for
Plan Review if required (Sec 3) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Subtotal $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK , ` � (J y�O
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY El (,
Trust Account #
TIME AFTER WORK IS COMMENCED Total balance Due $ I /
I: \DST \ELEC98.DOC REV 4/98
\I
CITY OF TIGARD SIGN PERMIT
P ERMIT #: SGN1999 -00039
DEVELOPMENT SERVICES DATE ISSUED: 4/19/99
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 EXPIRATION DATE:
BUSINESS NAME: PROGRESSIVE INSURANCE PARCEL: 2S101DC -0390
SIGN LOCATION: 071 SW SANDBURG ST
APPLICANT /AGENT: ZONE: C -P
BUSINESS TAX NO: JURISDICTION: TIG
SIGN
PERMANENT: X FREESTANDING: • FREEWAY:
TEMPORARY: WALL: Y ELECTRONIC: Y
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3' X 22"
TOTAL SIGN AREA: 68 sq. ft.
. WALL AREA: 4,500 sq. ft.
WALL FACE (DIRECTION): S
' SIGN HEIGHT: 17 ft.
PROJECTION FROM WALL: 1 in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Installing a permanent 68 sq. ft. wall sign
MATERIALS: ALUMINUM /NEO
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: Y
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 50.00
•
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. A sign permit shall expire 90
days from approval date. A temporary sign shall expire 30 days from approval date. A balloon sign shall expire 10
days frnm annmval data ' tValte
L
APPROVED BY: g
PERMITTEE SIGNATURE: 61-1/ II C
DATE: 4/19/99