Permit CITY OF TIGARD ELECTRICAL PERMIT
s COMMUNITY DEVELOPMENT Permit #: ELC2012 -00689
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/10/2012
Parcel: 2S 101 DA00104
Jurisdiction: TIGARD
Site address: 13333 SW 68TH PKWY
Project: Clear Channel Subdivision: VARNS ACRES Lot: 9
Project Description: (2) branch circuits for (2) signs
Contractor: COCHRAN INC Owner: TRIANGLE POINTE LLC
7550 SW TECH CENTER DR #220 901 NE GLISAN ST, #100
TIGARD, OR 97223 PORTLAND, OR 97232
PHONE: 503 - 234 -6564 PHONE:
FAX: 503 - 238 -2098
FEES
Quantity Description Date Amount
1 ea 12% State Surcharge - 12/10/2012 $7.63
Specifics:, Electrical
2 crt Branch Circuits wo /Purchase 12/10/2012 $63.60
Type of Use: COM Service or Feeder
Class of Work: OTR
Type of Const:
Occupancy Grp:
Total $71.23
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 0 R 952- 001 -0090. You may / o - btai in n — a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332,2344.
Issued By: J KlC_.I Permittee Signature: APPL- /64- 7/Oki-
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.
01 11:05:53 12-10-2012 1/3
Electrical Permit ApplicatiofIECEI VE I FOR 01.1.ICI: ll.: ONLY
City of Tigard Received
i ?-1
sr Pennit NceLe Acs/
Il a . co io g 9
13125 SW Hall Blvd., Tigard, OR 97223 DEC 1 0 2012 Plan Review
. Phone: 503.639.4171 Fax: 503.598.1960 . li'lateil
I 1 0 // ....
Date/By: Other Permit:
TIGARD
Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: IR ai : G El See Page 2 for
rn
Inteet www.tigard Notified/Method: 1 Supplemental Information
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0 New construction Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w/items checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Othea . where the available fault current 0 Marinas and boatyards.
'ekridoiti' .,': . :.:-Y::'... exceeds 10,000 amps at 150 volts or 0 Floating buildings .
less to ground, or exceeds 14.000 0 Commercial-use agricultural
0 1- and 2-family dwelling 'Commercial/industrial 0 Accessory building amps for all other installations. buildings.
1:2 Multi-family 0 Master builder 0 Other: ['Fire pump. 0 Installation of 75 KVA or
0 Emergency system. larger separately derived system.
1201 OM pap. SITE ii*i#0A 1.00. ..0* • .. ., : . . 0 Addition of new motor load of 0
Job no.:/z8Z/ Job site address: / 53.33 $) 66 fi/ 9 100HP or more.
0 Six or more residential units. 0 occupancy.
Recreational vehicle parks.
City/State/ZIP: C riz o niti) c,/e 9 7 z? 0 Health-care facilities. 0 Supply voltage for more than
0 Hazardous locations. 600 volts nominal.
,
Suite/bldg/apt. no.: Project name: ci e„, e 0 Service or feeder 600 amps or more.
• i . SOHCOUCE
Cross street/directions to job site: Desctiplloo I Q17. I Fee. 1 Total . 1 •
New residential single- or multi-family dwelling unit.
Includes attached garage. •
Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. addl 500 sq. R. or portion 33.92 . I
Tax map/parcel no.: Limited energy, residential
75.00 • . • DESCRIPTION OF WORK
(with above sq. R.) 2
. .
. , Limited energy, multi-family
WO 1z'-/ Pin V80 - .1 (z) g i9 71 ot reutFs residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation
200 ampnis or less 100.70 2
0 . PROPERTY OWNER ' ;: : :.;! • :. . :i. 0 TENANT : . ; 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name:
1501 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or '
City/State/ZIP: relocation
Phone: ( ) I Fax: ( ) 200 amps or less . 59.36 1 ,
_
08 2
Owner installation: This installation is being made on property that I own which is not 201 amiss to 400 amps 125.
intended for sale, tease, 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
El APPLICANT • ' I : .. ;'.' DI I CONTACT !TOE* ..... ' above service or ircuit feeder fee,
742 2
each branch c
Business name: 50_0( ck.S C.E)Cckl Ck-C.r. B. Fee for branch circuits without
service or feeder fee, first
. Contact name: ,s4 D e_ Lei es air, branch circuit I 56.18 1g 2
Each adcri branch circuit 1 - 7.42 7, y 2
Address: Miscellaneous (service or feeder not included)
• Each manufactured or modular
City/State/ZIP: , dwelling, service and/or feeder 67.84 2
Phone: (36,0 71,3 g 2.L I Fax: : 17/ ) 2p5 412,6s Reconnect only 67.84 2
- Pump or irrigation circle 67.84 2
E 6r 0 0-C-k 6: Ct9C- (' h n tin c.,i eD1-1‘ Sign or outline lighting 67.84 2
CONTRACTOR •
- Signal circuit(s) or limited-energy
Business name: (Q6 cu ..,rr.___ panel, alteration, or extension. Page 2 2
i .. . \ t) ,.
Each additional inspection over allowable in any of the above
. t -
Address: 7 550 5\ ( C *22 0 Additional inspection (I hr min) 66.25/hr
Investigation (1 hr min) 6.
cit cg
ct , Q 72. a 3
Industrial plant (I hr mm) 625/ hr 78.18/ hr
- .
Phone: eip 0.1)..,s' yizy z I Fax: ( _2 ¥2.6 A Inspections for which no fee is
specifically listed VA hr min) 90.00/ hr
CCB Lic.: '12_ 9,4 a 1 Electrical Lic.: ,347 5146, C. Suprv. Lie.: 3447 ; FEES: :-. • .
Subtotal:. fi3 r ip 0
Suprv. Electrician signature, required: \(
Plan review (25% of permit fee):
Print name: Ke 0 . . Date: /Z. -/O eI z, State surcharge (12% of permit fee): 743
Authorized signature: / .,
P ' z id 1 TOTAL PERMIT FEE 7/, 2_
Au 7-,
Thisverrolt application expires If a permit is not obtained within 180
0-. E
- ^ days after it has been accepted as complete.
Print name: ‘ i d d■ h. . Date: /Z . Number of inspections allowed per permit.
I AuileliroftPcnnils•ELC-PerrnitA • Arc 0713110 440-46157(11,05.COMMEB
01 11:06:22 12 -10 -2012 2/3
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined .. $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY: .
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
p Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
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