Permit ;se
/CA /
CITY OF TIGARD ELECTRICAL PERMIT
al
a • COMMUNITY DEVELOPMENT Permit#: ELC2013-00089
T t G A RE) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/07/2013
Parcel: 2S102AC00700
Jurisdiction: Tigard
Site address: 12550 SW MAIN ST 100
Project: Pacific Paint&Supply Subdivision: BURNHAM TRACT Lot: 1
Project Description: (4)sign or outline lighting. 2/10/14,reprinted to add suite address and correct project name.
Contractor: GARRETT SIGN CO INC Owner: DOLAN&CO LLC
811 HARNEY STREET BY FLORENCE T DOLAN
VANCOUVER,WA 98660 4523 NE DAVIS ST
PORTLAND, OR 97213
PHONE: 360-693-9081 PHONE: 503 972-5201
FAX: 360-693-5948
FEES
Quantity Description Date Amount
4 ea Sign or Outline Lighting 02/07/2013 $271.36
Specifics: 1 ea 12%State Surcharge- 02/07/2013 $32.56
Electrical
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $303.92
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 thr 952-0 0090. You may obtain a copy of the rules or direct questions to OUNC by calling 5 3.232,1987 or 1.800.332.2344.
C i �1
Issued By: Permittee Signature: C e--(e e�t�uc
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.
CITY OF TIGARD ELECTRICAL PERMIT
s • COMMUNITY DEVELOPMENT Permit #: ELC2013 -00089
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/07/2013
Parcel: 2S102AC00700
Jurisdiction: Tigard
Site address: 12550 SW MAIN ST
Project: Pacific Paint & Supply Subdivision: BURNHAM TRACT Lot: 1
Project Description: (4) sign or outline lighting
Contractor: GARRETT SIGN CO INC Owner: DOLAN & CO LLC
811 HARNEY STREET BY FLORENCE T DOLAN
VANCOUVER, WA 98660 4523 NE DAVIS ST
PORTLAND, OR 97213
PHONE: 360 - 693 -9081 PHONE: 503 - 972 -5201
FAX: 360 - 693 -5948
FEES
Quantity Description Date Amount
4 ea Sign or Outline Lighting 02/07/2013 $271.36
Specifics:
1 ea 12% State Surcharge - 02/07/2013 $32.56
Electrical
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $303.92
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. ATTE - • Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001 -0' 0 through • • R 95 , 11-0J90 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232 •87 or 1.800. • .2344.
Issue. =y: .. , / `— 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' J 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.
•
Electrical Permit Application R IVE F012 OFFICE us►� ONLY
City of Tigard a `�"'� l r' � ' Recei °ea ° 1 3
° 13125 SW Hall Blvd., Tigard, OR 9722 view a 5{ Permit Nob 3 1 D00�
Phone: 503.718.2439 Fax: 503.598.1960 6 2 13 Date/B : Other Permit: it PI-P, 1 3-000 31
T 1 G A k D Inspection Line: 503.639 Date Ready/By: luris: (D 65 See Page 2 for
Internet: www.tigard - or.gov CITY OF TIGARD Notified/Method: I � Supplemental Information
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PLAN .REV IEW
[1f ew construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
. '.CATEGORY: OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
El 1 - and 2 - family dwelling [r Commercial/industrial Accessory building less to grail other a exceeds 14,000 ❑ Commercial -use agricultural
❑ rY g amps for all other installationss . buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB ,SITE INFORMATION AND LOCATION • ' ' Emergency system. larger separately derived system.
0 Addition of new motor load of ❑ "A" "E ", "l -2" `I -3"
100HP or more. occupancy.
Job no.: Job site address: 2 .r o S w a • Cr.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: 1 a , i 2 p t o 4 . 9 1 1.7. 3 0 Health-care facilities. 0 Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: Project name: , ❑ Service or feeder 600 amps
J �s C1F't p at » SuP /�y
or more.
FEE SCHEDULE
. Cross street/directions to job site: s ,..) ^,repair t... o o o D 4 . • . Description I Qty. l Fee. I Total I •
New residential single- or multi- family dwelling unit.
S •^I r 4. , t.+ S. r. Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'l 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
' :DESCRIPTION.`OF WORK - (with above sq. ft.) 75. 2
Limited energy, multi - family 75.00 2
/- S T a w : L 1) 1 1. L ....A 1 ,. A r e' p Fa S oe t q residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
S I t.t ." S . 200 amps or less 100.70 2
:: ❑i ?PROPERTY: OWNER - I []'TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: '1> t; I F I C. P a• 1 N T ' S .A P p L y . 601 amps to 1,000 amps 301.04 2
Address: its S w w.. 41 ,.. ) ST. Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and /or
City/State/ZIP: - rt tw 4 A., D , 0 2 1 1 2 - 2 -; relocation
Phone: (Item ) L t 1 . 2.4.. o 3 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 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. -
Branch circuits - new, alteration, or ex tension, Rer panel _
Owner signature: Date: A. Fee for branch circuits with
above service or feeder fee,
® APPLICANT. 1 [�CONTACT PERSON 7.42 2
' � each branch circuit
Business name: �► IL It 15•r T S t M �.../ CI" B. Fee for branch circuits without
Le
• ( .4 C ' service or feeder fee, first
Contact name: So 4 r A g L o i.-- branch circuit 56.18 2
Each add'l branch circuit 7.42 2
Address: g 1 ( 1-1 p A,'' 4 N S T • Miscellaneous (service or feeder not inc luded) _
/State/ZIP: 9 L Each manufactured or modular
City/State/ZIP: tY U4t..t C - o H V .: 1 t...) q e to O dwelling, service and/or feeder 67.84 2
t
Phone: (3 t,o) to 9 3 . q o 1" t Fax: : (4.‘o) t, 7 3 . S-71-8 Reconnect only 67.84 2
E -mail' Pump or irrigation circle 67.84 2
So e'' e c. a at icTTS ►t,..i .aort
Sign or outline lighting ( 67.84 a7 / .34 2
- CONTRACTOR - Signal circuit(s) or limited -energy
Business name: 4q A R e T t SI a N Co . f Iva �, panel, alteration, or extension. Page 2 2
t Each additional inspection over allowable in any of the above
Address: g 11 H 04 a •' * y S T , Additional inspection (I hr min) 66.25/ hr
Investigation (I hr min) 66.25/ hr
City/State /ZIP: VA ,,c_, •a v e,� tJ..1 A 9 8 L L.,,,,, Industrial plant (I hr min) 78.18/ hr
Phone: (31...m) 1 .9 ro . 1 o 8 I - "bit, Fax: ( 3 L o) 4.9 3 . j 4 8 Inspections for which no fee is
specifically listed (h hr min) 90.00 / hr
CCB Lic.: to t. $ Z. t. Electrical Lc.: :4:44; - 1c rv. Lic.: 7 e o S t L ELECTRICAL PERMIT FEES . •
Subtotal: 7/ • 34
Suprv. Electrician signature, required:
Plan review (25% of permit fee):
Print name: Ai t c_ H A E t_ S t tit p s o .. 1 Date: t, I 12.41 ' t' 3 State surcharge (12% of permit fee): ,3a • 6
��' TOTAL PERMIT FEE: .�. Q,'1
Authorized signature:
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: ,5, E T A (1 o ,v Date: o i ( 2. 9 / I ; • Number of inspections allowed per permit.
l:\ Building \Permas\ELC- PermitApp.doc 07/01 /10 440.4615T(11/05/COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESI °DEN:TIA WORg,: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:
COMMERCIALWWORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ I nstrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ M edical
❑ Nurse Calls
❑ O utdoor Landscape Lighting*
❑ Protective Signaling
Other SUANAGE
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I: 1Building \Permits\ELC- PermitApp.doc 07/01/10