Permit CITY OF TIGARD ELECTRICAL PERMIT
V UUU PERMIT #: ELC2006 -00542
,� DEVELOPMENT SERVICES DATE ISSUED: 9/27/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S102AA -04100
SITE ADDRESS: 12230 SW MAIN ST ZONING: CBD
SUBDIVISION: MORINS ADDITION LOT : JURISDICTION: TIG
Project Description: Sign lighting for neon strip around building.
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:
INTEGRITY INVESTMENTS INC MULTI -LIGHT SIGN CO.
2229 NE BURNSIDE SUITE 86 809 NE LOMBARD ST
GRESHAM, OR 97030 PORTLAND, OR 97211
•
Phone: Contact #: FAX 503 - 280 -9624
PRI 503 - 281 -3083
FEES
Description Date Amount Reg #: ELE 26 -90CLS
[ELPRMT] ELC Permit 9/27/2006 $53.40 LIC 64107
[TAX] 8% State Surcharge 9/27/2006 $4.27 SUP 343SIG
Total $57.67 REQUIRED ITEMS AND REPORTS
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 or
1- 800 - 332 - 2344.
Issued By: Permittee Signature: A • J. /%
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: DATE:
LICENSE NO:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
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.
Elect. meal Permit Applicatio ol:I Icl: LiSI ()NIA.
City of Tigard SEP 2 '> 2006 Received? ( , , l
, / , , P Permit No.. (.70.511 13 S W Hall Blvd., Tigard, OR 97223 ° 20 0U P lan Review
: C Phone: 503.639.4171 Fax: ..503 .598.1960. Date/B . Other Peonit:
T I G n k 17 Inspection Line: 503.639 ,4175 'U1' ? It r� j Date Ready/By: UM ® See Page 2 for
. Internet: www.tigard- or.goJ Tyr nirm ' ,-.-.� ,� Notified/Method Supplemental Information
tC if rv4
TYPE OF WORK PLAN REVIEW
13 construction ❑ Addition /alterat ion /replacement Please check all that apply (submit 2 sets of plans wfitems checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGQRY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
( less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
12 , L . ° �,
1- and 2- family dwelling Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I -3 ",
Job no.: Job site address: /a. 3 SW rnA .57r Six or or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: 7J) / 0E. ❑ Health -care facilities. ❑ Supply voltage for more than
['Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: Project name: elo hlA/ 4sepE7--- ❑ Service or feeder 600 amps or more.
/�
FEE SCHEDULE
Cross street/directions to job site: t - ge m L Description I Qty. I Fee. I Total I •
New residential single- or multi - family dwelling unit.
• Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. fl. or portion 33.40
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family
44 IP e(/77/A/C L ,IJ residential (with above sq. ft.) 75.00 2
• 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
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
• City /State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) 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 599 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: '7)/L T/ -- L /G/17" s/GA/ eO , B. Fee for branch circuits
p� without service or feeder fee,
Contact name:
j//)'1 At/,t;/ / first branch circuit 46.85 2
Address: 70 t /J( LdM/3Aw ST Each add'l branch circuit _ _ 6.65 _ 2
Miscellaneous (service or feeder not included) _
. City / State/ZIP: P'it..6 4/2 7.2// Each manufactured or modular 90.90 2
i dwelling, service and/or feeder
Phone: (SOX) )el- .302' 3 I Fax:: Grp?) .2 • 60 — €74,24s Reconnect only 66.85 2
• E - mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 ,5 2
Signal circuit(s) or limited -
Business name: rgz/z 77 - , /G J /Cr✓ ea energy panel, alteration, or
• Address: 0 extension. Describe: Page 2 2
City / State/ZIP: ^+ 1 O 0 /\ Each additional inspection over allowable iD any of the above
I ` Per inspection 62.50
Phone: ( ) Fax:
/ / Investigation per hour (I hr min) 62.50
CCB Lic.: 6.1 / Q 7 Electrical Lic.: - qa ir Suprv. Lic.: .3.3,51/6. Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: - __../ Subtotal: ,53, 40
Print name: 1e72,k V giecoh J Date: 9— d2 7 D6 Plan review (25% of permit fee):
State surcharge (8% of permit fee): 104
Authorized signature: l /, %; TOTAL PERMIT FEE: 57„ 6/
Print name: t y — B6 This permit application expires if a permit is not obtained within 180
.J / i /YI d�e Da y - days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\ Building \Petmits\ELC- PetmitApp.doc 0523106 44046I5T(II /05 /COM/WEB
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- 260 -260)
Check Type of Work Involved:
• ❑ 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
I:\ Building \Pamits\ELC- PamitApp.doe 03/23/06