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Permit
CITY OF TIGARD 3 -- C)7 ELECTRICAL PERMIT ( PERMIT #: ELC2007 -00179 I ° COMMUNITY DEVELOPMENT DATE ISSUED: 3/23/2007 TIGARD 1 31 25 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S136CD-01000 SITE ADDRESS: 11745 SW PACIFIC HWY ZONING: C -G SUBDIVISION: LOT : JURISDICTION: TIG PROJECT: RECLINER CITY Project Description: Install (1) sign lighting. 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: MONAGHAN FARMS INC SALEM SIGN CO INC 14120 EAST EVANS AVE 1825 FRONT ST NE AURORA, CO 80014 SALEM, OR 97301 Phone: Contact #: PRI 503 - 371 -6362 FAX 503 - 371 -0901 FEES Description Date Amount Reg #: ELE 24- 125CLS [ELPRMT] ELC Permit 3/23/2007 $53.40 LIC 65297 [TAX] 8% State Surcharge 3/23/2007 $4.27 SUP 394SIG 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 rth in OAR 952 - 001 - 0010 through OAR 952 -001 -0100. You may obtain copies o hese rules or direct questions to OUNC at 503.246.6 9 or 1.80 . 32. 44 - Issued B aiM--34,- Permittee Signatur r„ 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. Oa . '2 ='07 09:58 FROM —SALEM SIGN CO 5033710901 T -995 P003 F -324 te' •'Ele�r`_ Permit Application rou Orrlcr VSL o: Lv <::- • Received n/� � • City of Tigard R E C . . \ E D Re t °?a D permit No.: 2 13125 SW Hall Blvd., Tigar OR`97223 Plan Review y' Phone: 503.639.4171 Fax: 503,59831 1 DateBv: Other Permit: TIGARD inspection Line: 503.639.4175 iv' m 2007 / Date Ready/By: See Page 2 for Internet: www.tigard- or.gov Notified/Method: Jerry: � Supplemeatal CITY OF FIGA€ O . . TYPIni't' Nei INISION PLAN REVIEW - NeW construction ❑ Addition/alteration/replacement Please check all that apply (submit 1 sets of plans w /items checked below): O Service or feeder 400 amps or more 0 Building over three stories. Cl Demolition ❑ Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑ Floating buildings. - less to ground, or exceeds 14.000 ❑ Commercial - use agricultural ❑ 1- and 2- family dwelling IS 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 ", "& ", "l -2 ", "1.3 ", I ix or or more. R occupancy. r Job no.: Job site address: /l 7L/ r I� �/� �(L ❑ $ix or man residential units. ❑ Recreational vehicle parks. City/State/ZIP: ❑ Health -sere facilities. ❑ Supply voltage for more than 7 — i � � © . - ❑ Hazardous locations, 600 volts nominal. Suite /bldg, /apt, no.: Project name: ) e , k -7 ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: i 7 / /lr ��il Dcrrription I Q9'• I pee. i Total I • Ncw 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. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential DESCRIPTION OF WORK (with above sq. ft.) — 74.00.. 2 ' - 1 Limitcd energy, multi - family 75.00 2 mss- r �A. _ i / f� (l residential (with above sq. n.) Services or feeders installation, alteration, and/or relocation .0 200 amps or less 80.30 2 elt PROPERTY OWNER I 44 TENANT 201 amps to 400 amps 106.85 2 Name: /DA 6ti rAloMb AJ 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: (i{ ( ‘ 9.0 tie f_A.5r v )s ft Over 1,000 amps or volts 454.65 2 City /State /ZIP: `- /Z./LA- ittaria ' o ,p ()/ 1 1 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 Branch circuits - new, alteration, or extension, per panel _ _ _ Owner signature: Date; , A. Fee for branch circuits with • APPLICANT I 0 CONTACT PERSON above service or feeder fee, 6.65 2 each branch circuit Business name: t5-e , a' 412_ 1,- B. Fee for branch circuits f lt sorvicc or feeder feeder fa, 46.85 2 Contact name: �( fait st branch circuit Address: /7?y S , �) / 7 5 4 f � , _ / Miscellaneous llan branch (s circuit 6.65 2 �.- "" Misceitancous (servile or feeder not included) City/State/ZIP: f ar) Each manufactured or modular G dwelling, service and/or &odcr 90.90 2 Phone; (56 c ) tom/ ( d c B Fax :: ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 CONTRACTOR - Sign or outline lighting / 53.40 5.3 vo 2 : ` ii v , ‘ / / Sierral p (a) or limited- o Business name or ��h-'C � / � ! �`l � energy panel, alteration, Address: extension. Describe: Page 2 2 City/State /ZIP: tl e& cr 73 0 / Each additional Inspection over allowable in any of the above Per inspection 62,50 Pho e: ) ax: ( f � �� � � (v 3 [. , � F �S`v ) ?J� � 4 % e, � Investigation per hour (1 hr min) 62.50 - CC / f®$ 1 Industrial p per hour 73.75 B Lie.. 65 9 7 El ectr i ca l L ic.: SUprv. Li e. .,?q ELECTRICAL PERMIT FEES Suprv. Electrician signature, required; j, , 7 46' �� Subtotal: 5 '/1) R � D e. Plan review (25% of permit fee): Print name: C� D SpAD State surcharge (8% of permit fee): Authorized signature: TOTAL PERMIT FEE: Tbis permit application expires if a permit is not obtained within ISO Print name: j Date: days after it has been accepted as complete. Number of inspections allowed per permit. t: 'ermit :ILLC- PnrmitApp.dac 05/23/06 440.461 ST( II /OS /COM/WEB