Permit •
CI TI( OF TIGARD 3.10•00 OF ELECTRICAL PERMIT
a PERMIT #: ELC2006 -00459
i DEVELOPMENT SERVICES DATE ISSUED: 8/16/2006
..� li 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1 S127DD -00100
SITE ADDRESS: 09730 SW CASCADE AVE ZONING: C -G
SUBDIVISION: LOT : JURISDICTION: TIG
Project Description: Lighting for (5) wall signs.
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: 5
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:
SHANE COMPANY MEYER SIGN CO OF OREGON
9730 SW CASCADE AVE 15205 SW 74TH AVE
TIGARD, OR 97223 TIGARD, OR 97223
Phone: Contact #: PRI 503 620 - 8200
FAX 503- 620 -7074
FEES
Description Date Amount Reg #: ELE 20 190CLS
[ELPRMT] ELC Permit 8/16/2006 $267.00 LIC 64014
[TAX] 8% State Surcharge 8/16/2006 $21.36 SUP 566SIG
Total $288.36 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 Notific - on Cen Those
rules are rth-in OAR 952-001-0010 through OAR 952 - 001 -0100. You may obtain copies oft =rules or ' qu = tuns to NCI
503 -24 699 or 1 -800- 2 0
Issued y : 0 tilrl it j Permittee Signature: .` -ft
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, (ease, or_re .
OWNER'S SIGNATURE: DATE:
C �
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N; DATE: 84/4 6
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.
Electrical Permit Application • FOR OFFICE USE ONLY
0.
City of Tigard t �� � it No.: )
`J g Dat Received : d / CV S ''
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 �i�l Date /B : Other Permit:
Inspection Line: 503.639.4175 ,, !„ e. „ Date Ready /By: MI RI See Page 2 for .
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
TYPE OF WORK • PLAN REVIEW
❑ New construction ® Addition/alteration /replacement Please check all that apply:
❑ Demolition ❑Other: • ['Service over 225 amps, comm'l ['Hazardous location
❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of I- and 2- family dwellings 4 or more new residential
❑ I- and 2- family dwelling ® Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Multi- family ❑Master builder ❑Other: ['Building over three stories ['Feeders, 400 amps or more
['Occupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park
Job no.: Job site address: 9730 SW CASCADE AVE
❑Health -care facility ['Other:
Submit 2 sets of plans with any of the above.
City/State /ZIP: TIGARD, OREGON, 97223 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: SHANE CO FEE* SCHEDULE
Description I Qty. I Fee. I Total I ''
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
•
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
5 ILLUM WALL SIGNS dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
® PROPERTY OWNER 12 TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: SHANE CO #10 601 amps to 1,000 amps 240.60 2
Address: 9730 SW CASCADE AVE Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State /ZIP: TIGARD, ORE, 97223 Temporary services or feeders installation, alteration, and/or
Phone: (503) Fax: ( ) relocation
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 600 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
® APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with
• service or feeder fee, each 6.65 2
Business name: MEYER SIGN CO OF OREGON branch circuit
B. Fee for branch circuits
Contact name: SAME • without service or feeder fee, 46.85 2
first branch circuit
Address: Each add'I branch circuit 6.65 2
City/State /ZIP: _ Miscellaneous (service or feeder not included)
• Pump or irrigation circle , 53.40 2
Phone:( ) Fax::( )
Sign or outline lighting 5 53.40 Job, p0 2
E -mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: MEYER SIGN CO OF OREGON
Address: 15205 SW 74 AVE Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State /ZIP: TIGARD, OR., 97224 • Investigation per hour (I hr min) 62.50
Phone: (503- 620 -8200) Fax: (503 -620 -7074) Industrial plant per hour • 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: 64014 Electrical 0- 190CLS a uprv. Lie.: SIG566 Subtotal 02 ( 00
Suprv. Electr' art signatu required: �i � , i( P lan review (25% of permit fee)
Print name:
/ .A/AI / State surcharge (8% of permit fee)
� ate: 08 / 16 /2006
L am'- Q L„ TOTAL PERMIT FEE u , 36
� Authorized signat / This permit application expires if a permit is not obtained within 180
� // days after it has been accepted as complete
' � iL� i��
Print name: /W I Date: 8 - - • Fee methodology set by Tri- County Building Industry Service Board
_ Number of inspections per permit allowed.
is\ Building \Permits\ELC- PcrmitApp.doc 12/. 440.4615T(10/02/COM/WEB
• City of Tigard Oregon • 13125 SW Hall Blvd. • Tigard, OR 97223
Er!
µ ,• a D 3 i
August 16, 2007 "`rt ''.
Meyer Sign Co. of Oregon, Inc.
15205 SW 74t Ave.
Tigard, OR 97224
Attn: Steve Murphy
Re: Permit No. ELC2006 -00459
Dear Mr. Murphy:
The City of Tigard has canceled the above referenced permit(s) and enclose a refund for the
following:
Site Address: 9730 SW Cascade Ave.
Project Name: Shane Co.
Job No.: N/a
Refund: ® Check #52925 in the amount of $150.59.
❑ Credit card "return" receipt in the amount of $
❑ Trust account "deposit" receipt in the amount of $
Notes: Per applicant's request as work was completed by another contractor. Due to age of
permit, refund 50% of permit fee per the Building Official.
If you have any questions please contact me at 503.718.2430.
Sincerely,
Dianna Howse
Permit Specialist
Enc.
•
1: \Bull ding\ Refunds\ Administration \LtrRefund - CancelPermit.doc 01/16/07
Phone: 503.639.4171 • Fax: 503.684.7297 • www.tigard- or.gov • TTY Relay: 503.684.2772
City of Tigard
TIGARD Tidemark Refund Request
This form is used for refund requests of land use, engineering and building application fees.
Receipts, documentation and the Request for Pe nit A coon or Rgiuxi form (if applicable) must be
attached to this form. Refund requests are due to Tidemark System Administrator by Friday
at 5:00 PM for processing each Monday. Accounts Payable will route refund checks to Tidemark
System Administrator for distribution. Please allow 1 -2 weeks for processing.
PAYABLE TO: Meyer Sign Co. of Oregon, Inc. DATE: August 1, 2007
15205 SW 74 Ave.
Tigard, OR 97224 REQUESTED BY: Dianna Howse
Attn: Steve Murphy
TRANSACTION INFORMATION:
Receipt # : 2006 -4125 Case # : ELC2006 -00459
Date: 8/16/06 Address /Parcel: 9730 SW Cascade Ave.
Pay Method: Check Project Name: Shane Co.
EXPLANATION: Per applicant's request as work was completed by another contractor. Due to age of
permit, refund 50% of permit fee per Building Official.
REFUND INFORMATION:
Fee Description From Receipt -Revenue Account No. Refund
Example: [BUILD] Permit Fee Example: 245- 0000 - 432000 $ Amount
[ELPRMT] ELC Permit 220 - 0000 - 431510 $133.50
[TAX] 8% State Surcharge 100 - 0000 - 207020 17.09
TOTAL REFUND: $150.59
APPROVALS:
If under $500 Professional Staff
If under $7,500 Division Manager
If under $22,500 Department Manager
If under $50,000 City Manager
If over $50,000 Local Contract Review Board
FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY
Case Refund Processed: Date: ? B .
I:\ Building \Refunds \RefundRequest.doc 05/23/07
Er il CITY OF TIGARD 8/1/2007 '
u 1 3125 SW Hall Blvd. 2 :52:43PM
Tigard, OR 97223 503.639.4171
TIGARD
Receipt #: 27200600000000004125
Date: 08/16/2006
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2006 -00143 [SIGN] Sign Permit 100- 0000 - 437000 34.00
SGN2006 -00143 [MISC] Misc Fee 100 - 0000 - 451000 5.00 •
SGN2006 -00144 [SIGN] Sign Permit 100- 0000 - 437000 34.00
SGN2006 -00144 [MISC] Misc Fee 100 - 0000 - 451000 5.00
SGN2006 -00145 [SIGN] Sign Permit 100 - 0000 - 437000 34.00
SGN2006 -00145 [LRPF] LR Planning Surcharge 100- 0000 - 438050 5.00
SGN2006 -00146 [SIGN] Sign Permit 100- 0000 - 437000 34.00
SGN2006 -00146 [LRPF] LR Planning Surcharge 100- 0000 - 438050 5.00
SGN2006 -00147 [SIGN] Sign Permit 100- 0000 - 437000 34.00
SGN2006 -00147 [LRPF] LR Planning Surcharge 100- 0000 - 438050 5.00
ELC2006 -00459 [ELPRMT] ELC Permit 220 - 0000 - 431510 267.00
ELC2006 -00459 [TAX] 8% State Surcharge 100- 0000 - 207020 21.36
Line Item Total: $483.36
Payments:
Method Payer User ID Acct. /Check No. Approval No. How Received Amount Paid
Check MEYER SIGN CO OF OREGON DEB 15723 In Person 483.36
INC
Payment Total: $483.36
ckeccipt.rpt Page 1 of 1
RE WED
• JUL 2 6 10U/
Building Division
CITY
TIGARD Request P.'
for Permit Action BUILDING DIVISIO
TO: CITY OF TIGARD
Permit System Administrator
13125. SW Hall Blvd., Tigard, OR 97223
Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov
FROM: ❑ Owner ❑ Applicant [ Contractor ❑ City Staff
(check one)
REFUND OR Name: •
INVOICE TO: (Business or Individual) 1‘k 9 /G� a . Q 02 e
Mailing Address: 15 (�S .6W
V ® ' ® City /State /Zip: - rl G-114 o Q
T
Phone No.: Co 6 2 82.1)0
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓):
I CANCEL PERMIT APPLICATION:
2' REFUND PERMIT FEES (attach receipt, if available).
❑ INVOICE FOR FEES DUE (attach case fee schedule and explain below).
❑ REMOVE CONTRACTOR. FROM PERMIT (do not cancel permit).
Permit #: r!� ��(p - Q0
Site Address or Parcel #: ('10 au eagaa Q Q.A 4Q
Project Name: /a/r) Co ..
Subdivision Name: Lot #:
EXPLANATION: ;1 g uu b\,,,&`( 8r`h. h 'to 1j(4
•
Signature: ` _.i —� Date: 7 - Zs — c7
Print Name: 57 t42 ke
Refund Policy
1. The Director or Building.Official may authorize the refund of:
a) any fee which was erioncously paid Or collected.
b) not more than 811% of the land use application fee when an application is withdrawn.or canceled before any review effort has been expended.
c) not more than 80% of the land use application fee for issued permits.
c) not more than 80°.%'o of the building plan review fee when an application is canceled before any plan review effort has been expended.
d) not more than 80% of the building permit fee for issued permits prior to any inspection requests.
2. Refunds will:be returned to the original Payer in the same method in which payment was received. Please allow 1 -2 weeks for processing refunds.
FOR OFFICE USE ONLY
Rte to Sys Admin: Date By Rte to Bldg Admin: Date - By
Refund Processed: Date c�_/ -7 By ,,,v/4 Invoice Processed: Date By
Permit Canceled: Date 7 / p 7 B Parcel Tag Added: Date By
Receipt #,Ig — ' ,5 Dated / 46, Method Amount
1: \Building \Forms \RegPermitAction.doc Rev 05/24/06• c dl 2�yt,v /0EC ,g,0Q //0"-Al
•