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Permit CITY OF TIGARD ELECTRICAL PERMIT • COMMUNITY DEVELOPMENT Permit#: ELC2015 00598 T i G p R O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/30/2015 Parcel: 1 S136CA01600 Jurisdiction: Tigard Site address: 11655 SW PACIFIC HWY Project: RV Northwest Subdivision: FAIRVALE Lot: 6 Project Description: Sign lighting for(1)sign. Contractor: CLARK SIGNS Owner: AMAN, WALTER S CREDIT SHELTER TR PO BOX 1113 AMAN,WALTER S MARITAL TRUST ET AL ST HELENS, OR 97051 BY AMAN, STEPHEN D TR PO BOX 4127 PORTLAND, OR 97208 PHONE: 503-781-6081 PHONE: FAX: 503-543-5141 FEES Quantity Description Date Amount 1 ea Sign or Outline Lighting 07/30/2015 $67.84 Specifics: 1 ea 12%State Surcharge- 07/30/2015 $8.14 Electrical Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $75.98 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty •des a • all other - • a• law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of '-suance, o if work is •,ed for more the 180 days. ATTENTION: Oregon law requires you to follow the rules ado• -d by the Oregon Utility Notifi•:ti- Cente Those r - :re set forth in OAR 952-001-0010 through OA 52-001-0090. You • -• - - ••y of the '-s or direc •uestions to OUNC by calling-8..232.1987•r 1.800.3 • Issued By: � — 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' 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 FOR OFFICE USE ONLY City of Tigard Q Received 7 , ���""" Date/B yI 13125 SW Hall Blvd.,Tigard,OR 97223 0 _ Plan Review •- Phone: 503.718.2439 Fax: 503.59 Date/By: Related Permit#: e. Gw �-IP v I �r, Inspection Line: 503.639.4175 �Q, Ready Date/By: Juris: 0 Page 2 for I 1 t,A k l) Internet: www.tigard-or.gov ` _ \ 3 Q O Notificd/Method: M` Supplemental Information• TYPE OF WORIf' - , PLAN REVIEW t"New construction ❑Addition/alteration'replacemerit. Please check all that apply(submit 2 sets of plans wiitems checked): ❑Service or feeder 400 amps or more ❑Building over three stories. El Demolition ❑Other: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONPIUCTION exceeds 10.000 amps at 150 volts or ❑Floating buildings. ❑ I-and 2-family dwelling Commercial/industrial ❑Accessor\ building less to ground.or exceeds 14.000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑ Multi-family Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived /-r 5' ❑Addition of new motor load of system. Job#: Job site address:it 40 E w ���,, i{t,� I00HP or more. ❑"A" "E" `l-2" "l-3" City/State/ZIP: ❑Six or more residential units. occupancy. tY ` ^7 Z ❑Recreational vehicle parks. C ( D l � ❑Health-care facilities. P Suite/bldg./apt.#: I Project name: v uJrv)© LAp„e- ❑[hazardous locations. ❑Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I QR. I Each I Iola! I New residential single-or multi-family dwelling unit. Subdivision: I Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add]500 sq.ft.or portion 33.92 I DES RIPTION OF WORK / Limited energy,residential 75.00 C S 0(N, I I G►4"N i f (' C l S 9 (with above sq.ft.) r / t A/ Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy _ ❑ See Page 2 ❑ PROPERTY OWNER I ❑ TENANT Services or feeders installation,alteration,and/or relocation Name: 200 amps or less 100.70 ' Address: 201 amps to 400 amps 133.56 '_ 401 amps to 600 amps 200.34 ' City/State/ZIP: 601 amps to 1,000 amps 301.04 ' Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 _ Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 _ Owner signature: Date: 401 amps to 599 amps 168.54 ' ❑ APPLICANT I ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel a A.Fee for branch circuits with Business name: above service or feeder fee, 42 each branch circuit Contact name: B.Fee for branch circuits without service or feeder fee,first Address: 56.18 ' branch circuit _ City/State/ZIP: Each add'l branch circuit 1 7.42 Miscellaneous(service or feeder not included) Phone:( ) Fax: :( ) Each manufactured or modular dwelling,service and/or feeder 67.84 '_ Email: Reconnect only 67.84 ' CONTRACTOR Pump or irrigation circle 67.84 Business name: mil- ( S L r.-r,S Sign or outline lighting I 67.84 W 7' 2 �� Signal circuit(s)or limited energy ❑ See Page 2 ' Address: f� (�, panel,alteration,or extension. g Ci /State/ZIP: Each additional inspection over allowable in any of the above City/State/ZIP: V,,, S �-- 7 � 'f Additional inspection(1 hr min) 66.25/hr Phone:(43 )33 1 C(7 I Fax:( ) Investigation(1 hr min) 90.00/hr Email:clA k.,.e..�CiLes„,,, !&kS .A__, ~� Industrial plant(1 hr min) 78.18/hr ����G�`�l G Inspections for which no fee is hr CCB Lic.:0G(Q 33 Electrical Li 1 7 ' . . Suprv.Lic- a?"O .j`4 I specifically listed(,hr min) 90.00/ ' ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: v Subtotal: Cry Print name: 00...J I a. CU Lr Date:� l� ❑Plan Review Required(25%of permit fee): — `� State surcharge(12%of permit fee): 7 '// TOTAL PERMIT FEE: ���V, Aut prized si, a �rrr....I r i This permit application expires If a permit is not tailed within 180 Priif •.me./� /(_______ Date:?A b/5-- da',s after it has been accepted as complete. a Number of inspections allowed per permit. I:Building,Permits,ELC_PemihApp_ELR_ERE.doc Rev 06;17/2015 440-46l5T(It/05'COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Fee for all residential systems combined: $75.00 Description Qt,. Each Total y Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 1 00.70 5.01 to 15 kva 133.56 '_ n Audio and Stereo Systems* 15.01 to 25 kva 200.34 Wind generation systems in excess of 25 kva: Burglar Alarm 25.01 to 50 kva 301.04 50.01 to 100 kva 552.26 ❑ Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 El Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 n Vacuum Systems* >100 kva—no additional charge 0.0 3 Each additional inspection over allowable in any of the above: Other: Each additional inspection is 66.25/hr 1 charged at an hourly(I hr min) Inspections for which no fee is 90.00/hr specifically listed I'_hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 Subtotal(Enter on Page I):+ Number of ins (SEE OAR 918-309-0000) pections allowed per permit. Check Type of Work Involved: n Audio and Stereo Systems n Boiler Controls I Clock Systems Data Telecommunication Installation I Fire Alarm Installation HVAC ❑ Instrumentation ❑ Intercom and Paging Systems n Landscape Irrigation Control* I I Medical I I Nurse Calls n Outdoor Landscape Lighting* I I Protective Signaling Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1:\RuildingTenn ts/ELC_PennitApp_ELR_ERE.doc Rev 06/17/2015