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Permit CITY OF TIGARD ELECTRICAL PERMIT 111111 111' COMMUNITY DEVELOPMENT Permit#: ELC2016-00180 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/30/2016 Parcel: 1S 134AA01 900 Jurisdiction: TIGARD • Site address: 10115 SW NIMBUS AVE 200 Project: I Love Kickboxing Subdivision: (KOLL BUSINESS CENTER,TIGARD Lot: B Project Description: Sign lighting for(1)wall sign. Contractor: MEYER SIGN CO OF OREGON Owner: ROBINSON, CONSTANCE A 15205 SW 74TH AVE BY KILLIAN PACIFIC LLC TIGARD, OR 97224 500 EAST BROADWAY, STE 110 VANCOUVER,WA 98660 PHONE: 503-620-8200 PHONE: FAX: 503-620-7074 FEES Quantity Description Date Amount 1 ea Sign or Outline Lighting 03/30/2016 $67.84 Specifics: 1 ea 12%State Surcharge- 03/30/2016 $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 Co. s nd 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 issu.nce, or if work is suspended for more the 180 days. ATT •• •N. • -gon law requires you to follow the rules adopted by the Oregon Utility Notificatio Ce,ter. Those rules are set forth in OAR 952-001-,.810 through OA' 952-8: •090. You may obtain a copy of the rules or direct questions to OUNC by calling 50 .232.1'•87 1.800.332.2344. Issu•• 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; t sl':ONLY CityofTigard EC I��l' r) Received 2© al A ) Permit#: &�z�C6--� 0 g Dale/B': a1 Ilhi 11 13125 SW Hall Blvd..Tigard.OR 9 2 Plan Review 0 Phone: 503.718.2439 Fax: 503.598.196(1 Date/B Related Permit#: �3/.t1 Of Q-OCV�7� Inspection Line: 503.639.4175 MAR 8 2016 ReadyDate/By: tuns: ® See Page 2for 1 I).A R I) Internet: www.tigard-or.gov U Notified/Method: Supplemental Information Cyt Q AMYE;R, :.. ., ,.8,.., S ,!0*,7,- 1 ' I-y* � a '. ., +f l X 'rt , .,,A z ifif ❑ New Construction Addition/ Ibl\ e' �hd'5/ 1 p sl Please check all that apply(submit 2 sets of plans«/nems checked): 0 Service or feeder 400 amps or more ❑Building over three stories. 1 ❑ Demolition ❑Other: where the available fault current 0 Marinas and boatyards. :. s '':( (1 ',,10)'11 , , exceeds 10.001)amps at ISO volts or 0 Floating buildings. El1-and 2-family dwelling ommerctal/industrial I=1Accessory building less to ground.or exceeds 14.000 0 Commercial use agricultural amps for all other installations. buildings. ❑ Multi-family 0 Master builder ❑Other: ❑Fire pump. ❑Installation of ISO KVA or n,.fx z j . �, cAl'IO l r Y -,"`,',.:i',.'. " rg ❑Emergency system. larger separately derived 0Addition of new motor load of system. Joh#: Job site address: 10115 5.;J. fl.1'M5 US _ i 00HP or more. ❑ A t 1_, 1_� City/State/ZIP: �(�� o� �j SU/AL+�' ° ❑Six or more residential units. occupancy. t //���3 ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: -( L ❑Hazardous locations. ❑Supply voltage for more than J� [ �J /` '�I �O I�-I GServicep 6OD colts nominal. / � ❑ or feeder 6(x)amps or more. Cross street/directions to job site: �f�� ( 140 . '> 'EE s .jED: ;' CM6' el 1 "1 vS I 5e1 Q Description j Qh. I Each l �Total '�` New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1.000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'I 500 sq.ft.or portion 33.92 1 :DESCRIFFION ' OkK '' Limited energy.residential 75.(10 2 (with above sq.fl) CUAiggf / /o�04( 6f/�M(/tJATx-6 �/ -. Lit withited aebove multi-family 75.00 - SI bid TV , xi Sr,,j 6 ` C-C- i Jw,I` , residential(with above sq.ft.) ,' Renewable Energy ❑ See 2 ❑ Services or feeders installation,alteration,and/Pageor relocation Name: / AJ jrn,tJ c. 1001IIJJ Q Au 200 amps or less 11)0.7)) 2 V D 8x,�}A-/�� flim HD 201 amps to 4(N)amps 133.56 2 Address: c/ 401 amps to 600 amps 200.34 2 City/State/ZIP: Vfr.uezUvim, �e, 16(1 0 601 amps to 1,0(5)amps 301.04 2 Phone: ( ) Fax: ( ) Over 1.000 amps or volts 552.26 2 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 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 Branch circuits-new,alteration,or extension,per panel "�:� LCAl51�! COI�' CT � ��° A.Fcc for branch circuits nidi Business name: $L.J #L I G,v 6/.. G 0� above service or feeder fee. /1 ,,�! each branch circuit 7.42 2 Contact name: - I V 0.1 Me-e_g CM t C..if(✓ B.Fee fir branch circuits without A-1)6— service or feeder fee.first Address: /t- S tb 5 S. , 711 H J6. branch circuit 56.18 2 City/State/ZIP: —7 A./ 0/L g i;;'I Each add'(branch circuit 7.42 2 ► Miscellaneous(service or feeder not included) Phone: (5'03) Ow, S too Fax: :(503 ) 4 j , -767 4. Each manufactured or modular 67.84 2 r 6 M. E�5` Ni W, do M dwelling.service and/or feeder Email: b Reconnect only 67.84 2 Y' i-,,.. *`:' .kr,.t Y:.. Y . '',;;.',.: :':,:24'.':.',., r g 4 y..: '-: 2 a'tti ."� Pump or irrigation circle 67.84 Business name: �6(16-4 j'J 6 d k Q,Od 0 Sign or outline lighting I 67.84 67,1# 2 Signal circuit(s)or limited-energy Address: (SLOS j.J. 7V 1 E_A--' . p. ❑ See Page 2 anel,ulter�tion,or extension. �^� G�!l/) Q n ` 2 Each additional inspection over allowable in any of the above City/State/ZIP: -/ 4 !( 0)1 t Additional inspection 11 hr min) 66.25/hr Phone:(503 ) 4(N . 8 7.4Q Fax:(5'03) 6 u , iv 7V Investigation(I hr min) 90.00/hr , q . industrial plant(1 hr min) 78.18/hr Email: C � � �� 6� Inspections for which no tee is 90.00/hr CCB Lic.: 4(JI 4 Electrical Lic.:74_l90 £L 'Suprv.Lic.: 5 f SSG specifically listed)ii:hr min) Suprv. Electrician signature,required: Subtotal _$'V Print name: (1 0 5 0 15 ALt../4y Date: 3/1-11 4 0 Plan Review Required(25%of permit fee): —__—. State surcharge(12% of permit fee): i', 1Y Authorized signature: G TOTAL PERMIT FEE: 7 S.?g This permit application expires if a permit is not obtained within 180 Print name: fl.((.41 6 M ee,f)dUkt I did Date: o i/11 /( days after it has been accepted as complete. Number of inspections allowed per permit. I:ABuilding VI'erniitsVIJ('_I'cnnitApp_111 Ji_t Ili.doe Ito% )s/17/2015 445-4615Ti I 1/45/CI1M/AP.li