Permit (133) 11111 CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2018-00070
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/31/2018
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Parcel: 1 S 134AA01900
Jurisdiction: Tigard
Site address: 10115 SW NIMBUS AVE 150
Project: Giant Gyros Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: B
Project Description: Sign lighting for(1)sign.
Contractor: JERRY M YOUNGER Owner: ROBINSON, JERRY CHRISTOPHER TRUS
840 NE VILLAGE SQUIRE AVE DIETRICH, NANCY BISHOP
GRESHAM, OR 97030 9701 SE MCLOUGHLIN BLVD
MILWAUKIE, OR 97222
PHONE: 503-380-4774 PHONE:
FAX: 503-253-9407
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 01/31/2018 $67.84
Specifics:
1 ea 12%State Surcharge- 01/31/2018 $8.14
Type of Use: COM Electrical
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 Codes and 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 issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OA 2-0/•090.1 ou may ob,in a copy of,rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
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Issued By: / 4 1 Permittee Signature: e
OWNER INSTALLATION ONLY /(J
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 603.639.4175 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 , : /C FOR OFFICE USE ONLY
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Cl of Tigard Received ) (' /�77— Permit No.: '
`J g DateBy: '/d'�/�i� "u�r� I��'"�t��"�c�1���l
1111 Y 13125 SW Hall Blvd.,Tigard,OR 97223 A5.° . ?_01b Plan Review ��1y,
'a Phone: 503.718.2439 Fax: 503.598.1960 -J Date/By: Other Permit: ; ,'W 0t)W t
10,0
TIGARD Inspection Line: 503.639.4175 ''e1 `#;'Date Ready/By: J�uris: > 0 See Page 2 for
Internet: www.tigard-or.gov ii t kit- "t -4t-' '.,'- ,tified/Method: r--.6 Supplemental Information
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❑New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked below
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: where the available fault current El Marinas and boatyards.
�� exceeds 10,000 amps at 150 volts or ❑Floating buildings.
-;,,,,4::11:k,, ,,�.. ���� �'�1. -:!".!;,4'1'4''':',.:1.!!'‘,,
- 1%.. less to ground,or exceeds 14,000 ❑Commercial-tlse agricultural
❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings.
0 Multi family ❑Master builder ❑Other , 0 Fire pump. 0 Installation of 150 KVA or
Emergency system. larger separately derived system.
�0 'ff.IUE'"� r� "1 ti�t� t lir Ut~ �talc '' Addition of new motor load of ❑"A» "E" "1-2" "1-3"
I_ 100 HP or more. occupancy.
Job no.: Job site address: 1011 c w .vt YhKJ u -7U AL 0 Six or more residential units. ❑Recreational vehicle parks.
.r 412-2; ❑Health-care facilities. 0 Supply voltage for more than
City/State/ZIP: t 1 ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: 0 Service or feeder 600 amps or more.
G-i A�fi 6—ITV-0s ''; ,..,F 1 cfED 11 ,
Cross street/directions to job site: U Description Qty I Fee. I Total I "
New residential single-or multi-family dwelling unit.
0, "`+ U W 3
Q C 0 it Includes attached garage.
Subdivision: _ Lot no.: 1,000 sq.ft.or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 1
Tax map/parcel no.: Limited energy,residential
75.00 2
' -'''',,60-4„ '� , F,R (with above sq.ft.)
Limited energy,multi-family
1 vt /1�fM vt eq 1'm — residential(with above sq.ft.) 75.00 2
lRenewable Energy .0 See Page 2
Services or feeders installation,alteration,and/or relocation
'''''''I'''*T"'''I J iiiitig**10':7:41.0"4"1" :''':' y 200 amps or less 100.70 2
201 amps t 400 mps 133.56
Name: f ,AIA T)Q C� VC- / 14_111, �v� _ 401 amps to 600 amps 200.34 2
Address: 10 1 Z fl S't co 601 amps to 1,000 amps 301.04 2
1 �v Over 1,000 amps or volts 552.26 2 7
City/State/ZIP: \../it IA teut U t /_ to 6 0 Temporary services or feeders installation,alteration,and/or s°
Fax: relocation
Phone:( �(06r, (�7 _ eV ( ) 200 amps or less 59.36 1
Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale,lease,r nt,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
Owner signature: a Date: Branch circuits—new,alteration,or extension,per panel
Irl, �/ „, \ A.Fee for branch circuits with
, r ilr ,, ,. =',,,,,,, ...Y above service or feeder fee,
7.42 2
Business name: la-1 o
each branch circuit
I W �C.t�� B.Fee for branch circuits without
Contact name: "� irk Iq service or feeder fee,first
�! Q IA56.18 2
1/l�l t r Q�' branch circuit
Address: ,2_,t S� Q�� /l1 Ge ebranch circuit 7.42) 2
Cit /State/ZIP: 1Miscellaneous(service or feeder not included)
Y 0 ii..—K,Q Q 2,G Each manufactured or modular
r dwelling,service and/or feeder 67.84 2
Phone:( (07 ) --lx--.2., C t L d Fax: ( ) Reconnect only 67.84 2
E mall ll `C Pump or irrigation circle 67.84 2
" �w l'i� t �.. g o g
t_� Si nor outline lighting titin
Business name: � " �' Signal circuit(s) rlimited-energy 67.84 2
See
f.��lti vw�, e-o ,11 t S panel,alteration,or extension. Page 2 2
Address: V L4,0 it.6- Ut,1(4 slp ci, ;,ed f 0'L/e_ Each additional inspection over allowable in any of the above
Additional inspection(1 hr mm) 66.25/hr
City/State/ZIP: G�,e..c tM f D G701a Investigation(1 hr min) 66.25/hr
Phone:(co ts(? U'1 1 Fax:( ) Industrial plant(1 hr min) 78.18/hr
p Inspections for which no fee is
90.00/hr
p signature,require': 2%? it (i/7 S� Ily listed(%2 hr min)
T P
CCB Lic.: Electric- ic.: u rv.Lic.: pectfica
�2�� � � � � E�,Ecv1�:ra� , T��w
Suprv.Electrician
Subtotal: (01 S Y
Plan review(25%of permit fee):
Print name: "'' i Da t, — , —
J - • � (( 7� 1 I State surcharge(12%of permit fee):
Authorized signatu -: P �,o f ` TOTAL PERMIT FEE:
,,rill
666
This permit application expires if a permit is not obtained within 1 0
Print name: `� t' ‘ u / •,I Date: ( X 1k• days after it has been accepted as complete.
fill * Number of inspections allowed per pennit.
1:\Building\Permits\ELC_PermitApp_ELR_ERE.d. Rev 05/21/201 440-4615T( 1/05/COM/WEB