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Permit (5) CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit p: ELC2010 -00635 -TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/09/2010 Parcel: 2S101 BB00401 Jurisdiction: Tigard Site address: 11880 SW PACIFIC HWY Project: Russ Chevrolet Subdivision: Lot: 0 Project Description: Reconnecting freestanding sign using existing electrical. Contractor: YESCO LLC Owner: KNAUSS, WAYNE ET AL 20100 SW 112TH AVE C/0 HUMBERSTON, RUSSELL D TUALATIN, OR 97062 REVOCABLE TRUST PO BOX 4300 BEAVERTON, OR 97076 PHONE: 503 - 612 -6672 PHONE: FAX: 503 - 612 -0914 FEES Quantity Description Date Amount 1 ea Sign or Outline Lighting 11/09/2010 $67.84 Specifics: 1 ea 12% State Surcharge - 11/09/2010 $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 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 OAR 952- 001 -0090. You may ob .•• = • • of , e ru e • r direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. • Issued By: L — —. _ / 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 \ F ©R;OF IC E USE•.01 R .�r , . - •. �a.; si.t�►tre►7rsy�snla s City of Tigard \� � , 0� 0 Date /B d 1(J F'�r Permit No. � I 4 t ° 13125 SW Hall Blvd., Tigard, OR 97223 1 ,.. .,. V Other Permit Phone: 503.718.2439 Fax: 503.598.1960 N� ySa. Inspection Line: 503.639.4175 ��G' ` • eady /By : Juris: ® See Page 2 for T 1 G A R D Al • Notified/Meth Su lemental Information Internet: www.tigard-or.gov C 0 ©�1`' pp TYPE OF WORK PLAN REVIEW ❑ New constructionAddition /alteration /r placement 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 ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 ainps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling Gg 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 ", "E", "I - ", "1 - ", 1 Job no.: Job site address: i 1 b fro Sw Pty; ( _ Six or or more residential Recreational L W y ❑ Si or more residential units. ❑ vehicle parks. CitylState /ZIP: 7; q � Oe q a 3 ❑ Ha facilities. ❑ Supply voltage for more than J ❑ Hazardous za locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: R S C / ',if_ ❑ Service or feeder 600 amps or more. (/�?•�/►�� FEE SCHEDULE Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 Total 1 New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.92 1 Limited energy, residential 75.00 2 DESCRIPTION OF WORK • (with above sq. ft.) l { L 0 e Limited energy, multi - family 75.00 2 12.q (tee e x 1 1 S f t. e S T 4 Vxd . J t y residential (with above sq. ft.) ) 1 Services or feeders installation, alteration, and /or relocation W / M et..) v.S • ■ r t" IC St. I s cl e r ‘ Le I 200 amps or less 100.70 2 e' PROPERTY OWNER E TENANT 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 Name: 20QS 601 amps to 1,000 amps 301.04 . 2 Address: \ \in S IA ) P(..:1 r; , (. W Over 1,000 amps or volts 552.26 2 �/ Temporary services or feeders installation, alteration, and /or City/State /ZIP: 7 i `) , r d o c47 aL2 3 relocation Phone: (5153) 109 _ 11 14 f Fax: ( ) 200 amps or less 59.36 I 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, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with „a... APPLICANT 1 d al CONTACT PERSON above service or feeder fee, 7 42 2 each branch circuit Business name: Y E.SC v B. Fee for branch circuits without service or feeder fee, first 56.18 2 Contact name: ` �C pP 1 a ‘4 to S branch circuit Each add' I branch circuit 7.42 2 Address: `2„,0 1 00 Std 1 1 a * 1 J r • Nliscellaneous (service or feeder not included) City/State/ZIP: T�Q.1 }; r 0 2 -I 7 Q (�- Each manufactured se and/or or r modular 67.84 2 ty dwelling, service and/or feeder Phone: (S 1 O / Reconnect only 67.84 2 ) ( _ ( — 7 � Fax:: ( Sd3 >l�� � U 1 , Pump or irrigation circle 67.84 2 A E - mail: t Y 1Lt hS L� yes GO,CbY Sign or outline lighting l 67.84 0 yy 2 (� CONTRACTOR Signal circuit(s) or limited - energy J r /�• //�� panel, alteration, or extension. Page 2 2 Business name: 7 E�W Each additional inspection over allowable in any of the above Address: 'L(7100 S vJ 1(9- t ti A v e • Additional inspection (1 hr min) 66.25/ hr /� r Investigation (1 hr min) 66.25/ hr City/State /ZIP: MARIA -V I n I vit, q 1 D l! a- Industrial plant (1 hr min) 78.18 / hr Phone: (5o3)(, d '1 ., (i tp 7 2, Fax: ( 50)&12 -017g Inspections for which no fee is 90.00/ hr specifically listed (%z hr min) CCB Lic.: Igo is' Electrical Lic : 37.5/t„I.S uprv. Lic.: 7, / G ELECTRICAL PERMIT FEES • Suprv. Electrician signature, required: Subtotal: (4)/ . Tel _ / Plan review (25% of permit fee): ir Print name: Fac - ' Date: 1 d - State surcharge (12% of permit fee): T.14 t %� 1 ,. TOTAL PERMIT FEE: 1 S t 9? Authorized signature: , This permit application expires if a permit is not obtained within 180 Print name: S '11 1 days after it has been accepted as complete. Q f f [ t r �i 1 Date: I pp ` Number of inspections allowed per permit. I: \Building'Permits\ELC- PermitApp.doc 07/01/10 440- 4615T(11 /05 /COM/WEB