Permit (9) CITY OF TIGARD ELECTRICAL PERMIT
' COMMUNITY DEVELOPMENT Permit #: ELC2011 -00581
[GARD 13125 SW Hall Blvd , Tigard OR 97223 503.718 2439 Date Issued: 10/19/2011
-F
Parcel: 2S115AB01900
Jurisdiction: Tigard
Site address: 16200 SW PACIFIC HWY G1
Project: Cardsmart Subdivision: 1994 -028 PARTITION PLAT Lot: 2
Project Description: Sign lighting for (1) wall sign
Contractor: SECURITY SIGNS INC Owner: SN PROPERTIES PARTNERSHIP
2424 SE HOLGATE BLVD 1121 SW SALMON ST
PORTLAND, OR 97202 PORTLAND, OR 97205
PHONE 503 - 546 -7114 PHONE:
FAX: 503 - 230 -1861
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 10/19/2011 $67.84
Specifics:
1 ea 12% State Surcharge - 10/19/2011 $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 0 52- 001 -0090 You may obta4 - - e rules or direct questions to OUNC by calling 503 232 1987 or 1 800 332 2344
s
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 RECEIvrr im roit oI'FICE USE ONLY .
14 Received
City of Tigard 0 r T e_ o 1 1 Dateiv / : t o/ Elam' Permit No.. j 1//.�Q 5
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review LLII
C Other Permit:
P 503.639.4171 Fax: 503.598.1960 !r Date/B : , i . I I r //
T I G A R D Inspection Lin 503.639.4175 pi A I\ I p, I ' l 1 FI G A R Q Date Ready/By: Just !a See Page 2 for
Internet: www.tigard- or.gov a . t \ - , : : f ` r t f o rk i r - R 1! , Notified/Method 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 ❑ Marinas and boatyards.
'..' - !, "l" '' fia'` ,
°: exceeds 10000 amps at 150 volts or ❑ Floating buildings
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°�.��*i�� ,'aa. , , ?-6 , Ae 41 = 4, _.w , .„, ..,, 2., .. .. ,.,e W ., - , ..„ ., .. -., _ ., ?, , 1 , .:,..' . „k r.,.;1.° 1:.kv : less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family 0 Master builder 0 Other:
❑ Fire pump. ❑ Installation of 75 KVA or
` ❑ Emergency system. .. larger separately derived system
f, 11 04' :, .;0 't. JOB + INFORM z ATION i1ND O A
, _ C TIO , IV . , �f •_ , , , . , 0 of new motor load of
_' �ty,�rv,�R �n � ! 1 M •;n;,_�8�„ - : _ --.. -� ., . . , x , . , . -..r "• , _ ,� , : . , , .., � ' n _ `�,a 4t . � ,• ❑ ••A ••E , •l _2 •' 1 -3°
Job no.: Job site address: ( rn7�o / Il � ......6. 0 1 . 4 .. looHP or more. occupancy.
I W S ON�� ct ❑ Six or more residential units ❑ Recreational vehicle parks.
City /State /ZIP: CI 1 11 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Project name: Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.:
$ �y r ❑ Service or feeder 600 amps or more.
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d (�l "'' :+ P ",;� la� '� - ?`".. F-,!EJSCHEDULE " a T;' p L �� 4`T"k„?,y`:; g.; °%
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
- Ea. add'1500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
.. t= a °� ", „r - „ a. , , s •K'.;ik. -• >p + e, y ,:...r. , 67.84 2
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' ,���_:�� �.,,i. ; r�^ �- DESC ,�`�WORI�..� „_��':» �s.�°�;' °s� „, trrL�=:�� ; (with above sq. f
w, ,,; ;• •.. .. +, r. u,: ..,• t Limited energy, multi- family
(('t u i �j residential (with above sq. ft.) 67.84 2
l l Services or feeders installation, alteration, and/or relocation
*Mount Only* 200 amps or less 100.70 2
'.0 , n , ®'x E ; ;' . '1 • rr° h : ' Vi a. :' ,,, r „ a, 1. z 201 am s to 400 am
: ��{,. , I'R ,- � I'� � �) ���- � 'M1`
� ;<':,+ �:: k ,,;�y � ; � s 133.56 2
P P
401 amps to 600 amps 200.34 2
Name:
, 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City /State/ZIP: relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
r Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
c *,7
:, '''' -:- Q n, t :*''41 .- ; ; , er , r;': above service or feeder fee
x, ''' - ;�tAEPLICAA 1 .. i. lt 6a :2�sry F " . D;,CONT? PERS,OIV w . ••. ^' 7A2 2
1 " , .,,h ::, .Q _ e ,.. J "q ' . . . . . - -. , �. , , r •' .., - • each branch circuit
Business name: Security Signs B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: Melissa Hayden branch circuit
Each add'l branch circuit 7.42 2
Address: 2424 SE Holgate Blvd Miscellaneous (service or feeder not included)
City/State/ZIP: Portland, OR 97202
Each manufactured and/or d/ r feeler 67.84 2
Y � dwelling, service and/or feeder
Phone: (503) 546.7114 Fax: : (503) 230.1861 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail: Melissa @SecuritySigns.com 2
t '' ' = t;.i :a' ` ^,�,� ; yr n . ., ^ F - - ,.. ; •;.,u - ,, .. Sign or outline lighting ' 67.84 7.
• ' "iwr V ;n'. µ': � ..�'w,X2 sx..' "S5'., ' +�"` " , r :_ ,; �.k i:P=. "''
:.>�t �a =s�:�, ,...,,r;� �_� r- � -�r.- . �:��`. .�P , •;, ^�).�� •.< , � ',' ��i „�."°r ��i,r:' >.�i"�',�� Signal circuit(s) or limited-energy
Business name: Security Signs panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 2424 SE Holgate Blvd Additional inspection (1 hr min) 66.25/ hr
City /State /ZIP: Portland, OR 97202 Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 546.7114 Fax: (503) 230.1861 . Inspections for which no fee is
specifically listed ('/s hr min) 90.00 / hr
CCB Lic.: 122809 Electrical Lic.: 26560CLS a Lic.: 383SIG l� '"°` (a,ELECTRICAt,'M!PERNIIT FEES: w z"< '°-tF°
Subtotal: (t 1. VC
Suprv. Electrician signature, required: .
Pl review (25% of permit fee): r----
Print name: Marc Linguist Date: State surcharge (12% of permit fee): q • !y
TOTAL PERMIT FEE: '75 . ?g.
Authorized signature: This permit application expires if a permit is not obtained within 180
Print name: Melissa Hay n Date: days after it has been accepted as complete.
Y N um be r of inspections allowed per permit.
I' Buildmg'Permns\ELC- PermiApp doc 10/01/09 440- 4615T(11/05 /COM/WEB