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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2020-00148 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03l30/2020 TIGARD g Parcel: 1 S136AD05901 Jurisdiction: Tigard Site address: 11455 SW PACIFIC HWY Project: Motel 6 Subdivision: None Lot: None Project Description: A new 24 sq.ft.internally illuminated wall sign on south elevation. Contractor: MEYER SIGN CO OF OREGON Owner: GOPAL LLC 15205 SW 74TH AVE 11455 SW PACIFIC HWY TIGARD, OR 97224 TIGARD, OR 97223 PHONE: 503-620-8200 PHONE: FAX: 503-620-7074 FEES Quantity Description Date Amount 1 ea Sign or Outline Lighting 03/12/2020 $67.84 Specifics: 1 ea 12%State Surcharge- 03/12/2020 $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 ules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 95 -0 . You obtain a o the rules or dire questions to OUNC by calling 503.232.1987 0 800.332.2344. Issued By: the 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 503.639.4176 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 ApplllcationRECEIVED FOR OFFICE USE ONLY City of Tigard Received // i • 13125 SW Hall Blvd.,Ti ard,OR 97223 ,1,el pp 7 t Dates ° l 'tee - 'L ► Phone: 503.718.2439 Fax: 503.598.1960 MAR 1 1 2020 Plan Review r Inspection Line: 503.639.4175 Ready DateBy: Ms: ® See Page 2 for `' i'l7 Internet: www.tigard-or.gov CITY OF TIGARD NolifiedlMelhod: Supplemental Information ■ s II • s xa,..,4 ?' 1YPE OF >: >: PLAN REVIEW 0 New construction lAddition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑Service or feeder 400 amps or more El Building over three stories. ID Demolition 0 Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION` „.. . exceeds 10,000 amps at 150 volts or 0 Floating buildings. E 1-and 2-family dwelling emu(Commercial/industrial ❑Accessory building less to ground or exceeds 14,000 0 Commercial-use agricultural amps ❑Multi-family E Master builder 0 Other: ❑Fine pumall other installations. 0Installation Fire for of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived T�� ❑Addition of new motor load of system T Job#: site address: 8455" �. 4C4 Fl 6 IU.1y I00HP or more. ❑"A""E""1 2" I-3" City/State/ZIP: /6,4114/ 0/L 97(7.01 i El or more residential units. occupancy. J'� Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: Project name: /► r 6 4. 0 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 Qtv. J Earl, I Total I 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'l 500 sq.ft.or portion 33.92 1 ' -;DESCRIPTION OF W RK Limited energy,residential G,,c).it)6 r //I t/I.4 './/7 // 0 in A/An-0 IX it 1.k. (with above sq.ft.) 7s.00 2 L1 �7, Limited energy,multi-family i r i is t 7 t Iif6, 'p L' r` 1.L-t T�t-+L a il.•, . residential(with above sq.ft.) 75.00 2 fir] timiii ElTENANTRenewable Energy 0 See Page 2 Services or feeders installation,alteration,and/or relocation Name: 0 JI/`.�. 200 amps or less 100.70 2 Address: //'i . id. ,-c c f iiik-1J 201 amps to 400 amps 133.56 2 City/State/ZIP: '6� i3O,L- 17J)3 / 401 amps to 600 amps 200.34 2 J 601 amps to 1,000 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:re Date: 401 amps to 599 amps 168.54 2 [ APPLICANT CONTACT PERSON Branch circuits-new,alteration,or extension,per panel A.Fee for branch circuits with Business name: /t, L.1/6 p./ d 1j/LF6Q� above service or feeder fee, �y7 C each branch circuit 7'42 2 Contact name: - d !/ / G A.>n i / B.Fee for branch circuits without Address: i 52 5— J �j l'Flu �-pr , bra i h or feeder fee,first 56.18 2 ,/ t /f r7—L branch circuit City/State/ZIP: 'mil (`/I nt 61L. 97)- Each add'l branch circuit 7.42 2 / (0,21/ Miscellaneous(service or feeder not included) Phone:( V) Z��I l' I Fax: :( ) Each manufactured or modular 67.84 2 Email: f t/N"'-I{'� in gi//EZ-i 1'a/a,J M dwelling,service and/or feeder 7 Reconnect only 67.84 2 , ,;,„,,v.,- 'I CONTRACTOR - Pump or irrigation circle 67.84 2 Business name: gig if_ 1/c,Al ci i e�C 1.,e , Sign or outline lighting At 67.84 47.41 2 52©5" J Ik-'. 7 l n ,,�. D See Page 2 2 g Signal circuit(s)or limited-energy Address: T- f{•(/ panel,alteration,or extension. City/State/ZIP: �i 1agA OIL 17d J--If Each additional inspection over allowable in any of the above 7 , Additional inspection(1 hr min) 66.25/hr Phone:(9!f�}}/) 23 L- ,�6�I Fax:( ) ,fir Investigation(1 hr min) 90.00/hr Email: � JLu.-(r,5 e /u.FclFC tf16,J 6.). ( 4M Industrial plant(1 hr min) 78.18/hr / �J `�,� Ar Inspections for which no fee is 90.00/hr CCB Lic.: I " !* Electrical Lie.: ./ Y Suprv.Lie.: 5/y - .../ 14 specifically listed('/z hr min) I{ ELECTRICAL PERMIT FEES '' Suprv.Electrician ig•a ' Subtotal: 6-7, Print name: /db te: 3/Q/)A ❑Plan Review Required(25%of permit fee): ••7 / HJ State surcharge(12a/o of permit fee): t�, (h Authorized sign • G 711 e _ TOTAL PERMIT FEE: 1 r,A7i /� /�•r ` This permit application expires if a permit is not obtained within 180 Print name: t.-r/1 /C L__ Date: 3 /g ZQ days after it has been accepted as complete. V" 440`-d'/6/ * Number of inspections allowed per permit. I:1Buading\Permits\ELC_PermilA ELR_ .doc Rev 06/17/2015 15T(Il/05/COM/WEB