Permit '.)i:
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CITY OF TIGARD
ELECTRICAL PERMIT
:7 = COMMUNITY DEVELOPMENT Permit #: ELC2010 -00106
T f GARj) 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/05/2010
„,,.,, , „ Parcel: 1S135BA00102
Jurisdiction: Tigard
Site address: 10124 SW Washington Square RD
Subdivision: Lot: 0
Project: FedEx Office
Project Description: Sign lighting to replace ELC2010- 00007.
Owner: FEES
PPR SQUARE TOO LLC Quantity Description Date Amount
BY THOMSON PROPERTY TAX SERVICES,
2235 FARADAY AVE STE #0 1 ea Sign or Outline Lighting 03/05/2010 $67.84
1 ea 12% State Surcharge - 03/05/2010 $8.14
PHONE: Electrical
Contractor:
RAMSAY SIGNS INC
9160 SE 74TH AVE
PORTLAND, OR 97206
PHONE: 503 - 777 -4555
FAX:
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. At work will
be done i cordance . 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. TENTION: Oregon • re• ires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -0 -0010 through OAR 9 01 -01 r You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
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Is ued By: _ / 1L:�:A _ ' I
a 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 an inspection that business day.
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 ' . ,.4 ; r`"it, I M USE � _ "; a ;
w' .., nr4..m.thrt* - it,+.*,, ,k r r a " .v+ fr40l !rmik l
Received
r , City of Tigard Date /B : Permit No.:
� q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
fi; y" ' tS-i Phone: 503.639.4171 Fax: 503.598.1960 Date /By: Other Permit:
'';fr't i Inspection Line: 503.639.4175 Date Ready /By: tuns ® See Page 2 for
`rd G grid Internet: www.tigard- or.gov Notified/Method: � /Q _ Supplemental Information
TYPE OF WORK PLAN rr REVIEW
K1 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.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling IS Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION" AND L O C A T I O N- °A °E ", °i -3", °1 -3 ",
El Addition of new motor load of
I00HP or more. occupancy.
Job no.: Job site address: .1 ❑ Recreational vehicle arks.
0%24 S.L. . � 1 {w��� ft 1 1 ❑ Si x or more residential units. p'
City /State/ZI ❑ Health -care facilities. ❑ Supply voltage for more than
1 l � I CI ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: c E6 El ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. 1 Fee. 1 Total 1 *
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: 1 Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
67.84 2
DESCRIPTION OF WORK . (with above sq. ft.)
Limited energy, multi- family 67.84 2
uA awl". t -fi � 0` S p residential (with above sq. ft.)
4a�.� v J Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
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
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
above service or feeder fee,
❑ APPLICANT 1 " ❑ CONTACT PERSON 7.42
each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: branch circuit
Each add'l branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67.84 2
Y dwelling, service and/or feeder
Phone: ( ) [ Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 ��/ 2
E - mail: Sign or outline lighting I 67.84 (' e. 2
CONTRryC l_OR Signal circuit(s) or limited- energy
Business name: R %i panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: ..t., ..t., t Additional inspection (1 hr min) 66.25/ hr
!� ` '7` Investigation (1 hr min) 66.25/ hr
City /State/ZIP:
,1c�0� ✓ t g ri tOka Industrial plant (1 hr min) 78.18/ hr
Phone: () 11 7 ... iiW s 1 Fax: () -777 . V) Inspections for which no fee is 90.00/ hr
specifically listed ('h hr min)
CCB Lic.: L 7 2 . Z Electrical Lic.: 24.1060$ Suprv. Lic.: &Masi ELECTRICAL PERMIT FEES S�
Suprv. Electrician signature, required: p �"L
Plan revie Subtotal: 101 (25% of per mit fee):
Print name: r / � I G t LA STt Date: 1 0 State surcharge (12% of permit fee): g 11169
TOTAL PERMIT FEE: 1`f53�
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: * Number of inspections allowed per permit.
I:\ Building \Pennits\ELC- PennitApp.doc 10/01/09 440- 4615T(1I /05 /COM /WEB