Permit 'CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00217
` COMMUNITY DEVELOPMENT
DATE ISSUED: 4/9/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S110DC -02200
SITE ADDRESS: 15660 SW PACIFIC HWY A -3 ZONING: C -G
SUBDIVISION: TIGARD PROMENADE LOT : 011 JURISDICTION: TIG
PROJECT: AFFORDABLE GRANITE
Project Description: Sign lighting for wall sign.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: 1
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
TIGARD CENTER GRAPHIC D'SIGN LLC
9777 WILSHIRE BLVD #609 2255 SE 122ND. AVE.
BEVERLY HILLS, CA 90212 PORTLAND, OR 97233
Phone: Contact #: PRI 503- 256 -2064
FEES
Description Date Amount Reg #: ELE 26- 1235CLS
[ELPRMT] ELC Permit 4/9/2007 $53.40 LIC 154462
[TAX] 8% State Surcharge 4/9/2007 $4.27
Total $57.67 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than ays. ATTENTIO Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 9 - 001 -0010 through 0 . 95 - -0100. You may obtain copies of these rules or direct questions t OUNC at 03.246.6699 1.800.332.2344. .
Issu d By: / ' OUNLALPU Permittee Signature: A A Ail 'V
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'N: 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 C "Iv .4 54
rein C1FFIt•R ItSI ONLY
City of Tigard Received
13125 SW Hall Blvd., Tigard, OR 97223
i �
Date /B : 9 d Permit No. , L7 - ��7
Phone: 503.639.4171 Fax: 5 ;; .: , .t;, , Plan Review
Inspection Line: 503.639.4175 �i� Date /By: Other Permit:
Internet: www.ci.tigard.or.us „4.,1)111,-":11„„ Date Ready/By: '
Notiti / n ® See Page 2 for
cd/Met So
( Supplemental Info
................ �ypy Jryt�}�....:: v::::::•:::.:v �.:::: ::4iii: }i;.i:4i+ } ii:i :.::.i:::�::i :;. ? ^:! ::::::::�:: ?:: ii. i:::!�:? : i:•i
............. P} : a/.1�lAl::::fiiiii '::.iii };'.iii::::.v: v::::.: v:......:.:v :.....:.....:::: i :•.:: . ....
.. .. ..::.. s.. :.: v::.:v:.::: :..v :v: ;:.i: }: ?. � iii : ?•:J: ii: :.::. i .::::.. ; _: iii ::•..::::: :; :;'; :: •.....: •.
.............. i. r.. . ?ii; /,.:!w:: ?J.S ?!�i': iii: i::::!Liiiii! <, ..:: r:::.v:.w:::::•:. :., .. » :: :::.. :�::. ... ....
........... \v:.:;v::v:::::, �::, ... ... .i :ii: iii:::.�::::v:::. ii9::�iY::�i:�:;.j;:;:;�
' .v: is iii: � is ii::.:::i: i::�i n . ,!:...; ..,� :...�
❑ New construction :.....:::. ,. >:::.:;::.;:;.:::;:.:.:.:.:! . �: �:.: �:.:.::.; �: ii�I: It1�VIE' �: ::: < >::: ><. >:;::,;:;.;.: ?.i:.;: ; ?::::.:.:;;:.
ction ❑ Addition/alteration/replacement Please check all that apply: ......... ..... '
❑Service over 225 amps, come! ❑Hazardous location
❑ Demolition ❑ Other:
i�:.;:.;i:.; >:<! ?.:;:.:.;: ?.: iii::<:< ::::::::::::::::.::< s•: �..:::..:..::.:.:. �: ::::;;;:..;•::.:;::;: x;;: r:;;•:: � i:.>:.;;:.:.:.;; :::•:::.: ::::::.:.............
:;;: ^:; :s<> >: >i;::::<; <::: >z:: :;.; >:;'. >.... ❑ Service over 3
...........::.,,::.,!:<:..: � % >�1i`: >;:,.. ....: ;.::.: ::> s::::; c s:>: 320 amps P g ❑ Bor more new oner residential
:»>:. f•> :::::: ?.:.:. .;::;::::: >::::> �:,:;.: :;:;:::;:::: >;:::;;::;:::;:;:: : of 1 -and 2- family dwellings 4 or in
0
1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ B
❑ Multi - family ❑ Master builder uildin over three stories ❑ Feeders, 400 amps or more
❑ Other: g
Occ
u
� tl
4 over
S
er 9
: SI�'>. '' Pan 99
.;.:::::. ::...,.,.. :•::::,•r .................:r tlA x.0 1:0 1 : ; • persons red structures or
• ............. . :.- n ufactu
Job no.: r ....... ...........:::..,.::::: :: ::: ?�� ......... ❑EgessAtghttng plan RV park
Job site address: 1 J c,ano A g i1 4 �_ ,>. ❑Health -care facility ❑Other:
City /State/ZIP: °� ' -7 tt J 1' zIw Submit 2 sets of plans with any of the above.
a f`7 `1 �r 4. The above are not applicable to temporary construction service.
Suite/bldg./apt. :... z .. .:...:.....:.. :......
no.: Project name: � :;;, > " -
. Cross street/directions to job site: 1 DesC1 I Qn I F'� I rural I ••
New residential single- or multi - fancily dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: E a. add'l 500 sq. R. or portion 33.40
Tax map/parcel no.:
1 Lot no.: 1
Limited
energy, residential 75.00 2
......... ........ :..:: ?.i;� ?? >:' »;: ?•:;:'.>:<::::;;;:•:I!" Limited energy, non -residential 75.00 2
C, � Each manufactured or modular
t Ur•f.,,�.i✓ (,,� J 4,t-- cm t � ,r-- L + dwelling service and/or feeder 90.90 2
+; .1.. f
‘ ! Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30
2
i1
1iti
7
::....;� .:::: ;: >»�' .;..:'.. ?•: 201
" : " ::: ";` ?:``'::` ?'`` "'`r` 400 am Ps ::: ;• ....:..
:,, . . amps to 40
... :.•:: :.......... �:: r?;_:• �:: �<•%:•:•: �.: �i ;: �> i£ .�::o.;:.: .::;:';;:.i:;::;;: P 106.85 2
Name: 4- C - 401 amps to 600 amps 160.
a 2
2
Address: 601 amps to 1,000 amps 240.60
97 60 /..„6#,F /1 f L -4- Coo ? Over 1,000 amps or volts 454.65 2
City /State/ZI / 2L` t L 1 t us ^ n ! Reconnect only 66.85 2
`( . ` f A Temporary services or feeders installation, alteration, and/or
Phone: ( ) I Fax: ( ) relocation
Owner installation: This installation is being made on property that I own which is not 200 amps or less 66.85 1
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 201 amps to 400 amp I 2
„f 401 amps to 600 amps 133.75 100.30 2
t ,,. D
B ranch circuits - -
Owner signature: S } f . :;:::.;::::::: ,alteration, or extensio
11'1?ii'IC' ate: per panel
. � I!('�Ik.,�f�)��Q0, , ; ,,.;;;, ,;, ? A. Fee fo bra etrewts w (th
Business name: serv or feeder fee, each
branch circuit 6.65 2
Contact name: B. Fee for branch circuits
without service or feeder fee,
Address: each branch circuit 46.85 2
City/State/ZIP: Each add'1 branch circuit 6.65 2
Miscellaneous (service or feeder not included)
Phone: ( ) I FaX:: ( ) Pump or irrigation circle ' 53.40
2
•Si
E
no ro
outline r
g ne lighting 53.40 7 '� 2
.... ....... . ...............
}... ': ,.. .
?:.. Signal curt(s) or limited-
GE► .
err
1y lr:
...... . .......... ::�•:::: r ii:;:;:•:>:> ;» :; » » ? » >:::<;�:::::: »:�» energy Panel, alteration, or
Business name: �A. t G D / L • Y LLC - extension. Describe: Page 2 2
Address: ' ' . `" fir sE, I 2:2 _,,, d Avg; ` - Each additional inspection over allowable in any of the above
Per inspection
City /State/Z1P: ()oar 6 c? 0 7 > 1 62.50
Phone: ( )
:1 Lr 3 Investigation per hour (I hr min) 62.50
�� Z --� Q 6 11 _ Fax: (s ) z ._...q173 industrial plant per hour 73.75
: <.
CCB
c.. r4. �{- El Ltc.: _ _ > :. >' : < : : : : : ::; :;: _:::::: : : :>r : *. f tic U . 4-k Subtotal 10$. > :::<:>;::::;>
�z L IL3sI Suprv. Lic.:I-ils 1
�( Subtotal 5 5, 1 7 1 6 Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print name: - MI Date: State surcharge (8% of permit fee) L I . 87
TOTAL PERMIT FEE '1,
Authorized signature.
tit/✓//����-�� "`` This permit application expires If a permit Is not obtained within 180
Print name: L.A. -r days after It has been accepted as complete
VA. -, H V /N 1 Date: 4-( 7 1 01 • Fee methodology set by Tri- County Building Industry Service Board
** Number of inspections per permit allowed.
HuildingPennits \ELC•PennitApp.doc 12/03 440-4615T(10/02/CUA1/WEH