Permit ; f q � t . p<;;:';','L CITY OF TIGARD
ELECTRICAL PERMIT
: ;: ° . COMMUNITY DEVELOPMENT Permit #: ELC2010 -00368
. Date Issued: 07/23/2010 ty
T I GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 1 S 133AD16200
Jurisdiction: Tigard
Site address: 12700 SW NORTH DAKOTA ST 100
Subdivision: Lot: 0
Project: Pasta Pronto
Project Description: (1) sign lighting
Owner: FEES
PACIFIC CREST PARTNERS SCHOLLS L Quantity Description Date Amount
1430 EASTSIDE RD
HOOD RIVER, OR 97031 1 ea Sign or Outline Lighting 07/23/2010 $67.84
PHONE: 1 ea 12% State Surcharge - 07/23/2010 $8.14
Electrical
Contractor:
TUBE ART SIGNS & SPORTS DISPLAYS
4243 -A SE INTERNATIONAL WAY
MILWAUKIE, OR 97222
PHONE: 503 - 653 -1133
FAX: 503- 659 -9191
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. Spec' 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 issuance, or if • ' suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notifi tion Center. • r rules are set forth in OAR
952- 001 -0010 through OAR 952 - 001 -0100. You m- • • • -,�y1 fir direct questions to OUNC by calling 50 2 .6699 • : r ' .2344.
Issued By: I . _ %�— Permittee Signature: t/
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 ,�� P 3 L. 6 . Ol I IaH JSL i ` w' °r .1z ;
City of Tigard (-:)\.\\,• O Received ^ / �/ • Pennit No
11111 / ® ' P�aO /O —(90264,17 �� Date/By: /3i
v 13125 SW Hall Blvd., Tigard, OR 972 ( Plan Review
1 ;, ;.. Phone: 503.639.4171 Fax: 503.59 Q �- O Date/By: Other Permit N�/►i0 - -eV/A"
' Inspection Line: 503.639.4175 4 Date Ready /By: Juri ® Se ee e Page 2 for
IIGARI� \\ ��^^--� O I ��i
:.r Internet: www.tigard- or.gov \�. J' - ' �� .cw : `S` N ) L lS Supplemental Information
TYPE OF WORK .S41' 4 . ) . PLAN REVIEW .
® New construction ❑ Addition /alteration / ient P lease check all that apply (submit 2 sets of plans w /items checked below):
❑ Demolition ® Other: SIGN V
�y < ❑ Service or feeder 400 amps or more ❑ Building over three stories.
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 E 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, ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "I 2 ", "I - ",
•
100HP or more. occupancy.
Job no.: 114702/1 Job site address: 12700 SW N. Dakota St. ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: 100 Project name: Pasta Pronto! ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: SW Corner of N. Dakota St. and the Description 1 Qty. 1 Fee. 1 Total 1 •
New residential single- or multi - family dwelling unit.
210 Hwy. Includes attached garage.
Subdivision: 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
Connection for (1) internally illuminated Wall Sign for Pasta Pronto. residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER ® TENANT 201 amps to 400 amps 133.56 2
Name: Pasta Pronto 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: 2467 NW 185 Ave. Over 1,000 amps or volts 552.26 2
City /State /ZIP: Hillsboro, OR 97124 Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that 1 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
® APPLICANT ® CONTACT PERSON above service or feeder fee,
7.42 2
each branch circuit
Business name: Tube Art Group B. Fee for branch circuits
Contact name: Rigel Aldridge without service or feeder fee, 56.18 2
g g first branch circuit
Address: 4243 -A SE International Way Each add'I branch circuit 7.42 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Milwaukie, OR 97222 Each manufactured or modular 67.84 2
dwelling, service and /or feeder
Phone: (503) 653 -1133 Fax: : (503) 659 -9191 Reconnect only 67.84 2
E -mail: raldridge@tubeart.com Pump or irrigation circle 67.84 2
CONTRACTOR • Sign or outline lighting 1 67.84 67.84 2
Signal circuit(s) or limited -
Business name: Tube Art Group
energy panel, alteration, or
Address: 4243 -A SE International Way extension. Describe: Page 2 2
City /State /ZIP: Milwaukie, OR 97222 Each additional inspection over allowable in any of the above
Per inspection 66.25
V CB Phone: (503) 653 -1133 Fax: (503) 659 -9191 Investigation per hour (1 hr min) 66.25
Lic.: 70956 Electrical Lic.: 37554CLS Suprv. Lic.: 366SIG Industrial plant per hour 78.18
ELECTRICAL PERMIT FEES:
Suprv. Electrician signature, required: t Subtotal: (0 7r ff [ '
Print name: Ken Schultz Date: 7/1/10 Plan review (25% of permit fee):
1 State surcharge (12% of permit fee): Le , / /
G
Authorized signature' y j - TOTAL PERMIT FEE: � / O
Print name: Rigel Aldri t ge / Date: 7 /1 /10 This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
• Number of inspections allowed per permit.
I: \ Building \Permits\ELC- Permit.4pp.doc 10/01/09 440- 4615T( I I /05 /COM/WEB