Permit A . " CITY OF TIGARD ELECTRICAL PERMIT
PERMIT
COMMUNITY DEVELOPMENT DATE ISSUED: #: E 11 / 08 00622
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135BD-01200
SITE ADDRESS: 09804 SW SHADY LN ZONING: C -G
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: ROVENTE PIZZA
Project Description: Sign installation.
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:
DONALD & CAROLYN FORBES ABLE SIGNS
DONALD & LINDA BURDICK 2007 SE POWELL
434 RIDGEWAY RD PORTLAND, OR 97202
LAKE OSWEGO, OR 97034
Phone: Contact #: PRI 503 - 232 -6430
FAX 503 - 235 -3530
FEES
Description Date Amount Reg #: ELE 26- 1119CLS
[ELPRMT] ELC Permit 11/5/2008 $53.40 LIC 134473
[TAX] 12% State Surchar 11/5/2008 $6.41 SUP 676SIG
Total $59.81 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 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Ce ter. Those rules are set forth in
OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions UNC at 3 46.6699 or 1.800.332.2344.
Issued By: / � / / j ■�r`� �ermittee • Signature: — - - - \ c -
`��. WNER 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 (� F OIL OFFICE U SE O
" ' City of Tigard Received `)
, 1� ertnit No.:
DDate/B _,
IN q 13125 SW all Blvd., Tigard, OR 972 100 Plan Review
C Phone: 503.639.4171 Fax: 503.598.1960 �,\OV 0 Date/B : Other Permit: v
l' I G A R D Inspection Line: 503.639 \�► , , Date Ready /By: ® See Page 2 f
Internet: www.tigard- or.gov ( ('` �* O 1� otified/Method: �� ► Supplemental Information
OF WORI C ' Y J PLAN REVIEW
El New construction ❑ Addition/alteratlo �tr epp lacement Please check all that apply (submit 2 sets of plans w /items checked below):
r
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ® Other: Sign Installati where die 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 ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ® Other: Sign Install ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: 081041 Job site address: 9804 SW Shady Lane 1 or more. occupancy.
❑ Six x o or r 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.: Project name: Rovente Pizza ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Corner of SW Shady Ln & Greenberg Rd. 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 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family 75.00 2
Sign Installation residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER ® TENANT 201 amps to 400 amps 106.85 2
Name: Rovente Pizza 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 9804 SW Shady Lane Over 1,000 amps or volts 454.65 2
City /State/ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and/or
• relocation
Phone: (503)720 -0067 Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
A. Fee for branch circuits with
® APPLICANT ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: Able Signs B. Fee for branch circuits
Contact name: Dave Lanphere without service or feeder fee 46.85 2
first branch circuit
Address: 2007 SE Powell Blvd. Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State/ZIP: Portland, OR 97202 Each manufactured or modular 90.90 2
dwelling, (503) 232 - 6430 Fax: : (503) 235 - 3530 Recon nect t only ye and/or feeder
Reconnect 66.85 2
E - mail: dave @ablesigns.com Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 1 53.40 53.40 2
Signal circuit(s) or limited -
Business name: Able Signs energy panel, alteration, or
Address: 2007 SE Powell Blvd extension. Describe: Page 2 2
City /State/ZIP: Portland, OR 97202 Each additional inspection over allowable in any of the above
Per Phone: (503) 232 -6430 Fax: (503) 235 -3530 Investigation 62.50
nvestigation per hour (1 hr min) 62.50
CCB Lic.: 134473 Electrical Lic.: ( 1 %ICI CLS Suprv. Lic.: 676SIG Industrial plant per hour 73.75 _
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required:i< Subtotal: 53.40
Print name: David Demuth Date: 11 -04 -2008
Plan review (25% of permit fee):
State surcharge (12% of permit fee): 6.41
Authorized signature: TOTAL PERMIT FEE: 59.81
This permit application expires if a permit is not obtained within 180
Print name: David Demuth Date: 11 -04 -2008 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\ Building \Permits\ELC- PermitApp.doc 05 /23/06 440- 4615T(I1 /05 /COMTWEB
f e '
CITY OF TIGARD
BUILDING DIVISION PERMIT #: EL.C;2008.00622
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: -i i/59200t)
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ' L L
INSPECTION WORKSHEET FOR DATE: 12/4/2008 TIME: 7:00AM PAGE: 20
SITE ADDRESS: 09804 SW SHADY LN CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: ROVENTE PIZZA
DESCRIPTION: Sign installation.
OWNER: FORIBES, DONALD 8, CAROLYN PHONE #:
CONTRACTOR: ABLE SIGNS PHONE #: £03 232 - f.130
Inspection Request Scheduled For: Date: 12/4/2008 Pour Time:
Code # Inspection Description ,Confirm # Contact # Message
140 Sign installation 503 -317 -6663
i ON `V l3E' .
Corrections /Comments /Instructions:
R a N ®E 4� comas itt\ jr ctl.f LQL
A
• 0%14 ik A 1 2,• 01
•
n PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL KCALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: t oV 66 L1 Date:4 4'4 Phone #: (503) 718- 2-8140-