Permit 7 CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00028
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/11/2011
Parcel: 1 S126CA01100
Jurisdiction: Tigard
Site address: 9009 SW HALL BLVD 100
Project: Target Subdivision: Lot: 0
Project Description: Sign lighting.
Contractor: VANCOUVER SIGN COMPANY INC Owner: DAYTON HUDSON CORPORATION
2600 NE ANDERSEN RD #50 BY TARGET CORP T -0345
VANCOUVER, WA 98661 PROPERTY TAX DEPT/TPN -0950
PO BOX 9456
MINNEAPOLIS, MN 55440
PHONE: 360 693 - 4773 PHONE:
FAX: 360 - 693 -2747
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 01/11/2011 $67.84
Specifics:
1 ea 12% State Surcharge - 01/11/2011 $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 rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -0D1 -0010 through OA 952- 001 -0090. You rp.ey..obta'• - •py or direct questions to OUNC by calling 503.23 r7 or 1.800.332.2 -.
Issued By: v ! Permittee Signature: J —/
/� r r i'
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 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.
S n/9-o 1 — v ) 1 •
Electrical Permit Application � � ' , FOR OFFICE USE ONLY .
City of Tigard f' i. ` 1 Received
f'ns , a u I b- „ Date /B : I it Permit No.: ` rr
13125 SW Hall Blvd., Tigard, OR 97223 _ — it g 7` a Pl R ev i ew •
\
' Phone: 503.639.4171 Fax: 503.598A60:''`' 1 0 Date /By: Other Permit:
TI CARD Inspection Line: 503.639.4175 `PN S Date Ready /By: .luris: ® See Page 2 for
Internet: www.tigard or.gov J r , a o Notified/Method: 7 6p Supplemental Information
TYPE OF WORK S t j� L,d :t'` � �� �� r � PLAN REVIEW
V V' ' Please check all that apply (submit 2 sets of plans w /items checked below):
New construction El Addition/alteration / replacement
fd.' ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CA TEGORY 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 S,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 LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "1 -3 ",
i00HP or more. occupancy.
G
Job no.: Job site address: 100 c, 5 w Nat 1 ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: 1 ; ,(, r c'i Ov� ❑ Health -care facilities. ❑ Supply voltage for more than
0 Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 1Cx) P roject name: r �, f , ed-t 0 Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. 1 Fee. I Total I *
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.92
Limited energy, residential
DESCRIP'T'ION OF WORK (with above sq. ft.) 67.84 2
o Limited energy, multi- family
l t / i 11 44,1 Y1.oure -Dl, /.....)cat S I C n l residential (with above sq. ft.) 67.84 2
l + - Services or feeders installation, alteration, and/or relocation
('
(1A' - 0 (L P. A °AV �'� I O / t /� J 200 amps or less 100.70 2
❑" PROPERTY OWNER a TENANT 201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
Ta'1'G( 9, ± 601 amps to 1,000 amps 301.04 2
Address: 1 0 5 (n ) Act( Over 1,000 amps or volts 552.26 2
. Temporary services or feeders installation, alteration, and/or
City /State /ZIP:
t iy,t fei i 0 R relocation
Phone: ( ) J Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I 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
A APPLICANT 71 CONTACT PERSON above service or feeder fee,
7.42 2
each branch circuit
Business name: Vaft 4o � J & - 5 i J V/ B. Fee for branch circuits
J for r�'1 without service or feeder fee,
Contact name: R, II
W 5 /� first branch circuit 56.18 2
Address: Z (D O O NE !1 rirlf eti Act - . 5 v Ea ch add'I branch circuit 7.42 2
/� '' -- ,�� Miscellaneous (service or feeder not included)
City /State /Zip: !'LGD
vQl(.l .V ec lit \\ Vet �
�6(.; f Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: (36,0) (0 y773 Fax:: (36 0 2) 4 2 Reconnect only 67.84 2
E - mail: 'f ei( e \J ✓'.5/ v (_,o corn Pump or irrigation circle 67.84 2
CON CTOR Sign or outline lighting 6 ) 67.84 ( ' Q '], 2
Business name: G0I�l�1P, V S 'n� energy panel, alteration, e r t mi, or
/� 1 `'` `/l energy panel, alteration, or
Address: zGoo NE A „Axe RL, 5U extension. Describe: Page 2 2
City /State /ZIP: \Ad n,G0lA v e Jo WA '3,566 I Each additional inspection over allowable in any of the above
( Per inspection 66.25
Phone: (360) 693 .L 77 7J Fax: ( 3 60 ) 61 a7 `1 investigation per hour (1 hr min) 66.25
CCB Lic.: (Q 3C' 5 ) Electrical Lic.: 37_ Ls Suprv. Lic.: �j/j/ �1� Industrial plant per hour 78.18
�� 77 ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: t 0 I h/ I
Subtotal: 6 7,,
— Plan review (25% of permit fee):
kW
Print name: WfrL a f Date: l.- j , State surcharge (12% of permit fee): $' , y
Authorized signature: t --- TOTAL PERMIT FEE: -- 5 , CI y
V This � / Z Q permit application expires if a permit is not obtained within 180
Print name: e f 5 .� , r ,1CY1 Date: l / ,(p days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\ Building Permits \ELC- I'crmitApp.doc 10/01/09 440- 46I5T(II /05 /COM /WEB