Permit iii CITY OF TIGARD ELECTRICAL PERMIT
II • .- COMMUNITY DEVELOPMENT Permit #: ELC2011 -00054
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/27/2011
Parcel: 1S135BB00500
Jurisdiction: Tigard
Site address: 10355 SW CASCADE AVE
Project: Fisherman's Marine & Outdoor Subdivision: Lot: 0
Project Description: Sign lighting.
Contractor: SECURITY SIGNS INC Owner: RAM /CASCADE CENTER LLC
2424 SE HOLGATE BLVD BY ELLIOTT ASSOCIATES INC
PORTLAND, OR 97202 901 NE GLISAN ST
PORTLAND, OR 97232
PHONE: 503 - 546 -7114 PHONE:
FAX: 503 - 230 -1861
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 01/27/2011 $67.84
Specifics:
1 ea 12% State Surcharge - 01/27/2011 $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 apprcable 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 i ,- _ • - • : ••• - the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Cent - rules are set forth in c • R
952 - 001 -0010 through 952 - 001 -0090. You may obta' - • • •f the es or dt ct questions to OUNC by calling 503.232r 32.2344.
A. Issued By: — � __�f � -. 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 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.
Electrical Permit Application FoR oI'Flcl: USE ONLY
City of Tigard
REEiew d o if' Permit No.: j ( OS
D ': 13125 SW Hall Blvd., Tigard, OR 97223' � P Other Permit _ l J� C . Phone: 503.639.4171 Fax: 503.5981.1.960 is Date/B
Inspection Line: 503.639.4175 \ , � ' "' Date Ready/By: El See Page 2 for
T lG A R D Notified/Method: Su
Internet www trgazd or gov �A' ���1 Supplemental Information
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i. , �' 1.4 x . .a ? , TYPE! OF WORK ,, r '.: r, . � PLANi'REVIEW ; a
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❑ New construction ® Addition /alteration
r lace flee ment ' u -grri w Please check all that apply (submit 2 sets of plans w /items checked below):
� t"� �7 ❑
�!(�Service or feeder 400 amps or more ❑ Building over three stories.
p
❑ Demolition ❑ Other: ‘11_p n.a LJ where the available fault current ❑ Marinas and boatyards.
p ,, w ' x u } y , 4 r * ry irNv y r emv.fias a exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
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,y . .., 4:N, CAT OF 4 ,�F '0 :� 1„?rt tff ndi-, v .� ,.?...
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: ❑ Fire pump. ❑ Installation of 75 KVA or
, � i � .. ❑Emergency system larger separately derived system
, ? t iil i , r n r Tf ,, ij9B SITE INFORMATION ANJ) LOCATION r F lj; 1. t a � 7? {v. ❑ Addition of new motor load of
Job no.: I Job site address: ❑ "A" "E" "1 - 2" "1 - 3"
L OJ Q J �� / �Q/1 100HP or more. occupancy.
0 Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: +�� ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: , f I, • S ❑ Service or feeder 600 amps or more
� -R t „:., ,4 r� a � {,�iai S LE > .- r a x 9 . t
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'l 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential '
Z 4 - '
x a ,> ', hkj to ., I +eta , DESCRIPTION' OFt`WORg k „ 1. "„ z, { p s 4'`� " a ' `` i (with above sq. ft)
67.84 2
Limited energy, multi- family 67.84 2
L�n _ C d cSit ` residential (with above sq. ft.)
►dx1�� ` y� J ►rJ Services or feeders installation, alteration, and/or relocation
*Mount Only* 200 amps or less 100.70 2
N� ` ® PROPERTX1,OW '11,.9 k d t I , 1 t , ` ; ' ®` T " a s c , ,. ` 201 amps to 400 amps 133.56 2
+?fi. i ar , i i,,... , �.. ...tip a� z .,,
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: ( ) I 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 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
I Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
f T a y x .` i i ®APPLICANT Tya Pag I y lln 1 ` CONTACT PERSONS , :A ; above service or feeder fee, 7.42 2
each branch circuit
Business name: Security Signs B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: Melissa Hayden branch circuit
Each add'l branch circuit 7.42 2
Address: 2424 SE Holgate Blvd Miscellaneous (service or feeder not included)
City/State/ZIP: Portland, OR 97202 dwelling, manufactured and/or d/ r modular feeder 67.84 2
Y � dwelling, service and/or feeder
Phone: (503) 546.7114 I Fax: : (503) 230.1861 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E Melissa @SecuritySigns com
, i t rr � � i � E� , � Sign or outline lighting j 67.84 67 t � 2
r W . ,i';Iit « , ;,, t, ;: ;; . , �a _ ,' „CONTRAGI OR, F, "` ; , i, "t, „, `... „ 1.l .@ . �. V.',. .:4 Signal circuit(s) or limited- energy
Business name: Security Signs panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 2424 SE Holgate Blvd Additional inspection (1 hr min) 66.25/ hr
City/State/ZIP: Investigation (1 hr min) 66.25/ hr
ity / State/ZIP: Portland, OR 97202
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 546.7114 I Fax: (503) 230.1861 Inspections for which no fee is 90.00 / hr'.
specifically listed ('/ hr min)
CCB Lic.: 122809 I Electrical Lic.: 26560CLS I Suprv. Lic.: 383SIG z - ";' a y'alj aP ELECTRICAL PERMIT -0FEE ''s„R,g w+ '
Suprv. Electrician signature, required: Subtotal: 6 ,6-1
Plan review (25% of pemvt fee):
Print name: Marc Linguist (� I Date: State surcharge (12% of permit fee): . 8 -. . I if
TOTAL PERMIT FEE: 7s", C{'r
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Melissa Hay n Date: * Number of inspections allowed per permit.
I:\Building\Permits\ELC- PermitApp.doc 10/01/09 440- 4615T(11 /05 /COM/WEB