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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2011 -00287 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/26/2011 Parcel: 2S102AB05300 Jurisdiction: Tigard Site address: 9169 SW BURNHAM ST Project: Tigard Vision Center Subdivision: KINGSTON Lot: PT 1 & \ Project Description: Sign lighting for (1) monument sign. Contractor: MEYER SIGN CO OF OREGON Owner: JB OAK HILL LIMITED PARTNERSHIP 15205 SW 74TH AVE 9169 SW BURNHAM TIGARD, OR 97224 TIGARD, OR 97223 PHONE: 503 - 620 - 8200 PHONE: FAX: 503 - 620 -7074 FEES Quantity Description Date Amount 1 ea Sign or Outline Lighting 05/26/2011 $67.84 Specifics: 1 ea 12% State Surcharge - 05/26/2011 $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- 001 -0010 through OAR 952- 001 -0090. You ma obtain a copy oft - ules or direct questions to OUNC by calling 503.23 1987 or 1.800. 2.2344. / Issued By: 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 OFFICE USE ONLY City of Tigard Received `J g � DateB ‘111111" : • // Permit No.: l ` 7 a ...c 13125 SW Hall Blvd., Tigard, OR 97223 ( • • Plan Review : , ' ' Phone: 503.718.2439 Fax: 503.598.19 (�,! t� (AN Date/B : Other Permit: . ' d GAR D Inspection Line: 503.639.4175 �� c 1. Date Ready/By: Juris: El See Page 2 for Internet: www.tigard- or.gov h` eotified/Method 7-..e‘ mental Information ,.k .x..o , "..� :...,:..x .. y .> .>tE ,::�.�,', „ ^x. •'. S e` �x .' >i ' : �.5.� F3 f`,x= a _ .. .,.�,- ,..;,.< .� \. 3 „ ., a ��,: �ae.,zl.�°' �•�:�w. `a�•.*�.' :� ^.'=�`< ``x �,� s:x,rz. °� ;:�..�. ] New construction ❑ Addition/alteration /replcLn 1� V Please check all that apply (submit 2 sets of plans w /items checked below): �,`` CI Service or feeder 400 amps or more 0 Building over three stories. ] Demolition '6ther: .. t� where CI Marinas and boatyards. tl ',' here the available fault current "' • slit' "` " avA ' _ _ 'V ','M ': exceeds 10,000 amps at 150 volts or Floating buildings. , _;r,,-- ,. , G,,, aE ,, ,, s COI S: iA, M ' N : ' t : " Vii: < - s•�� -� = � -''�^ �" ' " less to ground, or exceeds 14,000 13 Commercial-use agricultural ] 1- and 2- family dwelling [r Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ] Multi- family ❑ Master builder ❑ Other: Fire pump. 0 Installation of 75 KVA or ,, ❑ Emergency system larger separately derived system. , e =i '17.4: ' 5,,`:4,,m ,, : , 1 11[A :"['Tf1Nt, ND QCA . , „, - �. 1 3 „ %:���::�� %fir " ..bF ' >.:,�.. .,rs.���x ., '�� >� <::.;_. � rte. ° ;� .. ,.,?� �r. "�:��"„�; �'�i:•.�:,: ❑ Addition of new motor loa o ❑ 100HP or more. occupancy. ob no.: Job site address: I (c� S 3 {� ❑ Six or more residential units. ❑ Recreational vehicle parks. '3 El Health-care facilities. CI Supply voltage for more than :sty /State /ZIP: 1 l� O .9 1 7ZZ ❑ Hazardous locations. 600 volts nominal. tuite/bldg. /apt. no.: Project name: I " ❑ Service or feeder 600 amps or more. :ross street/directions to job site: Description II Q I F � I Total New residential single- or multi - family: dwelling unit. Includes attached garage. . subdivision: Lot no.: 1,000 sq. ft. or less 168,54 4 Ea. add'I 500 sq. ft. or portion '33.92 1 Fax map /parcel no.: Limited energy, residential r�; "'� ?: ''' ''`° �»; . " >a`..�_ - <...:.. -:;r.� .e..�- ate ;��3`^i,�i n`� l,, ,","s +'idi��*3`,?�, 75.00 2 „DS2I `E'1"CUN t0' : ,:';.:•:, .', .. ..s °- 1 ; ..,, (with above sq. ft.) . h" n :.. ,r - ., \\_.,...,:. ,:- a.:�.- Limited energy, multi- family .-T11-1A---- ( l) (' (�(.C.I \ l t /LicLT/� ' residential (with above sq. ft.) 75.00 2 ��� /' // r_ S � '(�' Services or e ers installation; alteration, relocation \ ery or e m a on, an or 200 a r less 100 70 2 .r �> t4T "`" �' ""�`�z ` " +'"" -'� ` *� s ;s ,:z 201 amps to 400 am 1 33.56 2 ; . ,: ,_,, . : P'..,,., Ia+ I Gi' t3 , * t< : OEV iVi , 3 `I 1 NAN ., : ?: i k.,v P P 401 amps to 600 amps 200.34 2 Vame: --1-1 ,, A (3r - t � l S t 0 ,v t�' �Yv 2- 601 amps to 1,000 amps 301.04 2 Address: CI (( 5' S ( LA . t , -,A_L-\.a ✓Y) Over 1,000 amps or volts 552.26 2 i /State /ZIP: 1 0 72.23 Temporary services or feeders installation, alteration, and /or 1 I C relocation • Phone: ( iS3) y-oS- ( ( Q Fax: ( ) 200 amps or less 59.36 1 201 amps to 400 amps 125.08 2 )wner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2 ntended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - new, alteration, or extension, per panel owner signature: f j4 Date: A. Fee for branch circuits with e . ' � *'- ` ` <,_ -' n >z ,° above service or feeder fee M "'` �_ ,7 ,, a' * =a1> T; > , S RS ; 7.42 2 �->, , e,��,...�,.�. n��s�m�.^ ,. , ....w ��_. a .. �� �.�..,. ,.>„ «� er, ...� _M . "_ u__y e " .. � - h r:0 each branch circuit 3usiness name: ,� �. s•l ` CO B. Fee for branch circuits without ii. !' ( .e — I _r service or feeder fee, first 56.18 2 :ontact name: *Ct, it_e_AA___ S ark a v1 branch circuit Each add'I branch circuit 7.42 2 Address: i S - 2 - 0 s ' S60 '7 1 l o ^ . -- Miscellaneous (service or feeder not included) :sty/State /ZIP: ci 7 Z Each manufactured or modular 67 2 T; �� lZ� C71Z, ' l dwelling, service and/or feeder 'hone: (S13 ) ( 0 - 2 , c , 8 p Fax:: (S63) (, — 7 6 --- (-I- Reconnect only - 67.84 2 :mail: (/V . Q2. ✓L --�,•. ne V-V 1 �� S'\ V( _ C-6 1"1.-- — Pump or irrigation circle 67.84 2 ~ .,. ti : F<y y , ;,. .' a? `," : rw 1•: r` w;V '': , Sign or outline lighting j 67.84 � -) ,V-/ 2 :At* , . >..,. .�t.... .$ w t ; �` iii 12 l l yl <_ , .1� ..a . 0 ft ° ea ,�.., ;.kex > Signal circuits) or limited- energy 3usiness name: ,p e ,� ( t vl panel, alteration, or extension. Page 2 2 .e „,, t i Each additional inspection over allowable in any of the above Address: ' 1 S o 5 Sly L f " Additional inspection (1 hr min) 66.25/ hr I Investigation (1 hr min) 66.25/ hr :sty/State /ZIP: i C ez ©� 9 -7 2----51 Industrial plant (1 hr min) 78.18/ hr Phone: (933 ) 6 0 Fax: (5?- (`p , 7 67 y. Inspections for which no fee is 90.00/ hr specifically listed (%z hr min) CCB Lic,. L(O( l{ Electrical Lic. — oaf._ Suprv. Lic,: L : - L TRt' topR ".ww - ' ,`„>•.'>; ng Su p 9 uire rv. Electrician signature, re " ' Subtotal: • (A'j, !'. Plan review (25% of permit fee): � � r Print name: e � . ' \ n , L Date: S � J , State surcharge (12% of permit fee): g ; i z1 Authorized signature: , y ` / "� J '/ TOTAL PERMIT FEE: �c� G This permit application expires if a permit is not obtained within 180 / days after it has been accepted as complete. Print name: vLdUk_. R.AkuLat in Date: "57 l t • Number of inspections allowed per permit. \ 'E Building PermitsLC- PermitApp.doc 07/01/10 440- 4615T(11/05 /COM/WEB