Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00349
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/24/2011
Parcel: 1S135DD03301
Jurisdiction: Tigard
Site address: 1 1945 SW PACIFIC HWY 206
Project: Wells Wigs Subdivision:PARK PLACE GARDEN APARTMENTS Lot:
Project Description: Sign lighting.
Contractor: SECURITY SIGNS INC Owner: TIGARD PLAZA LLC
2424 SE HOLGATE BLVD 8320 NW HWY 99
PORTLAND, OR 97202 VANCOUVER, WA 98665
PHONE: 503 - 546 -7114 PHONE:
FAX: 503 - 230 -1861
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 06/24/2011 $67.84
Specifics:
1 ea 12% State Surcharge - 06/24/2011 $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 0- ` :52- 001 - 009 You ma • • _ - •py of the r es or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: �. ��d — Permittee Signature: 410, �� /. /. / ..
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.
66N yr 1- 0
Electrical Permit Application F012 OFFICE USE ONLY
III Received 14 c:133/1- City 1 31 5 S of Tig ,
Dates ; � � Permit No.: //
2W Hall Blvd. Tigard, OR 97223 Plan Review
C . Phone: 503.639.4171 Fax: 503.59:. ' 31 � DateB : Other Permit:
Inspection Line: 503.639.4175 1 No tified/Method. f I 1 Date Ready/By: T� ^s' El See Page 2 for
Internet: www tlgazd or g ov � � %'
T I G A Ii D , Supplemental Information
`` a pple
-ti . a�i .i AWAF;aI�E'�' a t - - „:n o r s X, i 1 ". ,! .A- ifeA - Rat d' '? R
,,q.� `(t ;fi ,W1.,� �ti e A�?u.4 TI'PE OF WOR_I�. ,. , „ „Y. .n ,. 1 «? ;' F,:, 'A ':: `'m ' iI P LAN itE W r 4, , ° .., a ;
❑ New construction ® Addition /alteration/ k i% '0 Please check all that apply (su 2 sets of plans w / items checked below):
1C ' ❑ Service or feeder 400 amps or more ❑ Building over three stories.
El Demolition El OtherQ where the available fault current ❑ Marinas and boatyards.
” 4311"1 ' j r � :, itr s 6 q jrgiCrI?�"rx *rf exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
z , i : A,1 " ,F CATEGORY OF,UCONS, .�� CTION tv, u-2tr , it 'At
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 yt � ❑ Emergency system larger separately derived system
`” J(OB SITE"�INFORMATIONANI) LOCAITON ' i p.
..,_ �,1( ,�. ;" . — A� ..... .. , , . .. u ,.- r v; . i ,,,,,, -u z wn ❑ Add of new motor load of ❑ .. ,. <. 2 „ .. 3 „
Job no.: Job site address: I 1914,_<- / c9 I or a more. occupancy.
❑
0 Six or or more residential units. Recreational vehicle parks.
City /State/ZIP: ❑ Health - care facilities. ❑ Supply voltage for more than
r� ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: /, ej ❑ Service or feeder 600 amps or more.
"`""""'`l�^^ co W Bn ' t t 5 t;LFEE5SCHE:Mg.I r W GA inge
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: 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
r,+n 6P t-� tY' ; n5 t zi x F -� r 67.84 2
I AR . ` tiR .` �_ EN9):7SC WOIt IV ' ,,,,. ,? 4-0,Ag'glika z (with above sq. ft)
Ul �� Limited energy, multi-family 67.84 2
residential (with above sq. ft)
Services or feeders installation, alteration, and/or relocation
*Mount Only* 200 amps or less 100.70 2
s 'rt , t 1PROPERTY� QWNER` i } I " ' "` t 2 ® TENANT y 201 amps to 400 amps 133.56 2
.. ..,. ,�f u W .°`��� .air.. ear. �5��,.a � 3._.x" �,,,�w _.a.�„ a�.��,�r
Name: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
Y relocation
Phone: ( ) 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
r Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
e , E: 2 CON TA above service or feeder fee,
f „ A T ° ® , APPLICANT t y r g d,,r v w o l 1: , ® . CT PERSON , ,; ,i each branch circuit 7.42 2
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)
Each Manufactured or City /State /ZIP: Portland, OR 97202 d welling, service and/orifeeder 67.84 2
Phone: (503) 546.7114 Fax: : (503) 230.1861 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E Melissa@SecuritySigns.com
�* e h � b � .!, ( -'t;; ...x to agw � � � a � `i Sign or outline lighting I 67.84 C '7 , �( 2
° Glia #�r.irkf .°,y ; g i ; s ; ' ECONTRACTOR�rI,�+ tit; _ 5 'fir a . i 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: Portland, OR 97202 Investigation (1 hr min) 66.25/ hr
Industrial plant (1 lir min) 78.18/ hr
Phone: (503) 546.7114 Fax: (503) 230.1861 Inspections for which no fee is 90.00/ hr
specifically listed (i hr min)
CCB Lic.: 122809 Electrical Lic.: 26560CLS Suprv. Lic.: 383SIG k''
Suprv. Electrician signature, required: Subtotal: 4, 7, VI
Plan review (25% of permit fee):
Print name: Marc Linguist Date: State surcharge (12% of permit fee): (1 PI
TOTAL PERMIT FEE: '757 q l e
Authorized signature: This permit application expires if a permit is not obtained within 180
Print name: Melissa Hay n Date: days after it has been accepted as complete.
Y N umber of inspections allowed per permit.
I:( Building \Permits\ELC- PermitApp.doc 10/01/09 440- 4615T(11/05 /COM/WEB