Permit r.
CITY OF TIGARD ELECTRICAL PERMIT
1:1 ".`''- COMMUNITY DEVELOPMENT Permit #: ELC2009 -00153
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/07/2009
Parcel: 2S115AB01800
Jurisdiction: Tigard
Site address: 11354 SW DURHAM RD
Subdivision: Lot: 0
Project: Chase
Project Description: Sign lighting.
Owner: FEES
SN PROPERTIES PARTNERSHIP Quantity Description Date Amount
1121 SW SALMON ST 3 ea Sign or Outline Lighting 04/07/2009 $160.20
PORTLAND, OR 97205 1 ea 12% State Surcharge - 04/07/2009 $19.22
PHONE:
Electrical
Contractor:
EDS SIGNS NORTHWEST
P.O. BOX 2376
WILSONVILLE, OR 97070
PHONE: 503 - 582 -9400
FAX:
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $179.42
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the
180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Cente Those rules .re set •rth in OAR
952- 001 -0010 thro h O � R 952 -OO1 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2 46.66 - •or 1.: '»:1,y:.- •- --- - - -• -- -
Issued By: � � .� /��� � ` �� Q .' 1�G� Permittee Signatur =. .‘",":: ✓ AC&
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent,
OWNER'S SIGNATURE: Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for an Inspection that business day.
This permit card shall be kept in a conspicuous place on the Job site until completion of the project.
Approved plans are required on the Job site at the time of each inspection.
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-Elettrical Permit Application ! 1 =- I I - '
. . . FOR OFFICE t_i$F. ONLV
City of Tigard APR — 7 2009 RD: c f e i B y e q , 0q k....7LL Permit No Cr3Q-C. go kS•3
q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 CITY OF TIGARD Date/By: Other Perinit:5 00077
Ins Line: 503.639.4175 Date Ready/By: Sufis „, ) El 'S ee Page 2 for
TI Ins
D BUILDING DIVISIO• 1 1 (-
. , . Internet: www.tigard Notified/Method: Supplemental Information
: -
- -.
, . ._,. PLAN REVIEW
New construction 0 Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w/itetns checked below).
*I
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
•-•'^ .' ".: 'I : . ' -, : C:A '6D1■1 ,§TRUCTION' ,, . exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less to ground, or exceeds 14,000 0 Commercial-use agricultural
0 1- and 2-family dwelling ;RI Coinmercial/industrial D Accessory building amps for all other installations. buildings.
D Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or
, ., . . ., . . .,, .. 0 Emergency system. larger separately derived system.
- JOB_SITE INFORMATION. AND LOCATION - . '
- 0 Addition of new motor load of
100HP or inore. occupancy.
Job no.: Job site address: 1 i ,3$'/ 6(.4) ,., kb 0 Recreational vehicle parks.
0 Six or more residential units.
City/State/ZIP: 1 7 GAl26 o g . C - 7 ,,z,l.ei 0 Health-care facilities. 0 Supply voltage for more than
0 Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: Project name: C1-#9,56. 0 Service or feeder 600 amps or more.
- r I ; . '_ r :FEE
Cross street/directions to job site: 1/3 t-i- / 4///' Description . (M. I Fee. I Total I • I
New residential single- or multi-family dwelling unit. I
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. adcPI 500 sq. ft. or portion 33.40 1
Tax map/parcel no.: Limited energy, residential
75.00 2
DESCRIPTION OF : WORK ff - i ,, - . - - . ,---' - - . - - , ' - , - : - _. • :, .' ' , with above sq. it.)
Limited energy, multi
14CCAt C) P ,s i 6'1/ residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
.. . 0.110pERTY;.1,OWNE121.: , . - : ;. 1" -,.171 ,' -- ...;, 201 amps to 400 amps 106.85 2
Name: SEE /97-77;PC// 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) 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
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
Er AiTI,ICANT:: - - .T. , : , .-'.7,:" - ; . ,:; ..; +ERSON.: above service or feeder fee,
6.65 2
each branch circuit
Business name: Ehs 6/G-A B. Fee for branch circuits
without service or feeder fee,
Contact name: RO R.E- /4(....1:2_,L first branch circuit 46.85 2
Each addl branch circuit 6.65
Address: 10 tel / - 6 aj c 9 rj srl . 6 . 7x.L.E.: e. ...I c Miscellaneous (service or feeder not included) 2
City/State/ZIP: Lu 4 „ , ,, LI_ E c R, 9 707 0 Each manufactured or modular
90.90 2
i dwelling, service and/or feeder
Phone: (03) q _ g- yco Fax: : (6b3) 5-E.. - v/7 Reconnect only 66.85 2
E-mail: /212A & E0 6 /1/4/60 , C.0122 Pump or irrigation circle 53.40 2
s:5tONTRACTOit 1- , -E ' :-: . - --"..-. - - Sign or outline lighting 3 53.40 2
Signal circuit(s) or limited-
Business name: 4 ,S , C," _/U energy panel, alteration, or
Address: /0 9 --- ,_cco extension. Describe: Page 2 2 CO/ri/nE_Rc.E Ci e .57 11 .
City/State/ZIP: ti)/ Lc i/
'Li" ) Og . 9' 70 ad
70 Each ditional inspection over allowable in any of the above
Per inspection 62.50
Phone: (c&3) - 5'6 - (311(20 Fax: (6 ) 6 , -8 ‘ .q - 611:// Investigation per hour (1 hr min) 62.50
CCB Lic.: /2 .6.),6- la _ Electrical Lic.: cil 5 Suprv. Lic.: )4-, 516.. Industrial plant per hour 73.75
:-
Suprv. Electrician signature, require/,,/ , ..# 1 41&:: „. Subtotal:
Plan review (25% of permit fee):
6 ,
Print name: o k a , ,a... fi , /1, Ai -, Date:
State surcharge (12% of permit fee):
Authorized signature: ,_ TOTAL PERMIT FEE: 1- ci, L-4 2...
4
This permit application expires if a permit is not obtained within 180
Print name:_4v 4, ji v , ,,,
/ Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.