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Permit CITY OF TIGARD ELECTRICAL PERMIT 11114 COMMUNITY DEVELOPMENT Permit #: ELC2011 -00577 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718 2439 Date Issued: 10/20/2011 Parcel: 1 S134BC00200 Jurisdiction: Tigard Site address: 12198 SW SCHOLLS FERRY RD Project: Woo Hoo Subdivision: WINDSOR PLACE Lot: 32 Project Description: Sign lighting Contractor: GRESHAM NEON & SIGNS Owner: GREENWAY CENTER LLC 21551 SE STARK ST ANA KALAKAUA CENTER GRESHAM, OR 97030 2155 KALAKAUA AVE #602 HONOLULU, HI 96815 PHONE. 503 - 417 -4774 PHONE. FAX: 503 - 253 -9407 FEES Quantity Description Date Amount 1 ea Sign or Outline Lighting 10/20/2011 $67.84 Specifics: 1 ea 12% State Surcharge - 10/20/2011 $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 - - - • • - • 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 A NTION Oregon I- , re• res you to follow the rules adopted by the Oregon Utility Notificati.n Center Those rules are set forth in OAR 952 -00 -0010 through OAR 952 -0r •090 • may obtain a copy of the rules or direct questions to OUNC by calhn• • r 232 1987 or 1 800 3 2344. / Iss .-d By: �� \.it��L�i�. Permittee Signet )/ / s! r� %1 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. 10/13/2011 13:38 5035981960 CITY OF TIGARD /Uap/ x_00 ((2.---- PAGE 01/02 Electrical Permit Application l�Cl1t (ll.rl( 1 l''il: c111 .Y — . Received p No„ City of Tigard Receive �0� iL �� ■ 13125 SW Hall Blvd„ Tigard, OR 97223 Plan Rode* 11 • phone' 503.71$2439 Fax 503,59X l9 �Q� Datcll3y, 1,11; rkn 3° P d/MelAod: Other Permit. (� Pi a Inspection Line; 503 639.4175 i � ,r):,, otific Dale Rc�+aylBV' m,( Stet Page z for Supplemental Information Internet, www.tigard -or goy • nit OF WORK " \ r � y 'C..\V i u + . rY11 ;r . _T -, - • Please chock all that apply (submit ii Sets of plans w /items checked below) 0 t�t Now construction ❑Addition !alteration /fep∎ac rl�tq ,;:- ❑ Service or Feeder 400 Amps or more CI Building over three stories, CI Demolition 0 Other. '4.v where the available fault current ID Marinas and boatyards. C4TZ ___ � Y _ OF CO , , � exceeds 10,000 amps at 150 volts as ❑ Plotting buildings, iIG less to ground, or exceeds 14,000 ❑ Commercial -use agricultural 171 I 1- and 2- family dwelling Commcreial/industrial 0 Accessory building amps for all other installations, buildings Master builder 0 Other; ❑ Fire pump 0 installation of 75 KVA or 1:1 Multi � ❑ Emergency system. larger- sepnnHely dcnvcd system. JOB S1TE INFORMATION AND LOCATION Additin of new motor load of • El "N', T,' "1.2" "1 -3 ". ! W 100141 or more. occupancy, Job no.: Job site address: I W c,t in Six or more residential units. ❑ Recreational vehicle parks ❑ Health -care facilities, ❑ Supply voltage for more than City/State/ZIP: — 0 A _ v 4 d C ❑Hazardous locations 600 volts nominal. Suite/bldg./apt no.: 1 Project name: 0 Service or feeder 600 amps or mere. FEE SCHEDULE Cross street /directions to job site: Dacrt•iton r „ Fee. Total New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision Lot no. 1,000 s R. o rlcss _ - 1611,54 4 ._ Ea, add'! 500 sq. ft, or portion 33 92 1 Tax map /parcel n0 - : Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) — ) I Limited energy, multi- family 75,00 2 . �4 A. Q t \ vl, residential (with above sq. ft.) Services or Ceders installation alteration and /or relocation 200 amps or less 1111 1 ,70 H 4 PROPERTY OWNER 0 TENANT 201 amps to 400 amps 56 I , 401 amps to 600 amps 200.34 2 Name: 0 _ _ ....1 I , ♦ • 4 I 1 . i �,► - 601 amps to 1,000 amps 301.04 2 Address: r _ e4 i { / i q ;. 4 — lIPIEW Over 1,000 amps or volts 552.26 _ 2 Temporary services or feeders instillation, alteration, and /or City /State /ZIP: ,_.11 ` D- : . A e .'Y relocation Phone: ( co Fax: ( ) 200 amps or lets 59.36 1 n 2�© 201 amps to 400 amps 125 08 2 Owner instal ation: This insta ati 1s being made on properly 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. Branch circuits -new, alteration, or e lcfenainn, . er panel Owner signature: - pate: A Fee for branch circuits with 0 APPLICANT t�l CONTACT PEEN above service or feeder fee, 7,42 2 - Business name: //�� — o B each branch circuit , Fee for branch circuits wuhnut TT _ service or feeder fee. First 56 1$ 2 Contact name. , A ok i • L e branch circuit CJ � �n � ^ Each add'l branch circuit r 7,42 2 Each Address: v .. 2 — -ll� � Miscellaneous service or feeder not Included ry ch i manufactured or modular . City/State/ZIP; �l n Each m: service ice and/or feeder phone: (C © - j,) 2 — 4 tjio [ Fax:: ( ) � Reconnect only 67,84 El t ( 'Amp or imgatron circle 67 04 2 U. Sign or outline lighting 67.84 (p'7st 2 Z`OlV'y'RA OR Signal circuit(s) or limited -energy Business name; ■ . ' panel, alteration, or extension Pa: c2 2 r- ' . L ... A . _it -- _ Each additional Ins on over allowable in any of the above Address: t7 (4%(-) fM ' F v } i l,( 0 ,2 - y � /) e_ Additional inspection (1 hr min) 66,25/ hr / Investigation (1 hr min) 66.25/ hr City/State/ZIP: (�✓'�e. t l L g • a - Industrial plant (1 hr min) 78,18 / hr Fax: inspections for which no fee i s Phone: ( .� F ( 7/ /) 90,00/ hr 5 b l specifically listed (% hr min) CCA I. ic.' • $ F - AIM. T.ic : ELECTRICAL PERMIT FEES ' " / • 0., Subtotal 7, 1:-el Suprv. EIecttician�'; n soared: _ _. _ TIM Subtotal; _ , I Plan review (25 %of permitfcc)= — Print name: f ! j t �, styl : , : ,s Date: p 1 1 I , A State surcharge (12 %ofpermit fee): r,/ q r TOTAL PERMIT FEE Authorized signature: f : a . I ` � � 1 / � � This permit application expires if a permit ix net obta w;thin I ' days after it has been accepted as complete Print name: _ ti ,� Pile: f I) 2.0 ' N umber of insfieetions allowed per permit, 5 4 11 Dud dinµ6Perniirelgt,C- PermitApp 07/01 ' I 440- •elST(11 ,5/COM/WEa