Permit I }
CITY OF TIGARD ELECTRICAL PERMIT
• COMMUNITY DEVELOPMENT Permit #: ELC2009 -00297
Date Issued: 06/18/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503 639 4171 Parcel: 2S101 DA01000
Jurisdiction: Tigard
Site address: _FIR LP
Subdivision: Lot: 0
Project: Paragon Tile
Project Description: Sign /outline lighting for (1) sign
Owner: FEES
PARAGON INVESTMENTS LLC Quantity Description Date Amount
7100 SW FIR LP
TIGARD, OR 97223 1 ea Sign or Outline Lighting 06/18/2009 $53 40
PHONE 1 ea 12% State Surcharge - 06/18/2009 $6 41
Electrical
Contractor:
HIGHLIGHT SIGN CORP
P 0 BOX 23667
TIGARD, OR 97223
PHONE
FAX'
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $59 81
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law All work will
be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days ATTENTION Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center ' ose r -- ar et- h in OAR
952- 001 -0010 through OAR 952 - 001 -0100 You may obtain a copy of the rules or direct questions to OUNC by calling 503 24. 6699 or 800 33 2 4
Issued By: C is CtiL V � `l ' Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
4 1 ti 2 v e t.�
Electrical Permit Application
CE FOR OFFICE USE ONLY
•
11769 City of Tigard eBya Permit No « . o oaq 7
13125 SW Hall Blvd , Tigard, OR 97223 JUN 1$ 20 09 Plan Review
Phone: 503.639.4171 Fax • 503 598.1960 Date/By Other Permit
Inspection Line: 503 639 4175 CITY OF TIGARD Date Ready/By Juns ® See Page 2 for
Internet: www tigard-or gov BUILDING DIVISI INIotified/Method '7 I,G Supplemental information
TYPE OF WORK PLAN REVIEW
❑ New construction Addition /alteration /replacement Please check all that apply (submit 2 sets of plans whtems checked below)
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings
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
JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately denved system
❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "l -3 ",
Job site address: i � '� 100HP or more occupancy
Job no.:
/ �, I aL ��� (, ❑ Six or more residential units 0 Recreational vehicle parks
City/State /ZIP: 10 f4 f�'� ❑ Health -care facilities ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal
Suite/bldg. /apt. no.: l Project name: ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: 0 C22iNi Description I Qty. I Fee. I Total 1
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft or less 145 15 4
Tax map/parcel no.: Ea add'l 500 sq. ft or portion 33.40 1
Limited energy, residential 75 00 2
DESCRIPTION OF WORK (with above sq ft )
Limited energy, multi - family
I MO 0 et- 6) & " ON r~ b(. residential (with above sq ft) 75 00 2
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2 _
i, PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106 85 2
P Name: - i f`, •._( (_ 4 .I ' � " .,) c1 401 amps to 600 amps 160.60 2
y 601 amps to 1,000 amps 240 60 2
Address: "7i ctJ t - ..00 j Over 1,000 amps or volts 454 65 2
City /State /ZIP:' , 2. VA 0 0 9 .' 7. 7 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
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6 -65 2
Business name: • B Fee for branch circuits
y ` without service or feeder fee,
Contact name:
/ (J first branch circuit 46.85 2
Address: Each add'l branch circuit 6 65 2
Miscellaneous (service or feeder not included) .
City /State /ZIP: Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Phone: ( ) 3 ' ( "5c 1 9 Fax: : ( ) Reconnect only 66 85 2
E-mail Pump or irrigation circle 53 40 2
CONTRACTOR Sign or outline lighting f 53.40 2
Business name: 0 L 644 ,t— � ( (9-,i. —( Signal circuit(s) or limited -
./.4/ energy panel, alteration, or
To xJ7S .- O " �/
Address: extension Describe. Page 2 2
ti (� 1
City /State /ZIP: - ( �4 C�� r ( Z c/ 7 � L Each additional inspection over allowable in any of the above
/ _ Per inspection 62 50
Phone: ( ) b - o `-.0 , Fax: ( ) 2- L)
S J 2- ;� Investigation per hour (1 hr mm) 62 50
CCB Lic.: j 0Lf '5 ' Electrical Lic.. 5j7 1 Suprv. Lic.: industrial plant per hour 73.75
1 t i ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: ,,_,.._,(/ ,_ Subtotal-
7 Plan review (25% of permit fee):
Print name: (Z ` �- , .6) L� - g 12. Date: , ._ �, - —
State surcharge (12% of permit fee):
Authorized signature: TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
* Number of inspections allowed per permit
1 \Buildmg\Permits\ELC- PermitApp doe 05/23/06 440- 4615T(l I /05 /COM/WEB
\.
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined .. $75.00
Check Type of Work Involved:
n Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
n Vacuum Systems*
Fl Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
n Boiler Controls
❑ Clock Systems
n Data Telecommunication Installation
n Fire Alarm Installation
n FIVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
n Nurse Calls
❑ Outdoor Landscape Lighting*
n Protective Signaling
n Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I \Bwldmg\Permrts\ELC -Perm tApp doc 03/23/06