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Permit CITY TIGARD ELECTRICAL PERMIT V PERMIT #: ELC2004 -00109 DEVELOPMENT SERVICES DATE ISSUED: 3/8/04 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 PARCEL: 1 S135DD -04400 SITE ADDRESS: 11900 SW GREENBURG RD BLDG 1 SUBDIVISION: ZONING. C - BLOCK: LOT : JURISDICTION: TIG Project Description: Installation of (1) sign lighting. RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: 1 LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL: MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVCIFDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: B C ASSOCIATES SIGNCRAFT LLC 11900 SW GREENBURG RD 9033 SW BURNHAM TIGARD, OR 97223 TIGARD, OR 97223 Phone: 503 - 245 -6513 Phone: 503 - 639 -4910 Reg #: LIC 155420 ELE 34- 674CLS FEES Description Date Amount Required Inspections [ELPRMT] ELC Permit 3/8/04 $53.40 [TAX] 8% State Surcharge 3/8/04 $4.27 Rough -in Elect'I Final Total $57.67 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 th. • ; i •. . • TENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in e • R 952- 001 -0010 t' •ugh OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or 1 -80►.- 332 -2344. Is ued By: \ �,��i \ cif Permit Signature. 1/1 • 44_.) 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 639 -4175 by 7:00pm for an inspection the next business day • • Electra al Permit Application .. ; - FOR:OFFICE`USE ONLY ;: � City of Tigard Date/By: d © � �/ , ��� Q i Permit No. a014.4 Iv �t� / 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 1 :10000 � Date/B : Other Permit itebee . 1: Inspection Line: 503.639.4175 c'� - CI L, . Date Ready/By: pr a See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: /0 • Supplemental Information e rte, ,9aP,;i.�i rs'.•±:.; ` k:^ 5' t: "�' "w`: `+.,: °�5�.:: ' :s`. .. - a:.�. .. "Xh�.' .'°,tin +�,� , .c _ ;B`.`. : X�l': ':Ti. .I a 't�.' .�,,,a': "' '-.i% .t' $� -,9 .,"," °` .r 3�3� .. s. ,: 1 r`•'a: , : : >� ,. mac : ri g: s„ 'T YP ..OF` W , 1_ -' - 1 -- >`, .; ,f ,, , n ,i , r r, i REVIEW _ �a + *�.,a'w,'r.,�= �.'`�4� "sue, m � �r.�.�„�£T..'� -�+=- a. �.. .. �� "�:'m °:a -v_ „w's� a,r .. . _:� �. �,.�... , .:�. � _ »:?'c :, �--<. x..- "�-- �,.� -� �. . . ;N construction ❑ Addition/alteration/replacement " Please check all that appl ❑ Demolition ❑Other: EService over 225 amps, comm'l ['Hazardous location �' f°'�. ;. " "r`' 4.'445712:4 - - ssi.�i:. s t l :;� <:- Y - ? ;:' s' ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., v� t C A T EGORY Q :GONSTRIICTION a°' i !¢ ; >' ` of 1- and 2- family dwellings 4 or more new residential m, ,�- ..t§v.�....F a-,�. a " a :��, .nnM. �,ai._. *was �.'' �s:��* w.��.��.,�..,.w, -�� ❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure � ❑Building over three stories ❑Feeders, 400 amps or more ❑ Multi - family ❑ Master builder s g Other: ( ['Occupant load over 99 persons ❑Manufactured structures or ' T iril S'FTE FORi4IATIO Stir OGATIO '' S " park RV li' .i����.0 -.4x4 .a= �..._ : ,�.., , . � -.. �,, k: NA,, ,t ❑Egress/lighting plan P / ❑Health -care facility ['Other: Job no.: Job site address: it c 7C SCN 6 e je)tc 2 & R Submit 2 sets of plans with any of the above. City /State /ZIP: The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: Project name: ' °arAr 74.5ideftlWrOktg . - Description Qty. Fee. Total Cross street/directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: I S I 3500- 4400 Limited energy, residential 75.00 2 Limited energy, non - residential 75.00 • 2 .. a g ,:DASCRIPTIQ OF ' "7 '."�� ,'°� . �-,� _�� .. � _ � - _ „_.- � ��:t>��. •„„„ � .>� � . �;�r.�. ���r�s Each manufactured or modular 1 dwelling, service and /or feeder 90.90 2 /Unit- 7 u-of cS I b TD G1.__L 0- (C_. L Cx Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 4 Al ' `Ab PRO 'ERTY OWNER i , , , D ki.w ° ,. M r », 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: (-6,G _Assnce p s 601 amps to 1,000 amps 240.60 2 Address:c/p 19 oo .tom G QE7U ��� Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City /State /ZIP: 3 x) Temporary services or feeders installation, alteration, and /or Fax: ( ) relocation Phone: �� a4s • 4,513 200 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 600 amps 133.75 2 Owner signature: , 3 ` e 1/V(� L C .p _L LaS/' 1 (.Date: Branch circuits - new, alteration, or extension, per panel Eb= ;a # °:+;,. ..stag : -�... 'r'a :,.b t. - t ..,,,, (II �. .:r, „: r.,� " A. Fee for branch circuits with , � x� � �' "� A, .PLICANT 411 ,GO:tKO: "PERSON . . "' >i�: .:'''.t`. 'r,x. .r -.... <, !,i. -a ...Y ..1.n 'i h.�x. sma.+s€iu,. -:. ..; r..:zs.�,.- w.'a „'xx. service or feeder fee, each 6.65 2 Business name: C L14ssi C� £ t G-� - '1'v Z y S ryyt5 branch circuit Contact name: _ 1V lA B. Fee for branch circuits ut e: ) l �Q ( � without service or feeder fee, 46.85 2 each branch circuit Address: It /e(` / t47til D Each add'l branch circuit 6.65 2 City /State /ZIP: • lam 3 9 -7 22_ 4" Miscellaneous (service or feeder not included) /_ Pump or irrigation circle 53.40 2 Phone: ( 39 - ( ( � Fax.. 603 f "7/r ` � k--7 a 0 Sign or outline lighting 1 53.40 53%7-" 2 E - mail: i� Signal circuit(s) or limited - t s= r'- :. .�-��` : �-'� °��:: x ��fk C�ON�TT73AGTOIt„� . z�,i" ,:..� ;.�, .. ��;_ ��.,�, c energy Panel, alteration, or extension. Describe: Page 2 2 Business name: < a CT�UC ,Yl,,,'r Address: c403 3 f6 u_ tee tad r R.0 Each additional inspection over allowable in any of the above Per inspection 62.50 City/State /ZIP: ( ie D ell 22-3 Investigation per hour (I hr min) 62.50 Phone: (5c) Fax: (5O3 Industrial plant per hour 73.75 afieff 7 EIECT TCALPkPERM3 ES * '' "s> g ' _ CCB Lie.: 5 5 ZD Electrical Lie.: 34 (p7 4 CLS Suprv. Lie.: Subtotal ‘ ,.-5- ‘ 5. � Suprv. Electrician signature, required: c Plan review (25% of permit fee) Print name: � k J 3.1 k... Date: a (slo� State surcharge (8% of permit fee) y.9. 7 F' IL ` TOTAL PERMIT FEE '''') , 4 Authorized signature: .!9 A /'i • . This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: a A 1�► c ,( Lk I Y -Sj-es--- Date: 3 I / 4. * Fee methodology set by Tri- County Building Industry Service Board l ! ** Number of inspections per permit allowed. i \ Building \Permits\ELC- PennitApp.doe 12103 440 -46 15T(10 /02 /COM/WEB Electrical Permit Application - City of Tigard a Page 2 - Supplemental Information • LIMITED ENERGY PERMIT FEES: Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* n Other: WORK O ` . Y: = , -thaN1317,11, Fee for each commercial system $75.00 (SEE OAR 918 - 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems 7 Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC [l Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical n Nurse Calls ❑ Outdoor Landscape Lighting* n Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required • • for all other installations i :\Building\Pemuts\ELC- PermitApp doc 04/03