Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 00072
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/01/2012
Parcel: 1 S136CD00100
Jurisdiction: Tigard
Site address: 11705 SW PACIFIC HVVY
Project: Pacific Crossroads Subdivision: 2006 -016 PARTITION PLAT Lot: 3
Project Description: Sign lighting for mall sign on Pacific Hwy.
Contractor: SECURITY SIGNS INC Owner: PACIFIC CROSSROADS PROPERTIES IN
2424 SE HOLGATE BLVD BY WYSE INVESTMENT SERVICES CO
PORTLAND, OR 97202 1501 SW TAYLOR ST STE 100
PORTLAND, OR 97205
PHONE: 503 - 546 -7114 PHONE:
FAX: 503 - 230 -1861
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 02/01/2012 $67.84
Specifics:
1 ea 12% State Surcharge - 02/01/2012 $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 OA' • 101 -0090. You ma obtain - • of the r - •r direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ' /�.rr ��i . -_ 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 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.
•
Electrical Permit Applicatio
rok .:•,,Fici, I /SE ONLY
City of Tigard i,12N 31 2012 Received
. ...sto .
• , --- 13125 SW Hall Blvd,, Tigard, OR 97223' PI
11 11,
' g: . Phone: 503.639.4171 Fax; 503.59t,1960 ,
OF TIGARD p , / iffigi .. .. o r= Permit No..
Date/By; Reew
y vi .
Other Permit:
r
, , , .--,,,,_. Inspection Line: 503.639.4175
I
BUILDING DIV ISIO IN a.. D te Ready/Ry.. huts: id See Page 2 for
--.. - :;:. - j Internee www.tigard-or.gov Notified/Method: .c ----% , Supplemental Information
.. :''... '.; . .(:,;,' '', : -::::.: .:, :::'• ''. • .;7...•:• •:". •.: 1" '': '''''''":" !: :;: • ,!:,' !,........:::.;,!.: ';:i"':::::.". .:.q ..;:
0 New construction El Addition/alteration/replacement Please check all that apply (submit 2 sets of pliais w/items checked below):
LI Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Other: - where the available fault current 1:IMarinas and boatyards.
. .. •.;....'''. .. ......." .', .': ';'' .,." H.::•04,0:00, 0: . ,'.: . ,: exceeds 10,000 amps at 150 volts or 0 Floating buildings,
lest to ground, or exceeds 14,000 El Commemial-use agricultural
0 1- and 2-family dwelling Z Commercial/industrial 0 Accessory buildMg amps for all other installations. buildings.
0 Multi-family El Master builder 0 Other: LI Fire Pump 0 Installation of 75 KVA Or
p 0 Emergency system largat separately derived system
': •.•,,, i 1' '' ,',.' . , 1•' : ; •,, ;., .•':; ',:::•:. ::•.49P:'SM: pircoorp,..'..ar):-.4)04 .: I $.:;:. •.:;: :.: ; :. i .:•.. '. ;. : • ' 1:3 Addition of new motor load of 0 "A", "Xr, "1-2", "1-r,
Job no.; lob site address: 4 kr • ...k 0 1001-1P or more. occupancy,
Six or more residential units. I:Recreational vehicle parks.
City/State/ZI ' . 4,0 este— I e-r...:71-Me,..-- 0 Health-care facilities. 0 Supply voltage for more than
ID Hazardous locations. 600 volts nominal.
Suite/bldg./apt, no.: Project name: .. - „.., ...p.s7.!.J..=,fi..7.. ,.c.0 , . ,,. .
oetc.
!..,,.,,, ,.:.„,:og , :SCHEDT.V.a; i''!'!::,,!:::":
Cross street/directions to job site: , nocriptIon I or. I Re. 1 ' Thtal I *
New residential single- or rnalti.fainily dwelling unit.
riy)ovil s,-,' (V) Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4
Bs. add'l 500 sq. ft. or pardon 33.92 1
Tax map/parcel no.:
- Limited energy, residential
67.84 2
: i,:'• ''.' '; ''::: :Y''' ::::!;:,!L !,,-[ !•.hi:.!'.E'..i; 'i1 (with above Sq. ft)
67.84
Limited energy, multi-feruily
k i 4 4.c-7:JD a
2airelo'Ci e-XiK+iin Ai111 - rern residential (with above sci. ft.)
Services or tbeders installation, alteraiion, and/or relocatiOn 2
*Mount Only* 4..itC01 200 amps or less 100.70 2
.• [1:00,1,40iti(:.'d4Visiiii:ir :?.:::,:„. ' '•:; ;-'i .1,:!' i:::•.;;: : 201 amps to 400 amps '• 133.56 2
401 amps to 600 amps 200.34 2
Name:
601 amps to 1,000 amps 301,04 2
Address: Over 1,000 amps or voila 55126 2
• • Temporary services or feeders installation, alteration, and/or
City/State/ZIP:
relocation
Phone: ( ) 1 Pax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not ,
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amp , 168.54 2
1 Branch circuits - new alteration or extension. . er • : nel
Owner signature: Date: A. Fee for branch circuits with
I p•';' • O*Ai4t:!;. • !'.'•: : :::''..!....• ... "......•''' ..I.M . tiCtikitgOit ' '' 1 ' above service or feeder fee.
7,42 2
. • . . , .. , ... I I • I . • .' 1 ■ ■ ' ' • . I . • • • •• • • • • • •• , each branch circuit
Business name: Security Signs B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: Melissa Hayden branch circuit
Bach ad,d1 branch circuit 7.42 2
Address: 2424 SE Holgate Blvd Miscellaneous (service or feeder not included)
Bach manufacture.ri or modular -
84 2
City/State/ZIP: Portland, OR 97202 dwelling. service and/or feeder 67. ... ..
Phone: (503) 546.7114 1 Fax: : (503) 230.1861 Reconnect only — 67.84 2
, Pump or irrigation circle 67.84 2
- mail: lVisdissafilSecUritySigns.com .. .
Sign or outline lighting / 67.84 (fl, T11 2
; • :.. : , .., ;•,•E.:: :•:: ..;.:;:.:: , . ; : ' ;: ..... :•.;.:'•-:'::?C0IIITBAcTOL.. :, : :i : ! • . .• . . . • : ; ..' :, ; . • Signal circuit(s) or ittnited
Business name: Security Signs _panel, alteration, or extension, Piig/I,2
Each additional inspection over allowable in ay of the above
Address: 2424 SE Holgate Blvd Additional inspection (1 hr min) l' 66,25/ hr
_
Investigation Cl hr min)_ 66.25/ hr
C.ity/State/ZIP: Portland, OR 97202
. _
Indusinal plant (1 hr min) 78.18/ hr
Phone: (M)3) 546.7114 I Fax: (503) 230.1861 Inspections for which no fes is —
MOO/ hr
-- . specifically listed Ws hr min)
CCE Lie.: 122809 Electrical Lic.: 26560CLS fSuprv. Lic.: 383S1G ::::
Supry. Electrician signature, required: —
ii. Z . .,,-23r -------'
_ Subtotal:
Plan review (25% of permit fee): ..
Print name: Marc Linguist ____ _ _ _ - - — -1-Date: - _ State surcharge.(12% of permit fee): 1 iti
— _
TOTAL PERMIT naE: 95: 7 (
Authorized signature:
This Permit application expires if a permit is not ob tained within 180
- days after it has been accepted as complete:
Print name: Melissa Hey n Date:
* Number of inspections allowed per permit.
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