Permit CITY OF TIGARD ELECTRICAL PERMIT
• c • - COMMUNITY DEVELOPMENT Permit #: ELC2012 -00115
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/24/2012
Parcel: 251018800400
Jurisdiction: Tigard
Site address: 11844 SW PACIFIC HWY
Project: Park 217 Business Center Subdivision: TIGARD ROAD GARDENS Lot: 4
Project Description: (1) sign lighting for free standing pole sign.
Contractor: CAPITOL ELECTRIC CO INC Owner: WALTON CWOR PARK BC 8 LLC
11401 NE MARX STREET BY CTMT - WALTON RE TAX
PORTLAND, OR 97220 4678 WORLD PARKWAY CIR
ST LOUIS, MO 63134
PHONE: 503 - 255 -9488 PHONE:
FAX: 503 - 257 -7121
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 02/24/2012 $67.84
Specifics:
1 ea 12% State Surcharge - 02/24/2012 $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 OAR 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. /
Issued By: <0� 14 47415-e------ Pemtlttee Signature:
DA/ �/ / cs5 - Tle�/
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.
02/24/2012 10:03 5032551966 CAPITOL ELECTRIC PAGE 02
Electr milt ApDllcatlion R EC FI V F I UIIZ 01.H, I: i sl:,,w,.,
• City of Tigard Date • - . �C? cm+itno.' Z 90 / 45- 13145SWHal 97 Pl an • cw
FEB 2 4 2012 e� /a —
N...,...,?_• . Phone: 503.639,4171 rem 503.598.1960 Date/By: Other Perini
tU0.04/02 dOQO—
Ti‹ A ( r, I:T ti Line: 503.639,41 ?S CI �•
�� i i 7n: �[� Date R te' Julys: ❑ seot'1yre: MT
CInternet: : www.t d•or. f
BJ1ii moo, "dam' �i 1✓IJf%�d Notified/Metho , 77 �v! I saPplem<nml xrlion
❑ New construction J] Addition/alteration/replacement Please check aA that apply (submit 2 sets of plans wntema checked bole*);
❑ Demolition D Other: ❑ Service or feeder 400 ems et more
P 0 Building over three atones
where the available faun current ❑ Marinas and boatyards
o I- and 2- family dwelling 0 Commercial/industrial ❑ Accessory building exceeds 10,000 amps at ISO volts or ❑ Floating buildings
❑ Multi -famil O Master Builder ❑ Other
less to ground, oraxtxeds14,000 ❑ Commerelel- useagrlcunurar
amps for all omet lnstelbsuons buildings
Job n0.; 120439 Job site address: 111344-0411521 Pacific Hwy
❑ Fire Pump 0 Installation of 75 KVA or
-- ❑ Emergency system larger separately derived system,
City/State/7R: Tigard, Or 97223 ❑ Addition err new motor load et ❑ "A ", "E -2', "1 -3
1 ---_, 10t>FIP or more, ❑ occupancy
Suite/bldg./opt no,: IPtojcct name: Park 277 sign ❑ Six er more residential unus ❑ Recreational vehicle pants.
Cross Shcet/1)Irections to)ob site; Gardanplaca and Pacific — — 0 Health -care lhcilitics ❑ Supply voltage for more than
❑ Hazardous location 600 volts nominal.
❑ Service or fader 600 am or mom
Subdivision: Park 217 Lot no.:
Tax ma / arccl no.: Dewipdrls
Qtr. rte, . moil «
Now residential - single or multi-huffily dwelling unit
Install circuit to new sign on Pacific Hwy entrance 100 100 1) t. or less Karp ,
0 • . R less • r S 168.54 4
Ea. Add'I 500 ti nr portion S n.92 1
MDENIEMIIEMIIIIIEMIEIEEIESIEIIIIIIEIIEIIE Limited energy residential
Name: Swith above sq. ft.) $ 75.00 2
Limited energy. multi- family
Address; residential (with above s. ft.) S 73.00 2
Service or feeders installation, alteration, and/or relocation
City/State/ZIP; 200 amps or less S 1.00.7o
201 amps to 400 amps S 2
Phone: Fax; 401 amps to 600 amps $ 200.34 2
Owner installation: This installation is bein made on 601 tuns to 1000 amps S 301.04 2
g property that I own which is not Over 1000 amps or volts S 352.26 2
intended for sale, lease, rent or exchange, according to ORS 447, 449, 670, and 701 Temporary services or feeders installation, alteration, and/or
Owner signature: Date; relocation
Mniammiliumimminimminimell 200 amps or leas $ 59,36 1
201 a to 400 amps $ 125.08 I 2
Business Name: 401 amps to 599 amps S 16654 2
Branch clrceita - new, alteration, or extension. per panel
Contact Warne; A. Fee for branch circuits with —
service or feeder fee, each
Address: branch circuit S 7.42 2
B, Fee for branch circuits
City/State/ZIP: without service or feeder fee,
first branch circuit 5 56.18 2
Phone; pea: Each additional branch circuit — 5 742 _ 2
E -mail; Misecllaneous (service or feeder not included)
:.,Q.. Each manufactured or modular
dwelling, service and of fader a 67.14 2
Business Name: CAPITOL ELECTRIC CO., INC. Reconnect only S 67.64 2
Pump or irrigation circle S 67.84 2
or outline Ilth
Contact name: Gary Stolort
Sip or I s 67,84 417 e4 2
• `J_ Signal circuits) or limlfed
Address: 11401 NE MARX ST. energy panel, alterations, or
I Describe:
S 75.00 2
CiO/Statc/ZTP: PORTLAND, OR 97220 -1041 Puug 2
—
Tack additi It p ectlon over allowable in any of the above
' one: 503-265-9488 Fax: 03-267 -7121 Per inspection $ 662s
.
t CC13 Lk.: 48748 "Electrical Lie,: 26-496C S .. ro : 2865.5 / - Investigation per hour (1 hr min) S 66.25
industrial •lint • r h
Supi•v, Electrician signature, required: — - -- _ - - - -- -- -- - -..
hour
Print Name: R chard Martin l " D tc: 12 Plan l % of permit fez)
s 7
- — :" ".....:.. 67.84
76, as •
Autgarized signature: State surcharge ( 12% of perm it fee) $ 8,14
TOTAL PERMIT' FEE
Print Name: Richard Martin $ 76.96
—. This perish appindlen apt wq Kai penult it we obtained within ISO
dm en it b*e beer nuptial u compeel%
• Number of inspections per penult allowed,
1:lbulldI PemdhlEI.G- pmmitApp.doe 10/01/09 '
44044157p icisr0 W213
i