Permit CITY OF TIGARD ELECTRICAL PERMIT
s - COMMUNITY DEVELOPMENT Permit #: ELC2012 -00450
T I GA RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/30/2012
Parcel: 25101 DB
Jurisdiction: Tigard
Site address: 7320 SW Hunziker RD, BLDG#
Project: Eagle Home Mortgage Subdivision: Lot: 00100
Project Description: (1) sign or outline lighting
Contractor: MEYER SIGN CO OF OREGON Owner: CBRE, INC /ASSET SERVICES
15205 SW 74TH AVE 1300 SW 5TH AVE
TIGARD, OR 97224 PORTLAND, OR 97201
PHONE: 503 - 620 -8200 PHONE:
FAX: 503 - 620 -7074
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 07/30/2012 $67.84
Specifics:
1 ea 12% State Surcharge - 07/30/2012 $8.14
Electrical
Type of Use: COM
Class of Work: OTR
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 2 -001 -0 90. You may obtain a co y of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: J
CJC Permittee Signature: J „ ✓�
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.
ti
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Electrical Permit Application RECEIVED IOR OFFICE USE ONLY
City of Tigard Received
�• V Permit No. _ ....no 1 )„ , 0' Lb
II 13125 SW Hall Blvd., Tigard, OR 97223 ° 0 2012 Date/B : Plan Review I
C Phone: 503.718.2439 Fax: 503.598.1960 Date /B : Other Permit: v
I' I G A K D Inspection Line: 503.639.4175 , ; IT y, OFTIGARD Date Ready/By: See Page 2 for 41
Internet: www.tigard- or.gov 1'IF.It 1 Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW N
❑ New construction Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below): O
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. t)
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑ Floating buildings. t
less to ground, or exceeds 14.000 ❑ Commercial-use agricultural 0
❑ 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
❑ Emergency system. larger separately derived system. N
JOB SITE INFORMATION AND LOCATION --C-. ❑ Addition of new motor load of ❑ "A ", "E ". "I -2 ", "I -3 ",
Job no.: 2-I ( Job site address: 3-3 5v) 1w-4 E (KEl2 e. O 100HPor more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: i' i 4 4424 Dry 13-2-23 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: ( Project name: EA ( I-64E Nto2i 60 ,shs ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total 1 •
New residential single- or multi - family dwelling unit. r
Includes attached garage. S
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 I ..
Tax map /parcel no.: -
Limited energy, residential 75.00 2 tA'
DESCRIPTION OF WORK (with above sq. ft.)
I es' Limited energy, multi family 75.00 2
e- $I(.,1 ( Ci2IJ tJGt' O � residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name:
601 amps to I ,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 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 amps 168.54 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee 7.42 2
each branch circuit
Business name: M E «e...(4 S I Ug C . OF- O¢ B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: M,2TZL.L-L branch circuit
Each add'I branch circuit 7.42 2
Address: I c 2c5 5W 'I Li III A- VG Miscellaneous (service or feeder not included)
City /State /ZIP: 1 J i ki_o . 224 Each manufactured or modular 67.84 2
1 � dwelling. service and/or feeder
Phone: (5D3) 600 -- .Oc Fax: : (SD 3) 42.fl - ' -0 } Reconnect only 67.84 2
� Pump or irrigation circle 67.84 2
E - mail: ( L fy1.Yen's 1c ylCo. CDyu Sign or outline lighting r 67.84 (at 8') 2
CONTRACTOR Signal circuit(s) or limited - energy
Business name: panel, alteration, or extension. Page 2 _ 2
S,41 : _�� At-30,/,._ Each additional inspection over allowable in any of the above
Address: C� � Additional inspection (1 hr min) 66.25/ hr
Investigation (I hr min) 66.25/ hr
City /State/ZIP:
ll7 t i (if• Industrial plant (I hr min) 78.18 / hr
Phone: ( ) Fax: ( ) 570 5 ( � specifically listed ichhr no fee m n)ts 90.00/ hr
CCB Lic.: 4 Electrical Lic.20 - (6pCLS Suprv. Lic.:,54:S ELECTRICAL PERMIT FEES
et Subtotal: (03-.g+ Suprv. Electrician signature, required: Plan review (25% of permit fee):
Print name: AA RsoAp Date: / / .i 2 State surcharge (12% of permit fee): �' . ! '-}
TOTAL PERMIT FEE: 35-. ci D
Authorized signal e: — 1..." -- V----(2---Q { n This permit application expires if a permit is not obtained within 180
Print name: Q3 `I`r
V Q -I'A LA._ Date: � days after it has been accepted as complete.
�I p ` 2 • Number of inspections allowed per permit.
1:\ Building \Permits \ELC- 1'crmitApp.doc 07/01/10 440- 4615T(II /05 /COM/WEB