Permit . -1 ' , CITY OF TIGARD ELECTRICAL PERMIT
' .> COMMUNITY DEVELOPMENT Permit #: ELC2012 00530
T1GARD; 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/13/2012
Parcel: 2S101 DA00104
®/O Jurisdiction: TIGARD
Site address: 13333 SW 68TH PKWY, STE #"
Project: National American University Subdivision: VARNS ACRES Lot: 9
Project Description: Installation of (3) sign lightings. See SGN2012- 00139, SGN2012 -00140 & SGN2012- 00141.
Contractor: RAMSAY SIGNS INC Owner: TRIANGLE POINTE LLC
9160 SE 74TH AVE 901 NE GLISAN ST, #100
PORTLAND, OR 97206 PORTLAND, OR 97232
PHONE: 503 - 777 -4555 PHONE:
FAX:
FEES
Quantity Description Date Amount
3 ea Sign or Outline Lighting 09/13/2012 $203.52
Specifics:
1 ea 12% State Surcharge - 09/13/2012 $24.42
Electrical
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $227.94
Required Items and Reports (Conditions)
This per it-- s issued subject . the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law All work will
be do in accordance with appro :• plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
day . ATTENTION: Oregon law re. .res ou • follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
95 001 -0010 throug, OAR 952 -00 , .090. Yo -y obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
I s ued By: j` -. Permittee Signature: x
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 Application . n - ,k .,;. FOR OFFICE USE ONLY ; r .
City of Tigard Received Q /s. i . / Permit No.: E C, /a- - 0 0 536
III - ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date /By: Other Permit:
rTI:GARD Inspection Line: 503.639.4175 Date Ready /By: turn 0 See Page 2 for
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
Please check all that apply (submit 2 sets of plans w /items checked below):
® New construction ❑ Addition /alteration /replacement
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. 0
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural L
❑ 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 p
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", °1 -_ l 3
Job no.: Job site address: 2 ,* '�` t00HP or more. occupancy. I
1'� 3 w, (off ?Ail ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: i ��� � /� -y ❑ Health -care facilities. ❑ Supply voltage for more than
vG.1.� Q!C Q7 £2. 7 ❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: ; Project name: ❑ Service or feeder 600 amps or more. (A1
A?f�10 P�IIMI` R1C4NJ UIYV ►V. FEE SCHEDULE -40
Cross street/directions to job site: Description J Qo'. I Fee. I Total I *
New residential single- or multi - family dwelling unit.
Includes attached garage. O
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'l 500 sq. ft. or portion 33.92 1 3
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
t Limited energy, multi - family 75.00 2
. J l i..1 eActr I•A►T 3 residential (with above sq. ft.)
9 Services or feeders installation, alteration, and/or relocation
(3) Sign Circuits 200 amps or less 100.70 2
❑ PROPERTY OWNER ❑ TENANT 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
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and /or
City/State /ZIP: relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 I
• 201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54
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, 7 40 2
each branch circuit
Business name:
B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: branch circuit
Each add'I branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
dwelling, service and /or feeder 67.84 2
Phone: ( ) Fax:: ( )
Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mail: 2,0341-
Sign or outline lighting
.3 67.84 2
CONTRACTOR . _ Signal circuit(s) or limited- energy
Business name: Ramsay Sign Co. panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 9160 S.E. 74 AVE. Additional inspection (1 hr min) 66.25/ hr
City/State /ZIP: Portland OR. 97206 Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 777 - 4555 Fax: (503) 777 - 0601 Inspections for which no fee is 90.00/ hr
specifically listed (%2 hr min)
CCB Lie.: 63422 Electrical Lie.: 26 -106 c Suprv. Lic.: 493 sig ' ELECTRICAL PERMIT FEES
Amu
Suprv. Electrician signature, required: / /��/ (25% Subtotal:
Plan review (25 /o of permit fee):
Print name: Phill Steige t_ 2 Date:. w State surcharge (12% of pennit fee): M -
TOTAL PERMIT FEE: t,7 g ig,
Authorized signature:
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: * Number of inspections allowed per pennit.
1: \Building \ Permits \ELC- PermitApp.doc 07/01/10 440- 4615T(I l /05 /COM/WEB
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