Permit q CITY OF TIGARD ELECTRICAL PERMIT
1 111 — °' '' COMMUNITY DEVELOPMENT Permit #: ELC2013 -00174
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/19/2013
Parcel: 1 S 136DD05300
Jurisdiction: Tigard
Site address: 11850 SW 67TH AVE, STE# 100
Project: Guardian Subdivision: WEST PORTLAND HEIGHTS Lot: 9
Project Description: (1) sign lighting
Contractor: E S & A SIGN & AWNING Owner: PNWP LLC #2
89975 PRAIRIE RD PNWP LLC
EUGENE, OR 97402 6600 SW 105TH AVE #175
BEAVERTON, OR 97008
PHONE: 541 -485 -5546 PHONE:
FAX: 541 - 485 -5813
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 03/19/2013 $67.84
Specifics:
1 ea 12% State Surcharge - 03/19/2013 $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 ap•' - ble 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 s • •ed for more the 180
days. ATTENTI • regon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those r . :re set forth in OAR
952- 001 -00 thr•ugh OAR'952 -r s -10 :0 ou may obtain a copy of the rules or direct questions to OUNC by calling 03.232.1' :7 or 1.800.33
Issu d By: k / - i l___. 1A Permittee Signature: .r I4 i_V
OWNER INSTALLATION ONLY
i
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.
Ele Permit Application ikoloko)riti 0 I tt 10 t«0),Itri
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- - I City ofTignill
I A ,„
1 1. 14 .-.... 6 I 3IZ5 SW I lall Blvd., Tigard, OR 97223
I NIII I, : f 4 hone: 503.718.2439 Fax: 503.598.1960 i 3 / Perini! No.:Eke I go / 3-00 / 7
Plan Iteview
Dale/fly:
Other Permit:
ill v. 44 ' vio Inspection line: 503.639.4175
Internet: www.tigard-or.gov Nur ilierPMedrod Dab- Rentyilly:
r.,;,. I 14 See Pogo 2 for
I
Supplemental Information
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TYPE OF %VOI(I( Pl. 1N REVIEW
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Nem c deck all dal apply pubmiil sett of plaid %Wm. cl:cettal Mow):
El Now cOnsItuCtiorl I, I Addiliunirdtcridion/repineement
0 Serene or ruder .100 amps or mule 0 !Wilding m or duce siolki
0 DCM0iilion D Other: wit:wore .nailshle fault CUTWIll 0 N131111i$ and boal)ards
CATEGORY OF CONSTRUC l'ION
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exceeds 10,000 amps at ISO yobs or 0 floaring but Wino. ,e - N Q A
Jo% lo glOUIMI. or exeo:r1, 14,000 0 Commooi31-use agrieulimal
- - - - 0 3
El I - nird 2-lamily dwelling [Ti Conuncreild/industrint 0 Accessin y building amps for all Oilier inoalluiont building,
rl Muni-family 0 Master builder (83 Other; Sign 0 Fire 111111111, 0 Imiallation i175 KVA or
larger separately clerked sygeou. .....)
.IOU SITE INFORM TION AND LocsrioN 0 Addition of new motor lost! of
_ . ..
. ce
job 110.: 1 Job site address: 11850 SW 67111 Ave. 100I1P or more
Psis on imore lob:kraut uni Liuriruy.
torus n 16:en:Aimsl vehicle parlo.
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City/Stare/ZIP: Pot hand (Tigard) OR, 97223 011eahh.care froililiet. 0 Supply yolragc for more lion
V . __ . 1 --- -- — _ ____ _ Di t.,,,toni loationi. 600 Mrs nominal. .
...,
Suite/bldg./apt. no.: I Project name: Guardian 0 Seri icc or feeder 600 amps Ill NOW
................,.... ... ,.........- —...--,-.......... .
.. _ V FEE SCIIEDULE - \N
(loss meet/directions to job site iiir'oriii-Z; - - - - ' - _11 inf. I . r . 1= 1:1 D
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_ , - - New residential single or multl.family dwelling unit.
Includes (Moeller! garage.
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Subdivision: 1 Lot n sq, „ o.: 1,000 11. ot less
.. 168.54 V -
4
' -- - - -- ---- Fa cd400 '1 5 sq II or portion 33.92 I
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TnX rimpfpni (xi Ito.: . - - — _
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Ignited energy, residcadn1
---- - -- -- - 75.00 2
DESCRIPTION OF WORK it
(wh above sei. III
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- - - -- - I intilcs1 energy, mulii-family 2 • \N
0 15.00
InsInlialion / 1 or one (I) new illuminated wail sign residenrial (u h a
it bove sq, ii )
_ .._ _ •.. . _. _ _ _V_ _
Senicet or feeders instaliailan, antra Ion, and/or rclorailon N
200 multi or less 1110.70 2
pq PROPERTY OWNER 0 IF.NAN I. 201 amp; to 400 amps 133.56 2 VV VV - - 200.34 2
Nit1 n0: e 0 t oe ',Lc gi 6 ,,,,, e L4 /2. amps to 600 amps
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601 amps to 1,0(10 amps 301.04 2
Add
ress: 6 600 5,,,,,, /or t,,., $o 1).c - -
L 71 Oyer 1000 onspr soils
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• ' --- Temp miry services or feeders 1 nsiallatIon, allerallon, nun/or
City/Stme/ZIP: & A vtr-.46.4., / 0,A, et 7o fr relocation
Phone: (so) ‘2. 6 _ 3s -4, 0 ra ,,, : ( ) 200 amps or less
_-.- . . . - . - -
_125 08 _._ . .
Owner Installation: 'ibis i :Moir is elm; inade p pctly lin TOW s not 201111111)' 111 4°0 amP'
Wended For sale, lease,Atemeb ,r, alit ; to 0 S 447, 449, (5.-, id ni.
/ 401 ramps to 399 01110 _ _
Rrninclicirenilt - new, alteration, or erde_i 22
Owner signalti>7 e rLt, A I L4P Da0" 13 A. Fee for branch eircons wish
A • arm,: so vice or feeder fee,
efeJ APPLICANT I _ LI ('ON'TACT PERSON 711 2
each branch circuit — - - - - _. _ ..._ . _ . -. .
0. l'ec fin hunch circuits Wilmot
Business name: j\ L- 1._ C,_
C :civice.. or (ceder fee, firsi
.18 2
ontact trime 3re ? 1 si ,.. e0
_ ____ branch circuit
5 6 --
- - - Ertell ntkil branch mull 7.42 2
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Address: // 8- r 0 s . ,...). 41 le., Ave . W/o t., MIscrIlancous (service or (cede! noi It chided)
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Each num (Mum! or 'nodular
City/Sue/Z.1P: g,, e s pa. I 72,2- -I, IlwcIlisy, service_ atiLliro_feell_er ..... - (17-84 2
i'llone: ( 4. , ( , t 3 ) Ac, 7 - 11 1 s I nix: : ( sN, ,, -y l Reconnect only
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se-v- - - - -„- - - - - - — - - - — - - -- - - - Pump or ler igation circle 67.84 2
/ Te.C-S eA.4.6.)st4;. 0 Iseim4 wtr... 0 s _...... _
Sign or orrilino liglitml; _ I . _ .., 67.84
67.04 2
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CONTIL■CTOR _
_ Signal ciwirigs) or thorted.erter gy
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Business Millie: ES& Sign & Awning _orel„alicration, or extcnsiol2. - _ , Page 2 . . 2
A.
- -- . _ _ ._ _ _ _____ . _ _ . . _ Each arldltIonni inweellon over allownide in suly of the nbov_e__
Address: 89975 Prairie Rd. Additional insparion (I rim InIn) 66.25/ hr
In, esugalion (I la min) 66 25/ hr
Ciiy/Starel/.11 Eugene, OR 974112 _ ... . _
Indust planr (1 hr rain) 78 Itlf hr
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Phone: (S4 t) 485-5543 I Fax: (541) 015 Inspections for whist' no fee is 90 OW hr
-- -- - steeilie401/ listed1.4 kr min)
CCB Us.: 163470 I Electrical Lie.: 20-543CL I Sulam Lie.: •135S1G ELECTRICAL PERMIT FEES
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' - - -- - -- - • - - - - ---- --- ---- Subtotal:
Suprv. Flecri ieirin signature, re - - _-------- - quited: __ _ ____ __ __ - .
Plan review (25% of permit fee),
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Prim name: Kevin )(omi , Date: 3-
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, -- r_____ _ I • -- ---_ Stare surcharge ( I 2 tiptrinilloo): 67 '
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ToTA I. PERMIT FEE: 75.98
Authorized sign:Inv-rt A
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1 - _(1 d - . . I Id; perrull appUcarlon etphts II a permit is nor obtained nillrla ISO
(la's after 0 hat been accepted in complete.
rl mull mime: 1 OrlIC: - -- - - . Number of insporpons alien ed per immii.
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Midi,: P.1.1,10.1 r l'oloilApo.to: 01.01 IV 1 1 0 *I iTi I I OS CONOWEIS
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