Permit Ilk CITY OF TIGARD /b D PERMIT #RI ELC2006 - -00587
21111 DEVELOPMENT SERVICES DATE ISSUED: 10/17/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S111 DD -00201
SITE ADDRESS: 15943 SW HALL BLVD ZONING: C -N
SUBDIVISION: LOT : JURISDICTION: TIG
Project Description: (1) sign lighting.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: 1
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
ALMAL COOLEY LUMINITE SIGNS OF OREGON
15943 SW HALL 9126 SW RIDDER RD
TIGARD, OR 97224 WILSONVILLE, OR 97070
Phone: 503 - 413 -0467 Contact #: PRI 503 - 570 -6137
• FAX 503 - 570 -6138
FEES
Description Date Amount Reg #: LIC 156703
[ELPRMT] ELC Permit 10/17/200( $53.40 SUP 159S1G
[TAX] 8% State Surcharge 10/17/200( $4.27
Total $57.67 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by a Oregon Utility Notification Center. Those
rules are forth in R 952- 1 -0010 through OAR 952 - 001 -0100. You may obtain copies of these r I s or direct uestions to OUNC at
503 -24 6699 or 1 -800- 3
Issued y: ,,/, Atiug. .? Permittee Signature: b l/11 /7
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'N: DATE:
LICENSE NO:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
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 FoR oi• F Ici.: usi.: ()Nl.V
City of Tigard o wed /e ® , Permit No.. Z d,paa (r�oo 5S7
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/B . Other Permit:
TIC; n It a Inspection Line: 503.639.4175 Date Ready/By: 3uri la See Page 2 for
Internet: www.ligard- or.gov Notified/Method " (a - Supplemental Information
,, TYPE OF WORK PLAN REVIEW
❑ New construction Addition /alteration/replacement Please check all that apply (submit 2 sets of plans wfitems checked below):
❑ Demolition ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 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
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A" "E" "I - 2" "I - 3"
Job site address: 3 �j ( / /� 9 I ix or or more. R occupancy. r
Job no.:
______.2 � - ���`-' �/ � ! /Ll�(�'L� ❑Six or more residential units. ❑Receational vehicle parks.
City/State/ZIP:--7 irk., j Z '7 Z L4 ❑ Health -care facilities. ❑ Supply voltage for more than
C ❑ Hazardous locations. 600 volts nominal.
• Suite/bldg. /apt. no.: Project name: irGah ,,,e,(-- ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: gdev2S / jyl . 1 IA Description I QtY• I Fee. I Total I •
J New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
. Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
�
�a� /y/K ) L imited energy, multi - family
( .1� 7turd/ 9)-� / - l/�f t residential (with above sq. ft.) 75.00 2
I Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I 0 TENANT 201 amps to 400 amps 106.85 2
•
Name: dim/, ' UQIL 401 amps to 600 amps 160.60 2
��� / / 601 amps to 1,000 amps 240.60 2
/
Address: �7/ Over 1,000 amps or volts 454.65 2
/ / �/) O /3� /J Temporary services or feeders installation, alteration, and/or
City /State/Z1P: � �! 0E1 "/ / � f relocation
Phone:z$ 3)" 4 / 7 , z p j 4, Fax: ( ) 200 amps or less 66.85 I
Owner install 7 ati9n is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, Ir.: / et , / ?t, grcch. g} according to ORS 447, 449, 670, d 70V. 401 401 amps to 599 amps 133.75 2
Owner signattu : ( . / /L / G%(/ U141 " L� . Date: /67///7//r/ Branch circuits - new, alteration, or extension, per panel
A. Fee for branch circuits with
APPL I CONTACT PERSON above service or feeder fee, 6.65 2
i each branch circuit
Business name: /y7 /, - f 4 v, B. Fee for branch circuits
I `/ without service or feeder fee
�h ��
• Contact name: 46.85 2
�� / (fl first branch circuit
Address: ( / d/ ,5- 144,4 / A /C, Each add'I branch circuit 6.65 2
/ J (,;(2--) Miscellaneous (service or feeder not included) _
City/State/ZIP: ��GSI`// 4,U Each manufactured or modular
_ dwelling, service and/or feeder 90.90 2
Phone: ( ) F
ii '7d ��� Fax: ( ) Reconnect only 66.85 2
• E -mail: Ghe��� /J. 1 . ii , / ./&$i t /)$ , z..),-,_, Pump or irrigation circle 53.40 2
l� CONTRACTOR J Sign or outline lighting / 53.40 53 `rD 2
Business name: j- G/,�G�at, Jn�� Signal circuit(s) or limited -
1 energy panel, alteration, or
Address: 1/ ' �T, ,$ /J i t/ / extension. Describe: Page 2 2
•
City/State/ZIP: /1 /// if--Li Each additional inspection over allowable in any of the above
• ��
22 _/� Per inspection 62.50
Phone ) 7) -1( / 31 Fax ( Investigation per hour (1 hr min) 62.50
CCB Lic.: /57/7
5/./'71) 9 Electrical Lic.: 3q_ 53v f S Suprv. Lic.: /5 y Se Industrial plant per hour 73.75 _
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: 0/17/6, Subtotal:
Print name: (/i "'e / ( rn Date: eol, / / Plan review (25 of pe rmit fee): ?j • go
• State surcharge (8% of permit fee): S/ • ;7
Authorized signature: 0. 139Gn( L� TOTAL PERMIT FEE: ,5 7 , (, 7
Print name: Date: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
• Number of inspections allowed per permit.
. 1:\ Building \Petmits\ELC -Pe nitApp.doc 05/23/06 440.4615T(11/05/COM/WtB
4
Electrical Permit Application - City of Tigard
. Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
i RESIDENTIAL WORK ONLY: •
Fee for all residential systems combined $75.00
Check Type of Work Involved:
E l Audio and Stereo Systems*
❑ Burglar Alarm
El Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
El Vacuum Systems*
•
El Other
i COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
• system
(SEE OAR 918 - 260 -260)
Check Type of Work Involved:
El Audio and Stereo Systems
El Boiler Controls
El Clock Systems
❑ Data Telecommunication Installation
El Fire Alarm Installation
El HVAC
El Instrumentation
• El Intercom and Paging Systems
El Landscape Irrigation Control*
El Medical
• El Nurse Calls
El Outdoor Landscape Lighting*
❑ Protective Signaling
• • ❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\ Building\Pamib\ELC- PamitApp.doc 03/13/06