Permit CITY OF TIGARD ELECTRICAL PERMIT
• COMMUNITY DEVELOPMENT Permit #: ELC2013 00206
T t GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/04/2013
Parcel: 25101 DA00105
Jurisdiction: Tigard
Site address: 13009 SW 68TH PKWY A
Project: Extended Stay Hotel Subdivision: VARNS ACRES Lot: 9
Project Description: (1) sign or outline lighting
Contractor: RAMSAY SIGNS INC Owner: BRE/HV PROPERTIES LLC
9160 SE 74TH AVE TAX DEPTARTMENT
PORTLAND, OR 97206 EXTENDED STAY HOTELS
100 DUNBAR ST
SPARTANBURG, SC 29306
PHONE: 503 - 777 -4555 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 04/04/2013 $67.84
Specifics: 1 ea 12% State Surcharge - 04/04/2013 $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 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 52-001-0090. 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: Y p� t t t�V l.( ` D. Permittee Signature: DI,t , 1 r C Y4- 7/D u
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.
04/01/2013 07:18 5037770220 RAMSAY SIGNS PAGE 01/01
Electrical Permit Application I t,k t i t 1 I (I I , ,I 0\1
City of Tigard Received
13125 SW Hall Blvd., Tigard, OR. a EIVED Plan Review 4 1 sr' Permit Ne.; �/ 3—.60
/ _
I Phone: 503,718.2439 Fax: 503. 9 , •- a tAite.By Other Permit l.
l i , • I h inspection Line 503.639.4175
Date Ready/By. t3 See Page 2 for
Internet: www,tigarrd nr,gov - R 0 1 2013 Notiiled/M�t d; �� Supplemental information
•
New con q ��
E U' ;drAirr _ Y - . ! P13i4ht1 :W
struction ❑ Add1110p1 r . 1 IN V . , ON Please check all that apply (submit2 sets of plans wAkms decked below);
❑ Demolition. Other:
ii 1V ON ❑ Service or fcoder400 amps or mote ❑ Building over duce stories,
where the available fault current ❑ Marines and boatyards.
. CATEdbM' OF CONST1WC I ION exceeds 10.000 amps at 150 volts or ❑ Floating buildings,
less to around, or exceeds 14,000 ❑ Comm ereial-vae agricultural
❑ I- and 2- family dwelling I Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi-family ❑ Master builder (] Other: ❑ Fm pomp. 0 Installation of 75 KVA or
❑ Emergent system,
,JOB ' S iNFOI , MATION AND LOCATION y larger separately derived system.
". ❑ Addition of new motor load of ❑ "A" "R 9-2", -2" °1.3 ",
Job t 1o.. Job sift ad dress: l szEL� 2% . a5�
10011P or mote, occupancy,
Y ❑ Six or more residential units. ❑ Recreational vehicle partu.
City/State/ZTP: El Henitb are facilities, El Supply voltigc for more than
locations, 600 volts nominal.
Slit te/bldg. /apt. no.: j name: i,- ❑ rvice or feeder 600 amp. m. more,
�l Project � ��E4117Q�� ��ly se rdwalow .,,
' ,..
Sze , „.,FE ' :�SCB1tomE ,
Cross street/directions to job site: — mention Orr. I FM Toni I
New residential single- or multi- family dwelling unit.
includes attached garage.
Subdivision: Lot nn.: 1,000 aq. ft, or less 168.54 4
Tax map /parcel no.: E+. KIWI 500 gel, tit, or portion 33.92 1
Limited cnagy, residential 75.00
:_ D$S RiirtiON O Il' W 2
_ WORK (with about s q. tit )
Limited energy, multi- family
5 A e a01 LL residential (with shave sq. ft.) 75.00 2
Services or feeders installatio5 alteration, and/or relocation
200 amps or less 100,70 2 • [' "�i> pfeiiifiYilZ R • ,.. 0 TENANT 201 amps to 400 amps 133.56 2
Name; 401 amps to 600 amps 200.34 2
601 amps to 1.000 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 Ices 59.36 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 s 2
intended for sale, lease, rent, or exchange, according to ORS 447. 449, 670, and 701. 401 amps to 599 amps 168.54 2
Owner signature: Branch circuits- new, alteration, or extension, per panel
Date: A. Fee for branch circuits wish -
❑ APPLIC3I N? 'I' El CONTACT PERSON above service or feeder fey, 7.42 2
each branch circuit
Busine s name: 13. Fee for branch circuits wrrhout
9CrVICC Or feeder fee, first
Contact name: branch circuit 56.18 2
Address: — Each add'l br anch circuit 1 7.42 2
Miscellaneous (service or feede not included)
City/Statel7_1P: Each manttlhCturcd or modular
dwelling, service tidier fester 67.84 2
Phone: ( ) Fax:: ( ) Reconnect only 67.84 2
E-mail: Pump or irrigation circle
67.84 2
Sign or outline liglltin
COIV1R 01R ACk g 1 67.84 "r Ili 2
Signal Circuits) Or limited-energ
Businc nam !� � �C C _ s pane!, alteration., or extension. Page 2 2
Address: , L7 ►-S- a - H Each additional inspection over allowable in :ny of the above
`13 a..t ?7,e , 1{714 .Li , _ Additional inspection (1 hr min) 66.25/ hr
City/State/ZIP; ..,ii 1 l y ' • Investigation (1 hr min) 6625/M
• - Industrial plant (i hr min) 7R.18/ hr
Phone: ( . , � ) ,7 Fax: ) i C,1 l d inspection for which no lice is
CCB Lie,; . ii (�f ,- specificall listed (c /, ht' min) 90.00 / hr
Electrical Li c.; a
(l r ' Su pr'v. 1 1L �(miC� i ,( 'E L 'L"i - TRICAL ; ;P,1n t1 ;,,:, is ;41 ; ;; : ;:t
r Suprv, Electricia s • ature, required: / /r - i Subtotal (�)P
Print name. ' Plan review (25% of permit fcc):
4..L. (} Date: Q �� State surcharge (12"/e of permit fee): q^
r signature:
3,6-'
Authorized signat TOTAL PERMIT FEE; t"(r�7
This permit application expires If a permit Is not obtained within 160
Print name: 1 Date: days after It has been accepted as complete.
• Number of inspections Snowed per permit.
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