Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2013 -00314
Date Issued: 06/04/2013
T i GAR 13125 SW Hall Blvd., Tigard OR 97223 503.718 2439 Parcel: 1S136 DB02502
Jurisdiction: Tigard
Site address: 11634 SW PACIFIC HWY
Project: SUBWAY MONUMENT SIGN Subdivision: AZOIC TERRACE Lot: 1
Project Description: (1) sign lighting
Contractor: YESCO LLC Owner: KESSLER, JULES
20100 SW 112TH AVE 6501 SW OAK ST
TUALATIN, OR 97062 PORTLAND, OR 97223
PHONE 503 - 612 -6672 PHONE:
FAX 503 - 612 -0914
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 06/04/2013 $67.84
Specifics:
1 ea 12% State Surcharge - 06/04/2013 $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 0 • ' • 5 • 0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503 232.1987 or 1 800.332.23 • • .
Issued By: % /LL Permittee Signature:
OWNER INSTALLATION ONLY /
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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 503.839.4175 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.
02/20/2013 13:24 5039543543 PHOEN GUS PAGE 01/01
Electrical Permit Annlic: i i ■ roll orrice. tar: ()NIA'
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City of Tigard 7 UN ! ' 20 3, pate !� I � Pemtit�o;Ej�aO /3 - 113/
q 13125 SW Hall Blvd, 7i:. •, OR 9 ple
V Phone: 503.718.2439 Fax 503.5 '.• r Dater . Other Pc nit e,
inspection tine: 503.639.41 1 ► • ' 1 GN._ i g2 -�O
, t c, , It n F >� Si see Page 2 for
Internet: www.tigard- or.gov : U i 1 ING my II • • Supplemeotd Iaformatkn
TYPE OF PLAN REVIEW - .
® New construction ❑ Addition/alteration/replacement Please cheek - all thin apply (submit 2 sett of plans w /items checked below):
❑ Service or feeder 400 amps or reote ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault correct ❑ Marinas and boatyards.
CATEGORX OF CQNSTRUCTiON exceeds 1 0.000 amps at 1 volts or ❑ Floating b
less to ground, or exceeds 14.000 ❑ Commercial -use agricultural
❑ 1 - and 2- family dwelling ® Commercial /industrial ❑ Accessory building crops for ell other innelltrions bu
❑ Multi- family ❑ Master builder ❑ Other: ❑lin pump. ❑ Retaliation of 73 KVA or
' JOB $1}1'E IN FORMATION 'AND LOCAnbN - El hereon of m lest", separately derived system.
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0 Addition of lieu molar laid of ❑ "A" "E "1.3" '9 - 3"
Job no.: Job site address: 11634 SW Pacific any tooliP m tacit occupancy.
❑ Six or more ruidmtial win. ❑ Recreational vehicle park.
City /State/ZIP: Tigard OR 97223 ❑ Healtlt.c ate facilities. ❑ Supply volute tbr moto than
❑ Hazardous locations. 600 YOU nominal.
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Suite/bldg. /apt. no.: ( Project neme: Subway ❑ Suvieo at Roder 600 amps or more.
.•'•__1FEE SCHEDULE • .
Cross street/directions to job site: 72nd oaasprson 1 cry- 1 Foe I 'row 1 •
New residential tingle -or multi - family dwelling unit.
Includes attached garage.
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Subdivision: Lot no.: 1.000 sq. l3, or less 16834 4
Tax arep/pateel not: Ea. add'l 500 sq. R, or portion 33.92 1
Limited energy, residential 75.00 2
DESCRIPTION OF••WOJttt • .- (with above sq. R.)
Limited energy, mold- family 75.00 2
New pole sign circuit residenti (with above sq. fL)
Service; or feeden installation. alteration, and/or relocation
200 amps or less 1 00.70 2
RIZOPERTY OWNER � , ❑TENANT . 201 amps to 400 amps 13356 2
Name; William Balderstone 401 amps to 600 amps 2003 2
601 mops to 1,000 amps 301.0 2
Address: 2410 SE 121 Ave Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City /State/ZIP: Portland OR 97216 relocation •
Phone: (503)-866 -9607 Fax: ( ) 200 amps or less 5936 I
201 amps to 400 amps 125,08 2
Owner installaHon: This installation is being made on property that I own which is not 401 amps to 599 am .
amps
intended for sale, lease rent, or according to ORS 447, 449, 670, and 701. -
� Z Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A Fa Ibr branch circuits with
� , A ,P P LI C ApIT - , • .I' 0. CONTACT PEasoii . aboveservtx fee, 7.42 2
brawl circuit
Business name: YESCO LLC B. Fee for branch circuits without
service or feeder fee, first 56.18 .2
Contact name: Ken Mahoney branch circuit
Each oddi branch circuit 7.42 . 2
Address: 20198 SW 112 Ave Miscellaneous (service or feeder not Included) _
Each manufactured or modular
City/State/ZIP: Tualatin OR 97062 dwelling, service and/or feeder 67.84 2
Phone: (503 -) 612 -6672 Fax: : (503) 612.0914 Reconnect only 67.84 2
E -mail: lmnahoneyta�,yeaco.com , Premporirrigationdrcle 67,54 2
CONTRAC7Oit Sipe or online lighting I - 67.84 67.84 2
- - . Signal mrctat(s) or limited-energy
Business name: YESCO LLC panel, alteration, or estalsion Page 2 2
Each additional inspection over allowable in any of the above
Address: 20198 SW 112 m Ave Additional impaction (1 M min) 66.25! hr
City/State/Z[P: Tualatin OR 97062 Investigation (I hr mitt) 66.2.5/1v
indasiiel plan (1 hr min) 78.18/hr
Phone: (503 - 612 - 6672 l Fax: (503) 612 Inspections for which no fee is 90,00/ hr
specifically hoed (1'c- hr mint)
CCB Lae.: 188015 Electrical Lic.. 37 - Sicls Suprv. Lie.: 647sig ELECTRICAL PERMIT:, FEES ' _ • •
Subtotal: 67,84
Suprv. Electrician signature, required; , � Plan review (25% of permit fee);
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Print name: Eddie Lehigh _ iA / Y L^ Date: 7120/2013 State surcharge (12% of penult fee): 8.14
Authorized signature:
TOTAL PERMIT FEE: 75.98
This permit application ,spires if a permit Is not obtained withal 180
Print name: Ken Mahoney Date: 2/20/2013 drays atterit has Deco Accepted as complete.
Member of inspections allowed per permh,
t; ta PcnbotMpdoc Moth 0 44o44131111,0veowws0 •
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