Permit CITY OF TIGARD ELECTRICAL PERMIT
'`1 3 ' COMMUNITY DEVELOPMENT Permit#: ELC2015-00092
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/17/2015
Parcel: 1S135BB00300
Jurisdiction: Tigard
Site address: 10185 SW CASCADE AVE
Project: Lamar Billboard Sign Subdivision: HILLSBORO Lot: PTS 1-2
Project Description: (3)branch circuits for billboard illumination.
Contractor: DAVID STUCK ELECTRIC LLC Owner: PORTLAND GENERAL ELECTIC COMPANY
PO BOX 2582 121 SW SALMON ST
EUGENE, OR 97402 PORTLAND, OR 97204
PHONE: 541-542-0618 PHONE:
FAX:
FEES
Quantity Description Date Amount
3 crt Branch Circuits wo/Purchase 02/17/2015 $71.02
Specifics:, Service or Feeder
1 ea 12%State Surcharge- 02/17/2015 $8.52
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $79.54
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 952-001-0090. You may obtain of the rules or direct questions to OUNC by calling 503.232,1987 or 1.800.332.2344..
Issued By: `�`�"�C� Permittee Signature:
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 Applicati0 a I OHM 1 1( 1 1 .1 (1\I '
City of Tigard Received i
2015 „�
•
1111
]3125 SW Hall Blvd.,Tigard,OR 97223 r�8 1 Plan Review —
Phone: 503.718.2439 Fax: 503.598.1960V ppy� Date/B : er P it: ' �� a/1(-(,�.)
I � , P ti
Inspection Line: 503.639.4175 'V>#�AA a.: Ready/By: H Page 2 for
Internet: www.tigard-or.gov Cs IL-t�rr"Nig%i otified/Method: Supplemental Information
TYPE OF W ISO PLAN REVIEW
❑New construction Rt Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked below):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑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 k Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A","E","1-2","1-3",
Job no.: Job site address: /O/ 6,,r .5-W a��Q A1/L0. 1ix�°f more. occupancy.
❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: T16,4-40 O , OR 9 7 a z 7 ❑Health-care facilities. ❑Supply voltage for more than
d ❑Hazardous locations. 600 volts nominal.
- 12 Suite/bldg./apt.no.: Project name:4, q-R p/Li. 804 210 ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: C45-‘40 F al,/pi , 2S 41,/ ',- Description I Qty. I Fee. I Total 1 •
�LJN� GF 6 O��N�t/1G fie). Includes residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 1
Tax map/parcel no.: Limited energy,residential 75.00 2
DESCRIPTION OF WORK (with above sq.ft.)
Limited energy,multi-family
75.00 2
( r4M-t7CA/ op CS) t,is lust P4■4 Q Yu4 C-,9sze residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
4.v44/6t/3'T/OAI Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER ®'TENANT 200 amps or less 100.70 2
Name: L-/}# 14-/Q .444/4-1Z77.5"//IC 401 amps amps to 600 amps 00.34 2
to 600 amps 200.34 2
Address: G.9' . fZ i-V 30'• SAr- t 4-(tiro- 7,3 Q 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP: -yi m ; CR 97301 Temporary services or feeders installation,alteration,and/or
Phone:( ) Fax:( )
relocation
200 amps or less 59.36 1
Owner installation:This installation is being made on property that I own which is not
201 amps to 400 amps 125.08 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: Date: Branch circuits-new,alteration,or extension,per panel
I'APPLICANT I ❑ CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,
7.42 2
Business name: D411.1j7 _yrU C.t M Z,9-G7" C, $. C each branch circuit
B.Fee for branch circuits without
Contact name: ZIej-p/j 9 .5"71/Gfr service or feeder fee,first
branch circuit / 56.18 ..5—‘,i 811 2
Address: 94'5- TYi .0-; r A�. Each add'l branch circuit 7.42 )1-1,311 2
City/State/ZIP: 4'??C a1'sE', QQ 970y°?. Miscellaneous(service or feeder n included)
Each manufactured or modular 67 Rd � 'f
Phone:(SW) s-k3-GG /8 Fax: :( ) — dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail: 5 4ir 2 5-8? m v ai-47e/C a CG/'r1 Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: 404v/e Stu cg 40--L -a4G 4 At. Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 2
Address: PO BG 1,p Z 3—St Z Each additional inspection over allowable in any of the above
City/State/ZIP: A�t/G Lr 7 7i),O 2
Additional gati inspection() hr min) 66.25/hr
/ � Investigation(]hr min) 66.25/hr
Phone:(174/)/) K 6 5"-G fl $5 ' Fax:( ) Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
90.00/
tu-
CCB Lic.:(.5-1/77 Electrical Lic.:2.a- 7?C Suprv.Licht y 012 S specifically listed('/,hr min)
�y ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: 7L 6415,-- Subtotal 7/ 0 a,
Print name: )0/}(/ity ft snit/L. Date: at /1 Plan review(25%of permit fee):
State surcharge(12%of permit fee): •S pt
Authorized signature:4q'( ,r- TOTAL PERMIT FEE: 71.5-it —
Print name: t1 / O Date: T Per°dt application expires if a permit is not o pained within 180
/� days after it has been accepted as complex
• Number of inspections allowed per permit.
I:\Building/Pcmute',ELC_PemtitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(11/05/COM/WEB