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Permit (29) 1 CITY OF TIGARD ELECTRICAL PERMIT 7 COMMUNITY DEVELOPMENT Permit#: ELC2016 00260 TIGARD13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/03/2016 Parcel: 2S102CB03200 Jurisdiction: Tigard Site address: 9975 SW FREWING ST 210 Project: Accident Care Subdivision: FREWING'S ORCHARD TRACTS Lot: 21 Project Description: (1)sign lighting. Contractor: VISION SIGNS LLC Owner: MASSIH LLC 16127 NE THOMPSON ST BY PIERROUZ YASAVOLIAN PORTLAND, OR 97230 8 BECKET ST LAKE OSWEGO, OR 97035 PHONE: 503-442-1195 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Sign or Outline Lighting 05/03/2016 $67.84 Specifics: 1 ea 12%State Surcharge- 05/03/2016 $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. ATT : . • egon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001 .010 through OA' •. -001 0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.3 .2 4' Iss ed By: I /� �L� 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 App11CaitrfCEIVEP FOR OFFICE USE ONLY KrCity Tigard DaceiBed ^ � //-OOv of q �� ( may, Permit g: �O 13125 SW Hall Blvd.,Tigard,OR 9727f Plan Review Phone: 503.718.2439 Fax: 503.59419450 4 7.016 Date/By: Related Permit#: 644010l4—C re il/ T IGA RD Inspection Line: 503.639.4175 Ready Date/By: Juris: ® See Page 2 for ® Internet: www.tigard-or.gov ITV . '( Notified/Method: Supplemental Information TYPE t PLAN REVIEW Now construction D Other:oi17dlteratidn/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑Service or feeder 400 amps or more ❑Building over three stories. Demolition TYPE where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings. El1-and 2-family dwelling . Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑ Multi-family '---IMaster builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: A I Vil Job site address: .> c) `i ' 2t lav l tV' 100HP or more. g 7 V V �I ❑..A„ .,E„ ..l 2„ ..1 3„ City/State/ZIP: {� `} G y 7 ❑Six or more residential units. occupancy. To a�rt R V t� 7 ❑Health-care facilities. ,1 ❑Recreational vehicle parks. Suite/bldg./apt.#: ( d Project name: ALC i��M /n0,R .- ❑Hazardous locations. ❑Supply voltage for more than V ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE -- Description 1 Qty. I Each 1 Total I " q q W� S W rl�t fltjl(�' ' �� New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1 l DESCRIPTION OF WORK Limited energy,residential /-ed (ii it.11,11€/ 1 y� �,��` (with above sq.ft.) 75.00 2 T1 t c°a��f ifS r�/-/! �SY 6� GZ11 left Limited energy,multi-family residential(with above sq.ft.) 75.00 2 Renewable Energy ❑ See Page 2 PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name: ' /e a /1 G z y A�,0 I l ct 200 amps or less 100.70 2 Address: /�q(7/ I X,j r 201 amps to 400 amps 133.56 2 C� yl `� "" hie I 401 amps to 600 amps 200.342 I City/State/ZIP: / p 2 it,41]� (� /� /�r �3 601 amps to 1,000 amps 301.04 2 Over 1000 ams or volts 552.26Phone:(�Q3) '�� ��� � Fax:( ) , P 2 Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation: This installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale, lease,rent,or e ange,according to ORS 447,449,670,and 701./ 201 amps to 400 amps 125.08 2 Owner signature: Date: 3//7//,t_ 401 amps to 599 amps 168.54 2 APPLICANT (� CONTACT PERSON Branch circuits—new,alteration,or extension,per panel / A.Fee for branch circuits with Business name: above service or feeder fee, ��Si Ont l � each branch circuit 7.42 2 Contact name: Tern VS ✓ B.Fee for branch circuits without 7��. service or feeder fee,first 56.18 2 Address: 1c�a `7 /V F 146 �f t6� > branch circuit City/State/ZIP: I Each add'l branch circuit 7.42 2 �v JR /!�� d �� �17�2 3 D Miscellaneous(service or feeder not included) Phone:(sj',' 44! - 1/ 4 Fax: :( -03) r7..�_ �0,� 0/ Each manufactured or modular 67.84 2 Email: ! 7 S dwelling,service and/or feeder // �r F. 7-cm V > �� C C/�1 Reconnect only 67.84 2 fCONTR4CR ' ' Pump or irrigation circle 67.84 2 Business name: 1 I g ;231AS' j / C Sign or outline lighting I 67.84 47�y 2 Address: //'/ .� 7 ��,1LLLF /( 4nn�Z — pinna, Iter tions)or lextensionergy ❑ See Page 2 2 (G u� �(% panel,alteration,or extension. City/State/ZIP: Cgd f evA `( G" Each additional inspection over allowable in any of the above '/ 7,�3o Additional inspection(1 hr min) 66.25/hr Phone:6-e3 ) „5/1.4,2 _ `/‘i Fax:( ) Investigation(1 hr min) 90.00/hr ..! j/ Industrial plant(1 hr min) 78.18/hr Email: (/jj fl Ar , e 8 Inspections for which no fee is 90.00/hr j 2 viaO/ CCB Lic.: )7 � - Electrical c.: _. Suprv.Lie.: /7G r specifically listed('h hr min)ELECTRICAL PERMIT FEES Suprv. Electrician signature,required: • (i— / Subtotal: (Q 7. $`t Print name: Date: ❑Plan Review Required(25%of permit fee): ....iS State surcharge(12%of permit fee): 1(• / Authorized signature: •,/ TOTAL PERMIT FEE: 75.9' This permit application expires if a permit is not obtained within 180 Print name: �� A_/ III Date: /)7 1�� ` days after it has been accepted as complete. / /f' * Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 9975 SW FREWING ST 210, TIGARD, OR, 97223 Commercial - Electrical 199 Electrical final PASS - No C of O ELC2016-00260 Jeff Grove Violation Summary: Inspector Contractor