Loading...
Permit (11) 111111 CITY OF TIGARD ELECTRICAL PERMIT : COMMUNITY DEVELOPMENT Permit#: ELC2017-00419 Tf ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/28/2017 Parcel: 2S110DB00702 Jurisdiction: Tigard Site address: 15410 SW PACIFIC HWY Project: Jiffy Lube Subdivision: WILLOW-BROOK-FARM Project Description: (5)sign lightings for 2 wall signs, 1 awning sign&2 directional signs. Lot: 2 Contractor: MEYER SIGN CO OF OREGON Owner: 15205 74TH AVE ROTC OREGON LLC SW, OR 97224 ATTN: SCHOEBEL, RICHARD 8905 TOWN CENTRE DR, STE 108 SAN DIEGO, CA 92122 PHONE: 503-620-8200 PHONE: FAX: 503-620-7074 FEES Quantity Description Date Amount Specifics: 5 ea Sign or Outline Lighting 06/28/2017 $339.20 1 ea 12%State Surcharge- 06/28/2017 $40.70 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $379.90 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 iss -nce, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notifi -'.n Center. Those rules are set forth in OAR 952-001-0010 through R 952-001-0090. You may obtain a copy,111110 or direct questions to OUNC by callin. 03. 42. 987 or 1.800.3322 2344G . 7 a i�7� � Issued By:/72,.."? ` A Permittee Signature: L_, �_ 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 Application FOR OFFICE USF:ONLI" City of Tigard Received 13125 SW Hall Blvd.,Tigard, • ��! Date/B : CO 1 I f h Permit#: ,7-0p f1 Phone: 503.718.2439 Fax 50' !� E41 E Plan Review Date/B Related Permit#: : 111T I G A R D Inspection Line: 503.639.4175 ReadyDate/By: Internet: www.tigard-or.gov Notified/Method: ® See Page 2 for I (� 7 2C�1 Notified/Method: Supplemental Information TYPE OF WORK t PLAN REVIEW ❑New Construction RI Addition/tifily4(014CIGARD Please check all that apply(submit 2 sets of plans w/items checked): ❑Demolition 0 Other: �p1 vi j D QV "a ❑Service or feeder 400 amps or more ❑Building over three stones. CATEGORY 41I74�(3NIiJ jpAl i where the available fault current 0 Marinas and boatyards. exceeds 10,000 amps at ISO volts or 0 Floating buildings. 0 1-and 2-family dwelling dCommercial/industrial 0 Accessory building less to ground.or exceeds 14.000 ❑Commercial-use agricultural amps for all other installations. buildings. 0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATI ❑Emergency system. larger separately derived Job#: I Job site address: f Jill o v/,yv`' ///f e 0 ❑Addition of new motor load of system. ��/{�f 100HP or more. City/State/ZIP: "1-;-6/111-40 1 L 171-) ❑Six or more residential units. occupancy. ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: I Project name:Ji F,1 Lite ❑Hazardous locations. 0 Supply voltage for more than Cross street/directions to job site: ❑Service or feeder 600 amps or more. 600 volts nominal. FEE SCHEDULE Description I Qty. I Each l Total 1 * New residential single-or multi-family dwelling unit. Subdivision: I Lot#: Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 168.54 4 DESCRIPTION OF WORK Ea.add'1 500 sq.ft.or portion 33.92 Limited energy,residential I �da'� 2 i�1s-u. G!J 5 / 75.00 f / �" , (with above sq.ft.) 2 Its Q /y y��IC�1 I t�(*)�� j i b�i Z 77/or 6 Limited energy,multi-family tic- ( residential(with above sq.ft.) 75.00 2 PROP RTY OWNER , I i 0, TENANT. Renewable Energy ❑ See P2 Name: 1 Services or feeders installation,alteration,and/orage relocation /`��'�_'�/di��j le/454,v_ 0LllMtes 200 amps or less 100.70 2 Address: 15 ljXt" f -- 201 amps to 400 amps 133.56 2 City/State/ZIP: ��Z��.j � � � �� 401 amps to 600 amps 200.34 2 601 amps to 1.000 amps 301.04 2 Phone:( ) I Fax: ( ) Over 1,000 amps or volts 552.26 2 Email: Temporary services or feeders installation,alteration,and/or relocatin Owner installation:This installation is being made on property that I own which is not 200 amps or less intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps59.36 125.08 2 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 APPLICANT 1 . CONTACT PERSON Branch circuits-new,alteration,or extension,per panel /l l r��E 'fb CO- o f dl,`6o I t A.above for branch or feede wet, Business name: /1��+ a/� V/t,t' IV above service feeder fee, each branch circuit 7.42 2 Contact name: ©a; //` 1 �� B.Fee for branch circuits without Address: /5 5. �n LI i.AI 70 ' /1 1service or feeder fee,first T /r✓ branch circuit 56.18 2 City/State/ZIP: -776/4.,(6014;9. tL t 7 Each add'1 branch circuit 7.42 2 Phone: (t,// )43/._< 'OLS I Fax: :( ) Miscellaneous(service or feeder not included) Each manufactured or modular Email: A' ;T3 es_At tom,77 �r 6 J /i�►A , Reconnect only 67.84 2 dwelling,service and/or feeder 67.84 2 CONTRACTOR `�+'x-'l Pump or irrigation circle 67.84 2 Business name: iiiitiek ‘5,10 i_[ e g t 0 Sign or outline lighting 5 67.84 35, 2 Address: 152.6 S W . 7 T � /�(! Signal circuit(s)orlimited-energy --1-1.604-0-6 � panel,alteration,or extension. ❑ See Page 2 2 City/State/ZIP: / t 'r.A. OA— 17)-)4- 7 j 4. Each additional inspection over allowable in any of the above (/��� ) �` '� / ' T Additional inspection(1 hr min) 66.25/hr Phone: Z-32 _ 5O 2_( I Fax:( ) Investigation(]hr min) 90.00/hr Email: ?emu, -s Achim Lf/6 -� � plant(1 hr min Industrial � ) 78.18/hr CCB Li C.: Inspections for which no fee is Q/ Electrical Lic.: pA specifically , 90.00/hr /J2A-///�e s i Suprv.Lie.: 5 f S((�ry listed(/2 hr min) Suprv.Electrician signature,required: ,// �4ELECTRICAL PERMIT FEES 1 �.: Subtotal: � ..0� Print name: nitet I til,te: 5/i l / �7 0 Plan Review Required(25%of permit fee): State surcharge(12%ofpermit fee): B `t�D 70 Authorized signature: , ` t ,.. TOTAL PERMIT FEE: 3 7?F 70 / Cal This permit application expires if a permit is not obtained within 180 Print name: Aj ji(e� G ICY d a I Date: �!/ ✓ I �� I days after it has been accepted as complete. * Number of inspections allowed per permit. I:A Building\Permits\El_C_PermitApp_11,R_E121•1.doc key 06/17/2015 440-4615T(11/05/COM/W1113