Permit (7) �,, CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00015
Date Issued: 01/12/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S101 B600401
Jurisdiction: Tigard
Site address: 11880 SW PACIFIC HWY
Project: Russ Auto Subdivision: Lot: 0
Project Description: Sign lighting for sign off of Hall Blvd.
Contractor: YESCO LLC Owner: KNAUSS, WAYNE ET AL
20100 SW 112TH AVE C/O HUMBERSTON, RUSSELL D
TUALATIN, OR 97062 REVOCABLE TRUST
PO BOX 4300
BEAVERTON, OR 97076
PHONE:
PHONE: 503 - 612 - 6672
FAX: 503 - 612 -0914
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 01/05/2011 $67.84
Specifics: 1 ea 12% State Surcharge - 01/05/2011 $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, r if ork is suspend for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification C er Those rules re set forth in OAR
952 -001 -0010 through O • r • 52- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2 98 1.80. 2.23' .
Issued By: 111 i ���j `. 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.
y Perm g y�
ElectricaI it A icattioJ�3. � � � ;:q . 41.)" Q ' 'f aTltl."`1aa irs',-'�rt ':t *'rte
Fee Page 2 for
Received
t � & City Df Tigard Tigard '� � s..-- Permit No.: ° ] 3125 SW (T Blvd., Tigard OR 97223 t , ' Da s Re ii er. t� {(�aX) t S
p_ lam Review
L.. Phone: 503.718.2439 Fax: 503.598.1960 �� Other Permit
: .,i r � Date /By: 1, 1 e � 1 i 0 d3
II
TIGAIt15 Inspection Line g 03.639.4175 c t O ® • Date Ready /By: / /`/ f � e /'' ' .rnr is: T6
.�_._ Y:x . Internet: www.t and - ocaov 1 Notified /Method: �l 1 y Supplemental Information
I* " r I F ZYPF F 6 41 .1 . ) .,.. /Mign -- P N REaIEiV P :fir !
❑ New construction Addition /alteration /r aceme Please check all that apply (submit 2 sets 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.
a .mac,.;- - _
c - _
z r -
CATEGORYtOF CONSTRUCTION r I �' e xceeds 1 0,000 a mps at 100 volts or ❑ Floating buildings
-:, w „_; ,
less to ground, or exceeds 14,000 ❑ Commercial use agricultural
❑ I - and 2-family dwelling Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of75 KVA or
❑Emergency system.
larger separately derived system.
,„ .1 4iITE INFO AR 1AEIO? AND LOCATION;
..., .r .... .. „zone,. :, .,,..� .. �,,..„ , az...,: 3. ,�, <.:. B, `�..:. .,. ` ❑ Addition of new motor load of ❑ ,:A . "E”, °.i.2,,, "1-3",
Job no.: Job site address: � � �� �� I �t�I or more residential uniis. ❑ Recreational vehicle or more. occupancy. parks.
�
If . ❑ Six or
City /State /ZIP: 73a rd 07e. ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal.
�/ I.( I.I.T
Suite /bldg. /apt. no.: Project name: // U ❑ Service or feeder 600 amps or more.
K
.211 A.; I�,EE° SCItETULE = A ill
Cross.street /directions to job site: Description _ I Qty. I Fee. I Total
• - New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: - 1,000 sq. ft. or less 168.54 4
Ea. add'! 500'sq. ft. or portion 33.92 1
Tax map /parcel no.:
"� w ,� z DESCRIPI I:ON OF ° ORK:. Ln(wit . d energy, above residential
75.00 2
r Y Limited energy, multi family
RP ' residential (with above sq. ft.) 75.00 2
�Ge � l{� p rook eq J 1 7 �1 �' S� 5 Cr-04/ or feeders installation, alteration, and /or relocation
1 ✓✓ 200 amps'or less - 100.70 2
$ `, PROPERTI' `OR NER v . F _ ' CENANT 201 amps to amps 133.56 400 1 . 6 2
n 401 amps to 600 amps • 200.34 -2 _
N 1/ a , S - g 1 � � ci e it e . J �C ..5 3 601 amps. to 1;000 amps 301.04 2
Address: �' / � S e ri' H Over 1,000 or volts 552.26 2
t J L W 7 • Temporary services or feeders installation, alteration,.and /or
City /State /ZIP: / a , / (V relocation
Phone: • Fax: 200 amps or les 59.36 l
•
� � - . � � 201'amps to 400 amps 125.08 2
Owner installation: This installation is being made on property Mat .l own >vhich is not - . .
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
.Branch cit;cuits new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits it ith
APPLfCMNT 0 CON T ACT PERSO above serv or feeder fee,
7.42 2
each branch circuit
Business name: Y) -,- , B. Fee for branch circuits without
J service or feeder fee, first
- Contact name: - I go / , G-' S. branch circuit 56.18 2 •
NN � • /� Each add'I branch circuit 7.42 2
Address_ 2 / ls'�) /f dv1 _ /� +- � !� Miscellaneous (service or feeder not included)
—
City /State /ZIP: � � Each manufactured or modular
/ a /(,. v i ��, dwelling, service and/or feeder 67'84
Faz: : Reconnect only • - 67.84 2
Phone:
(5,23).--A-3 - /o ff (sa3 (� /� -��/
E-mail: � , p .f I`e _�
Pump r outline is circle / • 67.84 _ 2
mail
. 1,
/" t!n J j Si nor outline lighting _ 6.84 � � 2
. 17:. `itWSTRAGTOR„l�, . z t il 7 _ . . .
�.� ,,,, �.z, .' � ,, "' ..,., _. Si circtin(s) orlimited- energy
Business name: �S< �� panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: / bD S/ /42 4,„,,, Additional inspection (1 hr min) • 66.25/ hr
City /State /ZLP: � :
j //i / /(� e
Investigation p (t (1 mm) 78.28/ hr
I/�. [[(([[ Industrial plant (1 hr min) 78.18/ hr
Phone: 7 /�� F ax: �p Inspections for which no fee is
(���) (��� , `�'r I ( cro ) " / D .. `� - / � :specifically listed (%z hr min) 90.00/ hr
CCB Lic.: Electr Lic.: Suprv. t rxs IELECTRI PERMIT FEES`
� 5 37- 5 /BLS p Lie.: I!�7S � � � . _ .,,
. Subtotal 01.0 Y
Suprv. Electrician signature. required: -
�;,,�_ '_ , _ Plan review (25% of permit fee): _
Print name: 4v A Date: '5'b State surcharge (12% of permit fee): g,
i�� �Y XL11--.4 TOTAL PERMIT FEE:' 15 ,9?
n l
Authorized signature:
Thi per mit application expires if a permit is not o twined within 180
days after it has been accepted as complete.
Print name: iz „,,, �� 4l . Date: /Z) * Number of inspections allowed per permit.
•
I; \Building \Permits \ELC- PermitApp.doe 07/01/10 440 -461 ST(11I05)COM/WEB