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Permit CITY OF TIGARD ELECTRICAL PERMIT 11111 • COMMUNITY DEVELOPMENT Permit #: ELC2012 -00708 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/17/2012 Parcel: 2S115AB01900 Jurisdiction: Tigard Site address: 16200 SW PACIFIC HWY G2 Project: Foot Solutions Subdivision: 1994 -028 PARTITION PLAT Lot: 2 Project Description: (1) sign lighting Contractor: SIGNCRAFT ELECTRICAL ADVERTISING LLC Owner: SN PROPERTIES PARTNERSHIP 8900 SW BURNHAM, E109 1121 SW SALMON ST TIGARD, OR 97223 PORTLAND, OR 97205 PHONE: 503 - 639 -4910 PHONE: FAX: 503 - 639 -4999 FEES Quantity Description Date Amount 1 ea Sign or Outline Lighting 12/17/2012 $67.84 Specifics: 1 ea 12% State Surcharge - 12/17/2012 $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 pe • - • .'ect to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law. All work will be do - in accordance with - 'proved •lans. 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 la , requires • to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 thro gh OAR 95 •0 -001 ou m • y obtain a copy of • = rules or direct questions to OUNC by calling 503.232.1987 or 00.332.2344. Issued By: r 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 Application FOR OFFICE I SE ON 1.1 Received �J n /� City of Tigard Date /B : /02 P ermit No. Ekep"�CJ /p( -60 70i • 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review = Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Other Permit: ..3 -ad af I' I c. A R I) Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard - or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW NCW construction ❑ Addition /alteration replacement Please check all that apply (submit 2 sets of plans w /items checked below): 111111"""""������ ❑ Service or feeder 400 amps or more ❑ Building over three stones. ❑ 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 ❑ I- and 2- family dwelling Cgl Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- famil ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "l -2 ", "1 -3 ", (� r l OOHP or more. occupancy. Job no.: Job site address: i 01 00 S t,ra ZC ` i ` S \t4.hi ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP: --�+ p ❑ Health -care facilities. ❑ Supply voltage for more than \ 1 I �JeC� O 2 0 I t) a.� ❑ Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: `� ' Project name r3T Sa e ^ S ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: w f ..:V \tj ,Q _ Description i Qty. f Fee. I Total I , "e'� 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'l 500 sq. ft. or portion 33.92 I Tax map /parcel no.: Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) l .... Limited energy, multi- family n \ t"1 ©O k C 7 21 l it • CCU X ■ s'� /L residential (with above sq. ft.) 75.00 2 Services or feeders installation, alteration, and/or relocation S \ A \ Tct, , A 200 amps or less 100.70 2 ■1 PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2 Name: I amps to 600 amps 200.34 2 aa — • • • • • • • ► y . ` i 4 . ' y ). mps to 1,000 amps 301.04 2 Address: j,, 1 , A...0 ,g /feAn ti ; 5 Co re , • er 1,000 amps or volts 552.26 2 Temporary services or feeders installation, alteration, and /or (� City/State /ZIP: d ,. ,k - n 11 o Q l sco relocation Phone: �7 Fax: 200 amps or less 59.36 1 ( So� 9 / 3 - oat* ( ) 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7 42 2 each branch circuit — Business name: nA, X 7 ^ B. Fee for branch circuits without `� ` `} \ ►`I nJ� service or feeder fee, first Contact name: r k - e. branch circuit 56.18 2 v Each add'I branch circuit 7.42 2 Address: 1 lsao( s . LA..) T CAGs -1 hlt.o (J� S t7 x e 6 Miscellaneous (service or feeder not included) 1 Each manufactured or modular City /State /ZIP: ( — � ` Q 2 9 dwelling, service and/or feeder 67.84 2 Phone: (�3) / _ ,4Z4 _ 6 y© 0 Fax: : ( ) Reconnect only 67.84 2 t Pump or irrigation circle 67.84 2 E - mail: Sign or outline lighting 8 4 (e 78,42 CONTRACTOR Signal circuit(s) or limited - energy Business name: ` n- panel, alteration, or extension. Page 2 2 Sukne -a-FT E-tee4 -t. CA Mve-t \ Sl /l at -. Each additional inspection over allowable in any of the above Address: Raps) . � k „ 0` 1 e ��� Q Additional inspection (1 hr min) 66.25/ hr City/State /ZIP: Y�It�r \ 1 Investigation (I hr min) 66.25/ hr 1 �r � I 0 C /c, Q 3 Industrial plant (1 hr min) 78.18/ hr Phone:0,3) d 21q/c2 Fax: �)j3) tha FS 8 Inspections for which no fee is 90.00/ hr �.�S / / 4/...607 ty specifically listed (% hr min) �j L' Electrical Lic.:3 ClL . uprv. Lic.: 7a S `O ELECT PERMIT FEES r ) /O // _ Subtotal: 7, Suprv. (lectrician signature, required: !.� �� /per• Plan review (25% of permit fee): - -• Print name: 0,u' P ; e ,,_s Date: h State surcharge (12% of permit fee): g . / ' TOTAL PERMIT FEE: 7 5 ' ,9 Authorized signature: • 4 j' — • 4 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: c:f0 ‘/N-v\_ SC C Date: . /.; _I D ...j . Number of inspections allowed per permit. I:\ Building \Permits\ELC- PermitApp.doc 07/01/10 440- 4615T(11/05 /COM/WEB