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Permit (180) CITY OF TIGARD ELECTRICAL PERMIT I COMMUNITY DEVELOPMENT Permit#: ELC2018-00563 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/30/2018 T t c;, h � 9 Parcel: 2S103DD00850 Jurisdiction: Tigard Site address: 13815 SW PACIFIC HWY 30 Project: Boost Mobile Subdivision: None Lot: None Project Description: Sign lighting for(1)sign. Contractor: MEYER SIGN CO OF OREGON Owner: D W SIVERS CO 15205 SW 74TH AVE 4730 SW MACADAM AVE#101 TIGARD, OR 97224 PORTLAND, OR 97239 PHONE: 503-620-8200 PHONE: FAX: 503-620-7074 FEES Quantity Description Date Amount 1 ea Sign or Outline Lighting 08/22/2018 $67.84 Specifics: 1 ea 12%State Surcharge- 08/22/2018 $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 CR.es 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 ':'uance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notif -tion Center. Those rules are s= forth in OAR 952-001-0010 through OA 2-001- 90. You ay obtain opy of the rules or direct questions to OUNC by calli 503.232.1987 or 1. .332.2344. G Issued By: Permittee Signature: AI, - 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 503.639.4176 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 roR orrl( t 1 si:oyl.l City o Tigard ,, eeived 4xa1'7Date/B : i iA4 &: 7,621 11 - ciiiiiiwwf i itito 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review : ii Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#: / # .,A. i i , Inspection Line: 503.639.4175 O 2 r)O18 Ready Date/By: H See Page 2 for I WARD Internet: www.tigard-or.gov Notified/Method: !' Supplemental Information ❑New construction Addition/alterRIEffeWnDiviSION Please check all that apply(submit 2 sets of plans w/items checked): 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition ❑Other: where the available fault current 0 Marinas and boatyards. .,CATE RY OF CONSTRUCTION '-' exceeds 10,000 amps at 150 volts or ❑Floating buildings. 0 1-and 2-family dwelling DICommercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. D Multi-family ❑Master builder 0 Other: 0 Fire pump. 0 installation of 150 KVA or JOB 51 UE-I: FORMA ON AND I A' O ,1 13Emergency system. larger separately derived ft ❑Addition of new motor load of system. Job#: Job site address: /5/15' f. id //r 61//e J© 100HP or more. ❑"A","E","1 2 ,"I-3", City/State/ZIP: 7 6 4 �a�3 ❑R cu p 0 Six or more residential units. occupancy. Recreational vehicle arks. Suite/bldg./apt.#: Project name: got f t 6/LE 0 Hazardous locations. ❑Supply y v tome age or more than ❑Service or feeder 600 amps or more. Cross street/directions to job site: FEE SCNED11LE: Description I Qty. I Each I Total I * 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 '`- .i DESCRIPTION OF•WORk . -`= ''`` ' Limited energy,residential 75.00 2 Cn)4&Lr. //011-44A4/i /////G�t/,Jf-7T-� pi�C.C- (with above sq.ft.) Y' Limited energy,multi-family residential(with above sq.ft.) 75.00 2 Renewable Energy ❑ See Page 2 1')E# 3 i OWhI) C • u Services or feeders installation,alteration,and/or relocation Name: '7-)L _ "51 Ve200 amps or less 100.70 2 Address: I/736 IA) ,1/1-�%7 4-/`11 /7"er 'iv 201 amps to 400 amps 133.56 2 L 401 amps to 600 amps 200.34 2 City/State/ZIP: Ann-AM Z2 %7aJ/ 601 amps to 1,000 amps 301.04 2 i Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 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 exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature Date: amps168.54 2 tion,or extension,per panel 401 amps to 599 : APP.Tl 1T Branch circuits new,altera ' //// CUIIIAC! N A.Fee for branch circuits with Business name: /2/ 94-W__ q/d Com'. B�t // 7G A.._J above service or feeder fee, 7.42 2 /��y � � horahcircc Contact name: /✓�/ B.FeeFee b for branch circuits without G' service or feeder fee,first 56.18 2 Address: �S'i S 1, W 1 Ale. branch circuit City/State/ZIP: z et, 4d Each add']branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(I7/ ) Z - ,5-'11,,,21 Fax: :( ) Each manufactured or modular 67.84 2 Email: t .." 6 At.e y .&Li/6 AI 0ill/(•`� dwelling,service and/or feeder / Reconnect only 67.84 2 JJJ CO 0 i . ;; Pump or irrigation circle 67.84 2 Business name: fi yF� j/eA J k/.,yze�6,(, Sign or outline lighting / 67.84 c'7 iii 2 �j /, c � Signal circuit(s)or limited-energy 0 See Page 2 2 Address: /5-2,6 S /. r",. ( " panel,alteration,or extension. City/State/ZIP: j�671A,/) �� 7�..--171 Each additional inspection over allowable in any of the above / t Additional inspection(1 hr min) 66.25/hr Phone:(9 ii) Z Z ' 5- 0,2.1 Fax:( ) Investigation(1 hr min) 90.00/hr Email: //(11.44--1-11e /A/t'l /fi�a, �%M Industrial plant(1 hr mm) 78.18/hr Inspections for which no fee is 90.00/hr u/ CCB Lie.: 40// Electrical Lic.:2a-/,Q Cts Suprv.Lic.: (.5-'4 7 specifically listed('/2 hr min) ;k>r , fieri ICAL PE,! T:.FEES . Suprv.Electrician signature,requir•d: Nom' Subtotal: Print name: {),b A �'/ f D. e: 9/ 7 6 ❑Plan Review Required(25%of permit fee): "f 6 �� State surcharge(12%of permit fee): fj,ill Authorized signature: 7 TOTAL PERMIT FEE: 75-,15 This permit application expires if a permit is not obtained within 180 Print name: 7 C// ( Date:C 9/24// days after it has been accepted as complete. / j * Number of inspections allowed per permit. I:ABuilding\Permits 1ELC_PermitApp_ELR ERE.dor Res 06/17/2015 440-4615T(11/05/COM/WEB