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Permit (139) CITY OF TIGARD ELECTRICAL PERMIT IL `'-> COMMUNITY DEVELOPMENT Permit#: ELC2019-00152 Date Issued: 03/11/2019 T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S134BC00200 Jurisdiction: Tigard Site address: 12194 SW SCHOLLS FERRY RD Project: Monkey Subs Subdivision: None Lot: None Project Description: Sign lighting for(1)sign. Contractor: INTEGRITY SIGNS OREGON Owner: ATLAS GREENWAY LLC PO BOX 88 333 NW NINTH AVE, STE 1009 HUBBARD, OR 97032 PORTLAND, OR 97209 PHONE: 503-981-3743 PHONE: FAX: 503-982-8153 FEES Quantity Description Date Amount 1 ea Sign or Outline Lighting 03/11/2019 $67.84 Specifics: 1 ea 12%State Surcharge- 03/11/2019 $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 Code,- a d •II otther applicable law. All ,• will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issua-•:, • if •rk is s -•ended f• ore the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification • t: . ose -s - set forth in OAR 952-001-0010 through OAR 9 2-001-0090. You may obt-' a copy of tEe rotes•r direct questions to OUNC by calling 503.2 •r ••ir . 33,. --4. Issued By: 0 �, r ._ — .•rmittee Signature: � ,,,\C 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. EIVEDElectrical Permit Applica 111114 till It I I tilI►NI City of Tigard FEB 11.201,9:, Received 11/ Dotdl3v:, C41 ;I �� it No., rill'll 13125 SW Hall Blvd.,'Tigard,OR 97223 + , i t c `!� i ' Phone: 503.718.2439 Fax: 503 3 1 Plan lie: w �r e y 13ur213v 4 Permit:IJ - ,,,?�-/ lit,l tttl Inspection Line: 503.639.4175 ,,,r-,, e t, +...,,,�.., ,,/ Date Ready/ray ' gt See tPagea2 fo ((,/.,l Internet: www.tigard-or.gov 1 "r.' 1 Notitied/Method: � F._ pp Information MI TYPE OF WORK tla MMMMIMIIIIIIIIMIIIM ❑New construction 0 Addition/alteration/replacement Please elkeek all that apply( 1.. a 1 sets organs w./items:checked helriwl• Al 0 Service or feeder 400 ani•-.r more 0 nodding over three stories. ❑Demolition Other: N E l(V S 1(7.0 where the available Cauls at .'� •,.�...•.. _.. 0 Marinas and boatyards: CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 1. 1 ells or ❑floating buildings. dwelling �Commerual/industrial ❑Accessory building less to ground,or Meet 000 ❑ I-and 2-family0 Commercial-use agricultural 0 Mltlti;Tamilamps for all other Marano`n:, buildings. y 0 Master builder 0 Other: 0 fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION JOB system larger separately derived system, 0 Addition of new motor Is t ❑"A" "G" "t-2""t-3" Job no.: Job site address: Z q e,w (� ( IOOHP or more. occupancy. r+ ! j} ❑Six or more residential al i.. 0 Recreational vehicle parks, City/StatZIP: 1-1cb 0 j� 9-,.�3 ❑Health-care facilities. 0 Supply voltage for more than B s• ❑Hazardous locations, 600 volts nominal. Suite/bld .iapt.no.: Project name: 0 ,��E'v'i I S 0 Service or feeder 600 air,- . more. Cross sireet/directions to job site: n. — 111111111113. SCIIEDUI E UIN' a v. IIIINIKeRREMilliMMINIS r„ I' �_ JfC 1 S }- �} New residential single; ulti-family dwelling unit. "�1 I" Lp Includes attached gars[: € Subdivision: Lot no.;. 1;000 sq.R,or less ... ' Fe add'I 500 R.or,. Tax leap/parcel no.: �= II 168.54 33.9 Limited energy,resideritia�� DESCRIPTION OF WORK with above 0, 75-00 / Limited arra,multi.fat�r ;1/'�J /1/31/71i) s� -X L) {S i ` ki. residential with ahOve M�j �111113.1.11111 ' r V (l — ®r� © eacc,Pa•e 2 Servlet,or feeders in' ffilioe alteration and/or relocation go PROPERTY OWNER ❑ TENANT 200 amps or less mm� 100.70 / 201 amps to 400 amps , �1133 56 Nance: ATLAS l'. i't�- LL, t 401 amps to 600 amps INN= 200 34 ammo Address: 8 O8 5 t, A L ER -r-R6-E.+- °I 2cc 601 amps to 1,000 amps'' MN 301,04 111.1111113 City/State/zit'. 0 {( 2O5 Over 1,000amrzsorvoh9 552.26 Temporary services or iiers installation,alteration,and/or Phone: I ) ty8�y,1 3 I Fax:( ) relocation ( 200 amps or less 59,36 1 Owner ins tallation:This installation is being made on property that I own which is not �� intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701, 201 amps to 400 amps 125.08 2 alai= 4 ft 401 amps to 599 amps 168 54 Owner signature:_ Date: Branch circuits—new,. Et lion or extension r cr .anel PAPPLICANT i 0 CONTACT PERSON A.fret far branch circuitk above service or Ibede, I 11111 II Business name: [3,e4/11 U E 51 `? each branch circuit , B.roe for brunch eircuitt 111 Contact name: I`/11 I .C. 1--10/--INA;Aryl service or feeder fee,j` branch circuit City/State/ZIP: n Each add'l branch circum Address: BE.i �1R701 t 29--)00,". Miscellaneous service. �- ,i'.,1 in laded r Veal . ,. �,• Phone:( G> ) dwettat sctvirt andtnri' 67.84 ' 7 2 13 7 Fax::( _ ., 111 "` Reconnect only E-mail: /27//f'E ii ,W,( /1S/.,t.5 +� 11111111111=1111111111.111 1■ _... '.....!� Pum.or irrigation circld CONTRACTOR Sign routline lighung 67,84 Business name. , �: al euratii(s)or limitu• is Sec �`" .4 gip "=""""pat ,.mel.shemrion,or mach io III lta:1.2 2 Address: Each additional tna=ratio I ver allowable in art of tete above City/State/IIP '• Q — Additional inspection(f MD NM 66.25/hr 1��a )( n i1 ! investigation(1 hr min) 66,25/hr — Phone:( a t-y Fax:( .�} Industrial plant.(1 hr milt 78,18/hr m 1mo: -_ { ltrspet:norm for which no CCB Lie.: IS Electrical Lic.:GLS 20 ] Suprv. Ltc.:3qq J a,. incnit listed(t/r hr 20.00/hr Supra Elect ion signature,re4lelir.� I ► L PERMIT FEES 1 .r�a� —. .__.� _ Subtotal: ,pt Print n cmc. Plan rt vi- °/Of petmil fee):` t.t Ll acne: 2_ c3_ �q _. ° _.. . State vurcha- %of Permit fee). -,li ,i Authorized signature: T [y^^ Print name: .:,,„,^ ...rv.. .. Date:-.... .�„ This permit npplimtlon xtpi .,f a permit lis,ol•'Obtained within ISO days after has n accepted as complete.�_ • Nun3her of inspections thatt per permit I',.lholdina,J'ornns\EI c PermiiApp ELK_011:doe Km 0,,21/_013 140 t6t5Tt11/05/COM/WER