Loading...
Permit (2) CITY OF TIGARD ELECTRICAL PERMIT III 41. COMMUNITY DEVELOPMENT Permit#: ELC2019-00782 Date Issued: 11/04/2019 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S126CA01000 Jurisdiction: Tigard Site address: 9009 SW HALL BLVD 145 Project: Mr Bento Subdivision: None Lot: None Project Description: Sign lighting for(1)sign. Contractor: TRINITY ELECTRIC Owner: CAFARO NORTHWEST PARTNERSHIP 13422 SW 128TH PL PO BOX 422 TIGARD, OR 97223 FLORHAM PARK, NJ 07932 PHONE: 503-235-6481 PHONE: FAX: 503-579-3929 FEES Quantity Description Date Amount 1 ea Sign or Outline Lighting 11/04/2019 $67.84 Specifics: 1 ea 12%State Surcharge- 11/04/2019 $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 Codes a • other ap•licable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuan,,,��p���eror if ork i pended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notificatioenter. Tho - es are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obta' a copy the rules or direct questions to OUNC by calling 503. 2.1987.r 1.81'4. . .2344 Issued By: ,�,� +�� Permittee Signature: �Ky 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 I t)IR ( 1 1 1( I 1 `1 ON1i City of Tigard . Received `tl litateB :• // � _ -'t 13125 SW Hall Blvd.,Tigard,OR 97223 yo,* `�'i `''\ij °"` /•lan Review /`j "Arial� Phone: 503.718.2439 Fax: 503.598.19' j „ Date/B : Related Permit 6: Inspection Line: 503.639.4175 ?l f� o Ready Date/By: Ions: 10 See Page 2 for TIGARD 6 Internet: www.tigard-or.gov }r 7(Vi-" Notified/Method: ^" Supplemental Information ��{'TYPE OF WORK t PLAN REVIEW LIflsf New construction Addition/alteration/replacemepI s .. Please check all that apply(submit 2 sets of plans w/items checked). 0 Demolition /❑`Other: 3c7:IJ)�"a ' 0 Service or feeder 400 amps or more 0 Building over three stories. where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. 0 1-and 2-family dwelling ,Commercial/industrial 0 Accessory building less ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived ' f ❑Addition of new motor load of system. Job#: Job site address: go 0 y . H�.t t 9 J✓e( I00HP or more. ❑"A" "E" "1-2" "1-3" City/State/ZIP: (J Q 0 Six or more residential units. occupancy. �( r� 6'\ ( �7,2,, ❑Health care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: I CK Project name: M Y, 6.411--0 0 Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: StN ff a(( 6 tea Sl,., Pa[lam 10164 R( FEE SCHEDULE t Description I Qly. I Each I Total 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'I 500 sq.ft.or portion 33.92 I DESCRIPTION OF WORK Limited energy,residential 75.00 2 5' /^_n o e��� (with above sq. t) C�FJ ( Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 0 PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name: V`Iki /I� 200 amps or less 100.70 2 Address: "4 (� 114,1( t' 201 amps to 400 amps 133.56 2 009 ��' t3(v 4, * ‘ Li c 401 amps to 600 amps 200.34 2 City/State/ IP: Try� (7 P.._ (117)e": 601 amps to 1,000 amps 301.04 2 Phone:(7171 74,L/4 Fax:( ) Over 1,000 amps or volts 552.26 2 >r Temporary services or feeders installation,alteration,and/or Email: S',a -f- / r-ti 6.)1/10,-i?115 .C. w4 relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I intended for sale,leas r or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: ��,� Date:IC ( � 401 amps Ps to 599 amps 168.54 2 APPLICANT (a CONTACT PERSON Branch circuits-new,alteration,or extension,per panel ( A.Fee for branch circuits with Business name: -rhe vl efrt 5 trl'j S above service or feeder fee, 7.42 2 `tel each branch circuit Contact name: ".-.0 e- wee. B.Fee for branch circuits without Address: f y, 2 S h service it feederitfee,first 56.18 2 I !� f� ©t7- �?� � � branch circuit City/State/ZIP: RcA t f 9,%,..0 0 '?1(2-3 Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( "O3 )y-2_ a(9 3 Fax: :( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: I �fir�c Sign or outline lighting d 67.84 w7-" ' 2 l/f t Signal circuit(s)or limited-energy g Address: (3 4_� 5-1A)/ /2�'-ty /�/ , panel,alteration,or extension. 0 See Page 2 2 City/State/ZIP: /`(I Each additional inspection over allowable in any of the above R 9� 3 Additional inspection(1 hr min) 66.25/hr ��►- O 2y Phone:(q. f) 2_35 �� pr Fax:( ) Investigation(1 hr min) 90.00/hr Email: "SCJ Industrial plant(1 hr min) 78.18/hr I/4V)-f Inspections for which no fee is90.00/hr CCB Lie.: /53 t7 Electrical Lie.: 3if_663CSuprv.Lie.: ( specifically listed('/2 hr min) / ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: 0 4 Subtotal: G 7-'yli Print name: 'r N SU(/1 p �6 .3A Date:(( Q 0 Plan Review Required(25%of permit fee): f State surcharge(12%of permit fee): Authorized signature: / / ( (i 4- TOTAL PERMIT FEE: -75-A ff This permit application expires if a permit is not obtained within 180 Print name: (� .S ) t( e/"/1/ke Date: /"3 7"!1j days after it has been accepted as complete. moi- ," �qr""t 7 1 * Number of inspections allowed per permit. 1:\Building\'ermits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(I I/05/COM/WEB