Permit CITY OF TIGARD ELECTRICAL PERMIT
: '. COMMUNITY DEVELOPMENT Permit#: ELC2020-00223
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/18/2020
T I t;A Ii p 9 Parcel: 2S11 ODB01300
Jurisdiction: Tigard
Slte address: 15294 SW ROYALTY PKWY
Project: Tigard Animal Hospital Subdivision: 1996-010 PARTITION PLAT Lot: 2
Project Description: Sign lighting.
Contractor: TUBE ART SIGNS&SPORTS DISPLAYS Owner: TIGARD INVESTMENT PROPERTIES LLC
4243-A SE INTERNATIONAL WAY 11086 SE OAK ST
MILWAUKIE, OR 97222 MILWAUKIE, OR 97222
PHONE: 503-653-1133 PHONE.
FAX: 503-659-9191
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 05/18/2020 $67.84
Specifics:
1 ea 12%State Surcharge- 05/18/2020 $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, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 2-001-0090. You ay obtai cop f the rules or direct questions to OUNC by calling 503.232.1987 1.800.332.2334444. J. �
Issued By: / Permittee Signature: t ' Y�/'
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 RECEIVED FOR OFFICE USE ONLY
Received Permit# '00
City of Tigard APR 22 2020 Dateiv 12[7 v �CaQ�r
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Rev ew Related Permit#:
•- ' Phone: 503.718.2439 Fax: 503.598.1960CITY OF T IGARD Date/B
Inspection Line: 503.639.4175 BUILDING DIVi.33ON Ready Date/By: hues ® See Page 2 for
I I t,AR Il Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
Please check all that apply(submit 2 sets of plans w/items checked):
®New construction ❑Addition/alteration/replacement ❑Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less to ground,or exceeds 14,000 0 Commercial-use agricultural
❑ I-and 2-family dwelling ®Commercial/industrial ❑Accessory building amps for all other installations. buildings.
0 Multi-family ❑Master builder 0 Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address: 15294 SW Royalty Pkwy 10011P or more. ❑"A","E',"l-2', `I-3",
0 Six or more residential units. occupancy.
City/State/ZIP:Tigard OR 97224 ❑Health-care facilities. 0 Recreational vehicle parks.
❑Hazardous locations. 0 Supply voltage for more than
Suite/bldg./apt.#: Project name:Animal Hospital ❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site:SW Naeve St FEE SCHEDULE
Description I Qtr. I Each I Total I "
New residential single-or multi-family dwelling unit.
Subdivision: Lot ft: 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 1
DESCRIPTION OF WORK Limited energy,residential 75.00 2
(with above sq.ft.)
Install One iluminalted Sign Limited energy,multi-family
75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
❑ PROPERTY OWNER ® TENANT Services or feeders installation,alteration,and/or relocation
Name:Animal Hospital 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Address: 15294 SW Royalty Pkwy 401 amps to 600 amps 200.34 2
City/State/ZIP:Tigard OR 97224 601 amps to 1,000 amps 301.04 2
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: 401 amps to 599 amps 168.54 2
„ APPLICANT ® CONTACT PERSON A. ef circuitsbrac —r uw,alteration,or extension,per panel
s A.Fee for branch circuits with
Business name:Tuba Art Group above service or feeder fee, 7.42 2
each branch circuit
Contact name:Haley Arnell B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address:4243-A SE International Way branch circuit
Each add'I branch circuit 7.42 2
City/State/ZIP:Milwaukie OR 97222
Miscellaneous(service or feeder not included)
Phone:(503)748.9053 Fax: :(503)659.9191 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:harnell%=@tubeart.com Reconnect only 67.84 2
,_ .. "" 67.84 2
CONTRACTOR Pump or irrigation circle
Business name:Tube Art Group Sign or outline lighting I 67.84 2
Signal circuit(s)or limited-energy El See Page 2 2
Address:4243-A SE International Way panel,alteration,or extension.
Each additional inspection over allowable in any of the above
City/State/ZIP:Milwaukie OR 97222 Additional inspection(1 hr min) 66.25/hr
Phone:(503)748.9053 Fax:(503)659.9191 Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email:harnell@tubeart.com Inspections for which no fee is 90.00/hr
CCB Lie.: 70956 Electrical Lic.: 37554CLS Suprv.Lie.: 601SIG specifically listed(/hr min)
Approved ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: PaG•ed adi. Signature Subtotal: (p77 ,,,,S'y
Print name: David Jaque D : 4/2/2020 0 Plan Review Required(25%of permit fee):
'/^^ O State surcharge(12%of permit fee): fJir
A,.,4a TOTAL PERMIT FEE: '2a r cl
Authorized signature: This permit application expires if a permit is not obtained within l80
Print name: Haley Arnell Date: 4/2/2020 days after it has been accepted as complete.
* Number of inspections allowed per permit.
MBuilding\PermitsSELC_PermitApp ELR_ERE.doe Rev 06/17/2015 440-4615T(I I/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Description
Fee for all residential systems combined: $75.00 Qty. Each Total
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100 70 2
5.01 to 15 kva 13356 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >100 kva(fee in accordance 552.26 2
with OAR 918-309-0040)
❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is
charged at an hourly(1 hr min) 66.25/hr 1
Inspections for which no fee is 90.00/hr
specifically listed(%hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
(SEE OAR 918-309-0000) Nuroner of inspections allowed per permit
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
H Data Telecommunication Installation
Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
• ❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
1.\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015