Permit q CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2022-00814
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/12/2022Parcel: 2S102BD03000
Jurisdiction: Tigard
Site address: 13025 SW PACIFIC HWY
Project: Pool&Spa House Subdivision: NORTH TIGARDVILLE ADDITION Lot: 35
Project Description: Sign lighting for relocated freestanding sign.
Contractor: RAMSAY SIGNS INC Owner: TRUCK TERMINALS INC
9160 SE 74TH AVE PO BOX 2106
PORTLAND, OR 97206 BEAVERTON, OR 97075
PHONE: 503-7774555 PHONE:
FAX: 503-777-0220
FEES
Quantity Description Date Amount
Specifics: 1 ea Sign or Outline Lighting 12/12/2022 $67.84
1 ea 12%State Surcharge- 12/12/2022 $8.14
Electrical
Type of Use:
Class of Work:
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 r if work is suspended for more the
180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Ce Those rules are set forth in OAR ,
952-001-0010 throualb OAR 952-001-0090. You mavn�a co a rules or direct ouestions to OUNC by callinc 503.232. or 1.8 32.2344.
Issued By: '�� v mittee 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'N 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 USE ONLY
MRCity of Tigard i l RecDateived ,(� Permit
13125 SW Hall Blvd.,Tigard,OR6 GF W� plan Review
Phone: 503.718.2439 Fax: 503. 9 .1960a M n,3,, DateB : Related Permit#: _
Inspection Line: 503.639.4175 �y•("� 1 2 2Oe"? Ready Date/By pais: Ia See Paget for
0Internet: wu .tigard-orgov NIcu ied/Method: Supplemental Information
_... _... -
TYPE`OF-NOW -t . ..: ,-kl.. _ PLAN REVIEW - -
❑New construction ®Addition/ald1ration/xeplacement Please check all that apply(submit 2,els of plans w/items checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition El other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
❑ I-and 2-family dwelling ®Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency systemlarger separately derived
Job ; 60333 10b site address: [:]Addition of new motor load of system.
13025 SW Pacific Hwv 100HP or more. 0"A-,"E","I-2", •1-3",
City/State/71P: Tigard,OR 97223 ❑Six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg✓apt.#: Project name: POOL&SPA HOUSE ❑Ilazardous locations. ❑Supply voltage for more than
❑Service or feeder We amps or more 600 volts nominal_
Cross street/directions to job site: Pacific Hwy W&SW Frewing St FEE SCHEDULE
tlrsrri taa I Qtv. I Each I I oral
New residential single-or multi-family dwelling unit.
Subdivision: Lot 4: 36 Includes attached garage.
2S 102BD02900/R464615 1,000 sq.ft,or less 168.54 4
Tax map/parcel#: Ea.add'1500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
Install(1)Sign Circuit for(1)Freestanding Pole Sign"Pool&Spa House"
(with above s ft_ 75.00 2
Limited energy,multi-faznily 75.00 2
residential with above sq.ft.
Renewable Ener ❑ See Page 2
El PROPERTY OWNER -, ;:: El TENANT Services or feeders installation,alteration,and/or relocation
N ante: 200 amps or less 100.70 2
Address:
201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 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
-- - — Branch circuits—new,alteration,or extension,Per panel
APPLICANT ® CONTACT PERSON A.Fee for branch circuits with
Business name: Ramsay Signs above service or Feeder fee, 7.42 2
each branch circuit
Contact name: Chris Sloviek B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address: 9160 SE 74th Ave, branch circuit
City/State/ZIP: Portland, Each add'I branch circuit 7.42 2
Miscellaneous service or feeder not included
_- Phone:( -- )---971-334=3033 - - -Fuxt - )—-(503)961-7784—- - -Each manufactured or modular - -- --" - -
- 67.84 2
dwelling,service and/or feeder
.mail: permitsµramsaysigns.com ------ - -- -- Reconnect only 67.84 2
TR
CONACTOR ("
_ - _- Pump or irrigation circle 67.84 2
Business name: Ramsay Signs Sign or oudine lighting 1 67.84 67.84 2
Signal circuit(s)or limited-energy ❑ See Page 2 2
Address: 9160 SE 74th Ave, panel,alteration,or extension.
City/State/ZIP: Portland, Each additional inspection over allowable in anyof the above
Additional inspection(1 hr min) 66.25/hr
Phone:( ) 971-334-3033 Fax:( ) (503)961-7784 investigation(1 hr min) 90.00/hr
Email: permits@ratnsaysigns.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 9000/hr
CCB Lie.: 63422 Electrical Lie.: 26-106CLS Suprv.Lie.: 493SIG specifically listed Y,hrmin)
` - - —ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal' 67.84
Print name: Phil Steiger - Date: 11.9.22 ❑Plan Review Required(25%ofpermit fee):
State surcharge(12%of permit fee):
Authorized signature:
J6W-C'.�t� TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: ends slat rk Date: 1 1-9.22 days after it has been accepted as complete.
" Number of inspections allowed per permit.
L:BuildingTermits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(I I/05X0M/WLB