Permit 11 q CITY OF TIGARD ELECTRICAL PERMIT
le COMMUNITY DEVELOPMENT Permit U: ELC2013 -00198
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/16/2013
Parcel: 2S102AA05500
Jurisdiction: Tigard
Site address: 12215 SW MAIN ST 120
Project: All Stop Pipes and Tobacco Subdivision: KINGSTON Lot: 19
Project Description: (1) sign or outine lighting for new 2' x 10' wall sign
Contractor: JERRY M YOUNGER Owner: CHOI, WOO Y & MAN JA
840 NE VILLAGE SQUIRE AVE 2323 NE 165TH DR
GRESHAM, OR 97030 PORTLAND, OR 97230
PHONE: 503 -618 -7826 PHONE:
FAX: 503 - 253 -9407
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 04 /16/2013 $67.84
Specifics:
1 ea 12% State Surcharge - 04/16/2013 $8.14
Electrical
Type of Use: COM
Class of Work: OTR
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. ATTENT • . C =• on law re uires you to follow the rules adopted by the Oregon Utility Notification Center. Thos= rules are set forth in OAR
952 - 001 -0010 r•ugh OAR 9 -001- 90. Yo y obtain a copy of the les or direct questions to OUNC by calling 503.232.1987 or 1 : 32 Issued By. Permittee Signature: 4 `I 1\)
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' 1 . � / I r , `r f _ 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 RECEWED FOR OFFICE USE ONL\
MAR 2 7 2013
City of Tigard Received a ..-k ° 13125 SW Hall Blvd., Tigard, OR 972 �! j '�'�I �pp�� Date/By:
Permit No / L� x(/1 ./y0i�
4 , OF TIGA Plan Review D� t/ vl/1
1 Date/By:
Other Permit ,0/3 (0Q
Phone: 503.718.2439 Fax: 503.598.
T 1 G A R D Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By: saris: Fa See Page 2 for
Internet: www.tigard - or.gov Notified/Method: 7( Supplemental Information
is -.a F &`
•� . : ':�._ _.__::_... _.....- ,..- ..... -. om
�� `,, te ,4-i ».., ' �:� °'-sue 4:.' ; r
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ New construction ❑ Addition/alteration /replacement
❑ Service or feeder 400 amps or more ❑ Building over three stories.
$.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
a , --- s c 4 r ∎: r ° !- s exceeds 10,0 amps at 150 volts or
s . ` •` P ❑Floating buildings.
r.� 3 ° t..1.: ° ' '� less to ground, or exceeds 14,000
V 2 dwelling br ❑ Commercial -use agricultural
❑ I - and
y g ❑ Commercial /industrial 0 building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or o
. B e ' i a - •". V, ❑ Emergency system. larger separately derived system. ''
fir_ . cr ._. _ 0 Addition of new motor load of ❑ "A" °E" "1_2 •l_3^ Vu
Job no.: Job site address: 12215 SW Main St 100HP or more. occupancy. C
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than C;
❑ Hazardous locations. 600 volts nominal
Suite/bldg. /apt. no.: I �-0 I Project name: iru_ g .s , - €, ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: SW Commercial St. 43611;
Description Qty. Fee. Total •
New residential single- or multi - family dwelling unit.
Includes attached garage
Subdivision: Lot no.: 1.000 sq. ft. or less 168.54 4
Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.92 I
Limited energy, residential 75.00 2
,. s ,1 ',„ . __ .4�� (with above . ft.)
Limited energy, multi - family 7500 1-
2
Sign connection residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER '
TET ,;� 201 amps to 400 amps 133.56 2
Mw
Name: ham 401 amps to 600 amps 200.34 2
MO haws 1-1 I1,vk— A \c't 601 amps to 1,000 amps 301.04 2
Address: 1 ( - I j $ We V3 „.4v , \a.,
Over 1,000 amps or volts 552.26 2
City/State /ZIP: ca )e Niv es *f � o 3 a Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
made on property 201 amps to 400 amps 125.08 2
Owner installation: This installation is being p petty that I own which is not 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits - new, alteration, or extension, er panel
Owner signature: - _ Date: . A. Fee for branch circuits with
❑ APPLICANT ® CONTACT` PERSON above service or feeder fee, 7.42 2
each branch circuit
Business name: Artico Lite Inc B. Fee for branch circuits without
service or feeder fee, first
Contact name: Jennah Lee branch circuit 56.18 2
Each add'l branch circuit 7.42 2
Address: 8621 Se Powell Blvd Miscellaneous (service or feeder not included)
City /State /ZIP: Portland, OR 97266 Each manufactured or modula
dwelling, service and/or feeder 67.84 2
Phone: (503) 253 - 9406 Fax: : ( ) Reconnect only 67.84 2
E - mail: Pump or irrigation circle 67.84 2
;o e a.. � _ fi ° Sign or outline lighting X0 67.84 2
:— � ”- • . Signal circuit(s) or limited energy
Business name: Gresham Neon & Signs , panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 840 NE Village Squire Ave Additional inspection (1 hr min) 66.25/ hr
City /State /ZIP: Gresham OR 97030 Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 380 - 4774 41111fflt Fax: ( ) 10`, \ v` 1 Inspections for which no fee is
specifically listed (Y: hr min) ` 00 / hr
CCB Lic.: 72685 VI 67
AM, Af in
LS r ;; ' -� .
Suprv. Electrician signature, requir 4. A�'la' Subtotal: 67.84
�L� - • L = =�� Pl review (25% of permit fee):
Print name: Jerry M Younger Date: 3 - 14 - 2 1 13 State surcharge (12% of permit fee): '
....r1.
------e TOTAL PERMIT FEE: 75.98
Authorized signature: , ft--
�4 L This permit application expires if a permit is not obi ned within 181
r days after it has been accepted as complet
Print name: Jennah Lee Date: 3-14 -2013
Number of inspections allowed per permit.
I \ Building \Permits\ELC- permitApp.doc 07/01 /]0 440.4615T(] ] /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system •
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ A udio and Stereo Systems
n Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ F ire Alarm Installation
❑ H VAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
O Protective Signaling
n Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\ Buildin \Permits\ELC - PermitApp.doc 07/01/10
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12215 SW MAIN ST 120, TIGARD, OR, 97223
Commercial - Electrical
140 Sign installation
06/11/2013 00:00
ELC2013-00198
PASS
Violation Summary:
Inspector Contractor