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Permit u CITY OF TIGARD ELECTRICAL PERMIT 111 11 : COMMUNITY DEVELOPMENT Permit #: ELC2013 -00278 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/23/2013 Parcel: 2S102AA05500 Jurisdiction: Tigard Site address: 12215 SW MAIN ST 110 Project: JK Interiors Subdivision: KINGSTON Lot: 19 Project Description: (1) sign or outline lighting Contractor: SIGNCRAFT ELECTRICAL ADVERTISING LLC Owner: CHOI, WOO Y & MAN JA 8900 SW BURNHAM, E109 2323 NE 165TH DR TIGARD, OR 97223 PORTLAND, OR 97230 PHONE: 503 - 639 -4910 PHONE: FAX: 503 - 639 -4999 FEES Quantity Description Date Amount 1 ea Sign or Outline Lighting 05/23/2013 $67.84 Specifics: 1 ea 12% State Surcharge - 05/23/2013 $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 e . es forth in OAR 952- 001 -0010 through 0 952 - 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503, -• s br 1. • • • Issued By: i Permittee Signature: 4e//,/,' 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. RECEIVED F ,. . Electrical Permit Application F OW ORACE , LIS H tONIi1 ; • r T, A , Ci of Tigard M AY 1 6 2 013 Received Re eceived C(4/(13 S‹ Permit No.: 61.69013- 06,91,3" F i- ' ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review J 13 j ', Phone: 503.639.4171 Fax: 503.598.196 I nspection Line: 503.639.4175 `C Date/B : Other Permit: ITY OF TIGARD Date Ready /By: �._ 7uris. El See Page 2 for F I 1 ` A R °° g g BU ILDING DIVISIO /z • T s.. Internet: www.ti ard -or. Ov Date Notified/Method://4" 3 t �.� Supplemental Information TYPE OF WORK PLAN REVIEW [.New construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ 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. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I3 ", Job no.: Job site address: ^� 1 I OOHP or more. occupancy. TCT { �. LJ Gil t1 S T El Six or more residential units. ❑ Recreational vehicle parks. \ Q -� 3 YY ❑ Health -care facilities. ❑ Supply voltage for more than City /State /ZIP: --1-,A,,,,, I t ❑Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: Project name: ; \< u N .� e- ` d z'S ❑ Service or feeder 600 amps or more. - FEE SCHEDULE , Cross street/directions to job site: Description I Qtr. I Fee. I Total I • 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] 500 sq. ft. or portion 33.92 1 Limited energy, residential 67.84 2 DESCRIPTION OF WORK (with above sq. ft.) \--\ �� t5� 1 Limited ener multi - family 67.84 2 -(00 U r.�( / - , �� s '\ -() (�')( L am` ,,r,c residential (with above sq. ft.) �� \ Services or feeders installation, alteration, and/or relocatio \ r A C\ r r 1 2 \ A 47 200 amps or less 100.70 2 ❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 Name: Ce. n ) A. G ) \ 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 City /State /ZIP: Temporary services or feeders installation, alteration, and /or relocation Phone: SD \) G `'t 7 J j - e0 Fax: ( ) 200 amps or less 59.36 I Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 'w each branch circuit 7.42 2 Business name: i i Business . � I' � __�`, 40,23;, / '!� -U� t ,. ': B. Fee for branch circuits without service or feeder fee, Contact name: S �,, ■ em,t1 C first branch circuit 56.18 2 Address: 1 a� \. S �� , �—� Each add'I branch circuit 7.42 2 lJ� r Miscellaneous (service or feeder not included) City /State /ZIP: - 7 - ` � .�,A c 2 q -7 Each manufactured or modular 67.84 2 dwelling, service and/or feeder Phone: L5 Sg ... t s-, q l Fax: : ( ) Reconnect only 67.84 2 E -mail: Pump or irrigation circle 2 CONTRACTOR Sign or outline lighting 67.84 2 ' / ^ Signal circuit(s) or limited - Business name:.../ n �� •�e f 6-4 � ,, U? L� energy panel, alteration, or Address: g l 00 ` • lf / -g r� het �' /\ /G �� I s fJ`f � extension. Describe: Page 2 2 J City/State /ZIP: ; (. / - p I l ©c - q Tat) 3 Each additional inspection over allowable in any of the above / Per inspection 66.25 Phone: 5 03 ) &.3 LJ 9 1 I Fax: ( ) Investigation per hour (I hr min) 66.25 CCB Lic.:/ 5/S 4 a 0 Electrical Lic.:3 L1, A/ �� j Suprv. Lic.: 7 , f Industrial plant per hour 78.18 /3 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: P/- Subtotal: /� Iclizt Plan r eview (25% of permit fee): Print name: j f S Date: State surcharge (12% of permit fee) Authorized signature: 1 TOTAL PERMIT FEE: � This permit application expires if a permit is not obtained within 180 Print name: .---3) �� Date: S 5 O`(S/ u days after it has been accepted as complete. • Number of inspections allowed per permit. \Building\Permits\ELC- PermitApp doc 10/01/09 440- 4615T(I I /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 ... $67.84 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 $67.84 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ 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 I: \ Building \Permits\ELC- PermitApp.doc 10/01/09 Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 12215 SW MAIN ST 110, TIGARD, OR, 97223 Commercial - Electrical 199 Electrical ﬁnal PASS - No C of O May 2, 2014 at 2:10:46 PM ELC2013-00278 Jeff Grove Violation Summary: Inspector Contractor