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Permit • CITY OF TIGARD ELECTRICAL PERMIT 111 g COMMUNITY DEVELOPMENT Permit#: ELC2013-00588 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/02/2013 Parcel: 1 S 134BC00300 Jurisdiction: Tigard Site address: 12282 SW SCHOLLS FERRY RD Project: Boardwalk Burgers Subdivision: GREENWOOD TERRACE CONDO Lot: 17 Project Description: Reconnect existing sign. Contractor: TUBE ART SIGNS&SPORTS DISPLAYS Owner: FW OR-GREENWAY TOWN CENTER LLC 4243-A SE INTERNATIONAL WAY PO BOX 790830 MILWAUKIE, OR 97222 SAN ANTONIO,TX 78279 PHONE: 503-653-1133 PHONE: FAX: 503-659-9191 FEES Quantity Description Date Amount 1 ea Sign or Outline Lighting 10/02/2013 $67.84 Specifics: 1 ea 12%State Surcharge- 10/02/2013 $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. A ' •‘: -gon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-00 -0010 through OA' '52-00 -,+9s ou may obtain a copy of the rules or direct questions to OUNC by calling 503. 32.1987 or 1.800.332.2344. Issu.d By: —#• .1 Permittee 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' 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 Received © C 514 City of Tigard DateB : O Permit No.: G �/ -eel 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review C Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Other Permit: I'I G A K D Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑New construction ®Addition/alteration/replacement Please check all that apply(submit/sets of plans w/items checked below): ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition ❑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 pwnp. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system. ❑Addition of new motor load of ❑"A","E","1-2","1-3", Job no.: 121023/1 Job site address: 12282 SW Scholls Ferry Rd. I or more. occupancy. ❑Six x o or r more residential units. ❑Recreational vehicle parks. City/State/ZIP:Tigard,OR 97224 ❑Health-care facilities. ❑Supply voltage for more than ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: Project name:Boardwalk Burgers ❑Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site:SW 121's&SW Scholls Ferry Rd Description I Qty. 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 Ea.add'I 500 sq.ft.or portion 33.92 1 Tax map/parcel no.:R983537 Limited energy,residential DESCRIPTION OF WORK (with above sq.ft.) 75.00 2 Limited energy,multi-family 75.00 2 Service/Repair-Recconect existing sign to curcuit residential(with above sq.ft.) Renewable Energy ❑ See Page 2 Services or feeders installation,alteration,and/or relocation ❑ PROPERTY OWNER ❑ TENANT 200 amps or less 100.70 2 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 amps 200.34 2 Address: 601 amps to 1,000 amps 301.04 2 Over 1,000 amps or volts 552.26 2 City/State/ZIP: Temporary services or feeders installation,alteration,and/or Phone:( ) Fax:( ) relocation 200 amps or less 59.36 1 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 Owner signature: Date: Branch circuits—new,alteration,or extension,per panel ® APPLICANT ❑ CONTACT PERSON A.Fee for branch circuits with above service or feeder fee, 7.42 2 Business name:Tube Art Group each branch circuit B.Fee for branch circuits without Contact name:Jessica Kosmas service or feeder fee,first 56.18 2 branch circuit Address:4243-A SE International Way Each add'I branch circuit 7.42 2 City/State/ZIP:Milwaukie,OR 97222 Miscellaneous(service or feeder not included) Each manufactured or modular 67.84 2 Phone:(503)6531133 ex 1217 Fax: :(503)659-9191 dwelling,service and/or feeder Reconnect only 67.84 2 E-mail:jkosmas @tubeart.com Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 1 67.84 67 7.48# 2 Business name:Tube Art Group Signal circuit(s)or limited-energy See panel,alteration,or extension. Page 2 2 Address:same as above Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr City/State/ZIP: Investigation(I hr min) 66.25/hr Phone:(503)6531133 Fax:( ) Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: 70956 Electrical Lic.: 37554CLS Suprv.Lic.: 366SIG specifically listed(/:hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: (,7. 101 Print name: Ken Shultz Date: 10/2/2013 Plan review(25%of permit fee): -- Kaot, TOTAL State surcharge(12%of permit fee): ' I V Authorized signature: PERMIT FEE: 7sri'9 Print name: Jessica Kosmas Date: 10/2/2013 This permit application expires if a permit Is not obtained within 180 days after it has been accepted as complete. • Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(11/05/COWWEB 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 12282 SW SCHOLLS FERRY RD, TIGARD, OR, 97223 Commercial - Electrical 199 Electrical ﬁnal 2014-02-25 00:00:00 ELC2013-00588 PASS - No C of O Violation Summary: Inspector Contractor