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Permit CITY OF TIGARD ELECTRICAL PERMIT • • COMMUNITY DEVELOPMENT Permit#: ELC2013 00626 TIGARD 13125 SW Hall Blvd,Tigard OR 97223 503.718.2439 Date Issued: 10/21/2013 Parcel: 1 S134BC00300 Jurisdiction: Tigard Site address: 12244 SW SCHOLLS FERRY RD Project: Dollar Tree Subdivision: GREENWOOD TERRACE CONDO Lot: 17 Project Description: Reconnect existing signage 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 10/21/2013 $67.84 Specifics: 1 ea 12%State Surcharge- 10/21/2013 $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 ATTENT regon law requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-001 through 0 952-0 090 You may obtain a copy of the rules or direct questions to OUNC by calling 503 23 1987 or 1.800 332 2344 Issued By. (— �CX Permittee Signature: VW 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 Applicat}'q li ' • T, . FOR OFFICE USE ONLY Cl of Tigard CEiVFt Received p, � City g DateB /0 : A, b Permit No C._!ei 5_co. �A '� 13125 SW Hall Blvd,Tigard,OR 97 Plan Review Other Permit Phone: 503 718 2439 Fax 503.59 ,A6 b 21 2013 Date/B ' C IGARD Inspection Line. 503 639.4175 Date Ready/By. Suns 0 See Page 2 for Internet• www.tigard-or.gov CITY OF TIGARD Notified/Method Supplemental Information TYPE Oii4tww_p',.7 alvisiniv 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 ❑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 El Master builder ❑Other: ❑Fire pump ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION El Emergency system larger separately denved system ❑Addition of new motor load of ❑"A","E","1-2","1-3", Job no.: 121023 Job site address: 12244 SW Scholls Ferry Rd or more occupancy El S Six ix o or r more residential units ❑Recreational vehicle parks City/State/ZIP:Tigard,OR 97223 ❑Health-care facilities ❑Supply voltage for more than ❑Hazardous locations 600 volts nominal Suite/bldg./apt.no.: Project name:Dollar Tree ❑Service or feeder 600 amps or more FEE SCHEDULE Cross street/directions to job site:SW Scholls Ferry Rd&SW Springwood Dr 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 Re-connect existing signage residential(with above sq ft) Renewable Energy El 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'l branch circuit 7 42 2 City/State/ZIP:Milwaukee,OR 97222 Miscellaneous(service or feeder not included) Each manufactured or modular 67 84 2 Phone:(503)6531133 ex 1217 Fax: :(503)6599191 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 b 1.gC/ 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(I hr min) 66 25/hr City/State/ZIP: Investigation(1 hr mm) 66 25/hr Phone:( ) Fax:( ) Industrial plant(1 hr min) 7818/hr Inspections for which no fee is 90 00/hr CCB Lic.: 70956 Electrical Lic.: 37554CLS Suprv.Lic.: 366SIG specifically listed(%1 hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: e07.514/Print name: Ken Schultz Date: 10/21/2013 Plan review(25%of permit fee): ------State surcharge(12%of permit fee): g.I V Authorized signature: Q�� TOTAL PERMIT FEE• �5 .9 Print name: Jessica Kos s Yn� Date: 10/21/2013 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\Buil ding\Permits\ELC_PermitApp_ELR_ERE doc Rev 05/21/2013 440-4615T(11/05/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 Fee for all residential systems combined $75.00 Description I Qty. I 1 Total I Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5 01 to 15 kva 133.56 2 n A• udio and Stereo Systems* 15 01 to 25 kva 200 34 2 nBurglar Alarm Wind generation systems in excess of 25 kva: 25 01 to 50 kva 301 04 2 I-1 G• arage Door Opener* 50 01 to 100 kva 552 26 2 >100 kva(fee in accordance with 552.26 2 n Heating,Ventilation and Air Conditioning OAR918-309-0040) System* Solar generation systems in excess of 25 kva: 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: ElOther: Each additional inspection is charged at an hourly(1 hr mm) 66 25/hr ] Inspections for which no fee is 90 00/hr specifically listed(%1 hr mm) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system $75.00 Subtotal: (SEE OAR 918-309-0000) Plan review,if required(25%of permit fee): State surcharge(12%of permit fee). Check Type of Work Involved: TOTAL PERMIT FEE: , This permit application expires if a permit is not obtained within 180 n Audio and Stereo Systems days after it has been accepted as complete. • Number of inspections allowed per permit ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation n HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* n M• edical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling n O• ther Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I\Building\Permits\ELC_PermitApp_ELR_ERE doc Rev 05/21/2013 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 12244 SW SCHOLLS FERRY RD, TIGARD, OR, 97223 Commercial - Electrical 199 Electrical ﬁnal 2014-02-25 00:00:00 ELC2013-00626 PASS - No C of O Violation Summary: Inspector Contractor