Permit CITY OF TIGARD ELECTRICAL PERMIT
111 COMMUNITY DEVELOPMENT
*P® •
Permit#: ELC2013 00645
T IGAg 0 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/28/2013
Parcel: 1 S134BC00300
Jurisdiction: Tigard
Site address: 12240 SW SCHOLLS FERRY RD
Project: Rite Aid Subdivision: GREENWOOD TERRACE CONDO Lot: 17
Project Description: Reconnect existing signage. 11/25/13,reprinted to add(2)additional sign lightings,for a total of9).
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 10/28/2013 $67.84
Specifics: 1 ea 12%State Surcharge- 10/28/2013 $8.14
Electrical
Type of Use: COM 2 ea Sign or Outline Lighting 11/25/2013 $135.68
Class of Work: ALT 0 ea 12%State Surcharge- 11/25/2013 $16.28
Type of Const: Electrical
Occupancy Grp:
Total $227.94
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 acco •= + wi :•'roved 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. ATTE∎ ON: Oregon law re. -. you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0o 0 thro gh OAR 952-001-•r90. Ai.. ay obtain a copy of the rules or direct questions to OUNC by callin.g 3,.232.1987 or 1.800.332,2344.
Issue. By: _ 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 Applicatio - FOR OFFICEUSE ONLY City of Tigard Date/B d / A i r/ PermitNo.: xea/ Q06 S
13125 SW Hall Blvd.,Tigard,OR 9 RECEIVED• Plan Review
•
• ° Phone: 503.718.2439 Fax: 503.598.19(IQO,, q Date/B : Other Permit:
T I Gib KD Inspection Line: 503.639.4175 �IVV 2 2013 Date Ready/By: ions 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
01Tk3 0
TYPE OFr � � aG ... PLAN REVIEW
❑New construction ®Addition/altera to r pl'ac m '. l�4tl 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 ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND!,L'OCATION ❑Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A","E","I-2","l-3",
Job no.: 121023/1 1 Job site address: 12240 SW Scholls Ferry Rd. Six xHP or more. occupancy.
El Si or 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.: I Project name:Rite Aid ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site:SW 121st&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
Service/Repair-Recconect 2 existing sign's to curcuit residential(with above sq.ft.) 75.00 2
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
' ❑ •PROPERTY OWNER I ❑ 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:( ) I 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,alterationzor extension,per panel
®,APPLICANT ' I ❑ CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,
Business name:Tube Art Group each branch circuit 7.42 2
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 I 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 2 67.84 l .( 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 min) 66.25/hr
Phone:(503)6531133 Fax:( ) Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lie.: 70956 I Electrical L' '37554CL I Suprv.Lie.: 366SIG specifically listed(%:hr min) 90.00/hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,requi -d d:_,...". Subtotal: /3.5—.6g
Print name: Ken Shultz / Date: 11/25/2013 Plan review(25%of permit fee):
State surcharge(12%of permit fee): /4•a
Authorized signature: TOTAL PERMIT FEE: /5 / . 9(�
This permit application expires if a permit is not obtained within 180
Print name: Jessica osmas Date: 11/25/2013 days after it has been accepted as complete.
• Number of inspections allowed per permit.
:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(11/05/COM/WEB
CITY OF TIGARD ELECTRICAL PERMIT
q
4 2 • COMMUNITY DEVELOPMENT Permit#: ELC2013-00645
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/28/2013
Parcel: 1 S134BC00300
Jurisdiction: Tigard
Site address: 12240 SW SCHOLLS FERRY RD
Project: Rite Aid 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 10/28/2013 $67.84
Specifics:
1 ea 12%State Surcharge- 10/28/2013 $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 a . • '_.- .ith approved •fans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. • NTION: Oregon -. requi - you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-0'.1-0010 through OAR 95 r r -009• Y ay obtain a copy of the rules or direct questions to OUNC by calling 503.2 1987 or 1.800.332.2344.
Is-ued By: �� / Permittee Signature: AI. - 4�6 1 ' - t'►'v"J-�
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 t.= FOR OFFICE USE ONLY ,
~ N 0��� ecpived 3J
City of Tigard n ` uat o Permit No.: f �l3_�JD fp S
n 13125 SW Hall Blvd.,Tigard,OR 97223 lab Review
C • Phone: 503.718.2439 Fax: 503.598.1960 OCT c2 8 201 Date/I3 : Other Permit:
TI GA R D Inspection Line: 503.639.4175 3 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
CI OF P!G„iii
TYPE OF WORKaJI[flMwr f'tlllnnr PLAN REVIEW
`°''.,I t11of01;' 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.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ I-and 2-family dwelling ®Commercial/industrial ❑Accessory building amps for all other installations. buildings.
El Multi-family ❑Master builder ❑Other: ❑Fire pump. El Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION
0 Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A","E","1-2","l-3",
Job no.: 121023 Job site address: 12240 SW Scholls Ferry Rd 100HP or more. occupancy.
❑Six or 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:Rite Aid ❑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
Tax map/parcel no.:R983537 Ea.add'I 500 sq.ft.or portion 33.92 1
Limited energy,residential
sq.ft.) 75.00 2
DESCRIPTION OF WORK • (with above q
Limited energy,multi-family 75.00 2
Re-connect existing signage 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)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 a„® 67.84 Col.g1/ 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(1 hr min) 66.25/hr
Phone:( ) 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: 697.V/
Print name: Ken Schultz 10/21/2013 Plan review(25%of permit fee):
State surcharge(12%of permit fee): frit
Authorized signatur- •
TOTAL PERMIT FEE: 7!j• 15
Print name: Jessica K as 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:\Building\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 Qtr 1 Fee I Total
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 Audio and Stereo Systems*
15.01 to zs kva 200.34 2
nBurglar Alarm Wind generation systems in excess of 25 kva:
25.01 to 50 kva 301.04 2
n Garage 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 OAR 918-309-0040)
System* Solar generation systems in excess of 25 kva:
Each additional kva over 25 7.42 3
n Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: - Each additional inspection is
charged at an hourly(1 hr min) 66.25/hr 1
Inspections for which no fee is 90.00/hr
specifically listed(%hr min)
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
n Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
n HVAC
❑ Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control*
❑ Medical
n 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_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
12240 SW SCHOLLS FERRY RD, TIGARD, OR,
97223
Commercial - Electrical
199 Electrical final
2014-02-25 00:00:00
ELC2013-00645
PASS - No C of O
Violation Summary:
Inspector Contractor