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Permit CITY OF TIGARD ELECTRICAL PERMIT �� t 1. • COMMUNITY DEVELOPMENT �. Permit#: ELC2013-00713 Date Issued: 12/03/2013 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 �!i Parcel: 2S112DC00701 Jurisdiction: Tigard Site address: 15989 SW 72ND AVE Project: Domino's Subdivision: FANNO CREEK ACRE TRACTS Lot: 39 Project Description: Sign lighting for new sign. 2/25/2015: REPRINT permit to correct address from 15985 to 15989. Contractor: ADVANCED ELECTRIC SIGNS INC Owner: PACIFIC REALTY ASSOCIATES 1550 DOWN RIVER DR ATTN: N PIVEN WOODLAND, WA 98674 15350 SE SEQUOIA PKWY#300 PORTLAND, OR 97224 PHONE: 360-225-6826 PHONE. FAX: 360-225-8299 FEES Quantity Description Date Amount 1 ea Sign or Outline Lighting 12/03/2013 $67.84 Specifics: 1 ea 12%State Surcharge- 12/03/2013 $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 rules are set forth in OAR 952-001-0010 through .R --0090 You may obtain a copy of the rules or direct questions to OUNC by calling 503.2,32.1987 or 1.800.332.2344. Issued By: " �r�� / � Permittee Signature: O'`) /771,41e4—/-..7011 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. CITY OF TIGARD ELECTRICAL PERMIT 111 �. COMMUNITY DEVELOPMENT Permit #: ELC2013 -00713 T [GA RD 13125 SW Hall Blvd., Tigard OR 97223 503 718.2439 Date Issued: 12/03/2013 Parcel: 2S112DC00701 Jurisdiction: Tigard Site address: 15985 SW 72ND AVE Project: Domino's Subdivision: FANNO CREEK ACRE TRACTS Lot: 39 Project Description: Sign lighting for new sign Contractor: ADVANCED ELECTRIC SIGNS INC Owner: PACIFIC REALTY ASSOCIATES 1550 DOWN RIVER DR ATTN: N PIVEN WOODLAND, WA 98674 15350 SE SEQUOIA PKWY #300 PORTLAND, OR 97224 PHONE: 360 - 225 -6826 PHONE: FAX: 360 - 225 -8299 FEES Quantity Description Date Amount Specifics: 1 ea Sign or Outline Lighting 12/03/2013 $67 84 1 ea 12% State Surcharge - 12/03/2013 $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 rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You ma obtain a co•y of th =.may- erect questions to OUNC by calling 50123 1987 or 1 800 33 - •44 Issued By: �r 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 City of Ti and Received Permit No 1114 q g 611i Date/B a/3 i 4., r� 1 — . i 13125 SW Hall Blvd., Tigard, A16 Plan Review Phone. 503.639.4171 Fax 55i • 6 Date/By Other Permit T I G A R D Inspection Line 503 639 4175 'T'-• Date Ready/By. 1°ris ® See Page 2 for Internet www tigard or.gov d `� 0 Notified/Method f Supplemental Information TYPE OF J ` �R� . PLAN REVIEW ❑ New construction Addition/alte� /. V i 1 ` ` V Pl ease check all that apply (submit 2 sets of plans w /items checked below) ``�� ❑ Service or feeder 400 amps or more ❑ Building over three stones. El Demolition ❑ Other: 1SC3 V where the available fault current ❑ Marinas and boatyards. CATEGORY OF c % M UCTION 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 121 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 ", "1 -3 ", I Job no.: Job site address: i5 18 5 W 7 L rt d ! V i x or or more t esidential units ❑ Recreational occupancy eati ❑ Six or more residential vehicle parks City/State /ZIP: 7 Gi J a 0 If '� ZZ L1 ❑ Health -care facilities ❑ Supply voltage for more than ❑ Hazardous locations 600 volts nominal Suite/bldg. /apt. no.: Project name: O a 1(Y\ %(\ oiS ❑ Service or feeder 600 amps or more FEE SCHEDULE Cross street/directions to job site: 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 145 15 4 Ea. add'l 500 sq ft or portion 33.40 1 Tax map /parcel no.: Limited energy, residential `� DESCRIPTION OF WORK (with above sq ft ) 75.00 2 ` Limited energy, multi - family 75 00 2 �n\ Q�, r Y -Qkut e2/,l_54 In, *y U � residential (with above sq ft ) � Services or feeders installation, alteration, and/or relocation 0.)k G 1 1/4 \- Vv29.3 \09 D 200 amps or less 80 30 2 ® PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106 85 2 - Name: Kt^ c Y, v 401 amps to 600 amps 160 60 2 1 601 amps to 1,000 amps 240 60 2 Address: • Syv s ev,to la_ p {� _00 *306 Over 1,000 amps or volts 454 65 2 City/State /ZIP: poi -\ o 2- 1i Z Temporary services or feeders installation, alteration, and/or relocation Phone: (503 ) (. 2,4 — CO 0° Fax: ( ) 200 amps or less 66 85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100 30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133 75 2 Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ® APPLICANT ❑ CONTACT' PERSON above service or feeder fee, each branch circuit 6.65 2 Business name: /Id V&A eAec. r—I c S Io3�S B Fee for branch circuits Contact name: e without service or feeder fee, 46.85 2 J 'v't. first branch circuit ��.p Each add'l branch circuit 6 65 2 Address: ''��0 uo� �\ ` u� ' Miscellaneous (service or feeder not included) City/State /ZIP:w0 bd∎A d V1)0L- q F(121' Each manufactured or modular 90 90 2 22 ,T� ^ ,S "" q� Fax: dwelling, service and/or feeder Phone: �blJ ) aa Co p 2.(.Q ( ) Reconnect only 66 85 2 E -mail: 5 It...kit, fa ad va- +18'Cl4.Q,Ie,C,'Cr'1L g i U ri . corn Pump or irrigation circle 53 40 2 CONTRACTOR Sign or outline lighting / —55,10 674 2 Signal circuit(s) or limited - Business name: f 3 3 J G _n C i P 5 i t45 energy panel, alteration, or Address: �'�,�,n� J extension Describe Page 2 2 City/State /ZIP: Each additional inspection over allowable in any of the above Per inspection 62 50 Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62 50 CCB Lic.: O FJ L40 Electrical Lic.: - 7-1 , I CJ . Suprv. Lic.> 307 TL Industnal plant per hour 73 75 r I �J I t r ELECTRICAL PERMIT FEES - Suprv. Electrician ign ture, required: /0/ Subtotal a •. S1 Print name: S S‘�c, Date: 1L/3 /)? Plan review (25 % of permit fee) ( 4 State surcharge (12% of permit fee) p , Pi Authorized signature- PERMIT FEE. 7s, i[ This permit application expires if a permit is not obtained within 180 Print name: ��/� � ,� Date: 1 2�� 1/3 //_5 This after it has been accepted as complete'. • Number of inspections allowed per permit 1 <� I \Budding\Permits\ELC- PermitApp doe 05/23/06 440 -4615T(11 /05 /COM/WEB 1 ) S 3 cif 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: rCOMMERCIALWORIKONLY: - Fee for each commercial $75.00 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\Permds\ELC- PermitApp doc 03/23/06 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 15985 SW 72ND AVE, TIGARD, OR, 97224 Commercial - Electrical 199 Electrical ﬁnal 2014-01-27 00:00:00 ELC2013-00713 PASS - No C of O Violation Summary: Inspector Contractor