Permit CITY OF TIGARD ELECTRICAL PERMIT
a. ' COMMUNITY DEVELOPMENT Permit #: ELC2013 -00733
T i G A R TD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/11/2013
Parcel: 1 S 135AB01003
Jurisdiction: Tigard
Site address: 10330 SW GREENBURG RD
Project: Red Lobster Subdivision: METZGER, TOWN OF Lot: 9
Project Description: Sign lighting for (1) wall sign and (1) monument sign.
Contractor: VANCOUVER SIGN COMPANY INC Owner: LINCOLN CENTER LLC
2600 NE ANDRESEN RD #50 BY SHORENSTEIN PROPERTIES LLC
VANCOUVER, WA 98661 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 360 - 693 -4773 PHONE:
FAX: 360- 693 -2747
FEES
Quantity Description Date Amount
2 ea Sign or Outline Lighting 12/11/2013 $135.68
Specifics:
1 ea 12% State Surcharge - 12/11/2013 $16.28
Electrical
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $151.96
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 rul =. adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001- 0090. You : • • •• , ,•y of the rules o • irect questions to OUNC by calling 503.1987 or 1.: 10.3 . '44.
Issued By: v � v ^-- - - - ignature: _ ` — K
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 AQplicationRECEIVED I OR OFl I( I: 1 -1. O \I 1
Cit of Ti and Received
y g DateB : /A dara Permit No.: ^Z.� , f _ 711 13125 SW Hall Blvd., Tigard, OR 97223� Plan Review
a
Phone: 503.639.4171 Fax: 503.598.19 1 1 2013 Date/B : Other Permit:
Ti G A R I) Inspection Line: 503.639.4175 Date ReadyBy: Egill 65 See Page 2 for
Internet: www.tigard - or.gov CITY OF TIGARD Notified/Method: Supplemental Information
Tirk .t 1NG DIVI P REVIEW
Please check all that apply (submit 2 sets of plans w /items checked below):
[gI 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.
(A1 Ili . 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 larger separately derived system. arge system.
r N `AND LOCATION 4 ❑ Addition of new motor load of ❑ "A" separately deriv
Job no.: Job site address: /0 33o 5 LA3 („se.aribt�.rq Re. Six o e r c
J 0 or nare residential units. ❑ R ecreational vehicle parks.
1
City / State/ZIP: ' - 1 ,1 O R 9 7 Z z Health -care facilities. ❑ Supply voltage for more than
I ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: e CAJ Lob ster
❑ Service or feeder 600 amps or more.
:. * SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total _ I •
/ New residential single- or multi - family dwelling unit.
5 IA) i- i a,�, k . n %-[ o n -L A61. 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.: Limited energy, residential
0P5 WORK
' fi (with above sq. ft) 67.84 2
Limited energy, multi - family
1) if l r.t fri i ri 4 - e .ri, wall 51 11 residential (with above sq. ft.) 67.84 2
f '' `�� wLtt (� t Services or feeders installation, alteration, and/or relocation
ec(, 1/v1 o n, t.t,wl tw�t t p n
200 amps or less 100.70 2
-q . Q I p p 1 , 4 l _ 0n TE1!4A t1'T 201 amps to 400 amps 133.56 2
Name: R e LO ,bs..tei e 401 amps to 600 amps 200.34 2
A 601 amps to 1,000 amps 301.04 2
Address: /0 33 0 s t G re.e.ir1 �.rG f7 b t rL Over 1,000 amps or volts 552.26 2
City / State/ZIP: r pj 9 7 Z Z3 J Temporary services or feeders installation, alteration, and/or
5 , , S 'r , relocation
Phone: ( ) v I Fax: ( ) 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
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
_' - :.r .1, _ >' b: i t s n 1`' :' t 19; 0 l T}) 0f above service or feeder fee, 7.42 2
each branch circuit
Business name: \), (1 , 1%,0 u u ex , s;%y-1 B. Fee for branch circuits
without service or feeder fee,
Contact name: R e,, Stn C first branch circuit 56.18 2
Address: 2600 A/F. mil(eSeM I4 L if50 Each aad'1 branch circuit 7.42 2
Miscellaneous (service or feeder not included)
City /State/ZIP: 0006.4,0 j ex- GJA %L 1 I Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: (36,o) (9'3 2 177 I Fax: : ( 360 64 Z797 Reconnect only 67.84 2
E-mail: Pump or irrigation circle / 67.84 2
'h i r 1 A ' ^,` Si or outline lighting ( ` 67.84 2
Signal circuit(s) or limited -
Business name:
�i� .l'(,ln I.IVP.r 5■gYl energy panel, alteration, or
extension. Describe: Page 2 2
Address: J
z foil o N e Artd e-se_ i 6, # S0
City /State/ZIP: V4.4 c O t A U �� IA) i g�� Each additional inspection over allowable in any of the above
a Per inspection 66.25
Phone: ( 340 b9 5 4I 77 Fax. ( 360) 693 17 Investigation per hour (1 hr min) 66.25
CCB Lic.: 6 ZQ 5 I Electrical Lic.: 37_ 114 GLSI Su . Lic.: 526 _ 5 d Industrial plant per hour 78.18
lt?' r : . '" ELECTRICAL PE r" )F
Suprv. Electrician signature, required: Fr �;' Subtotal: 1 � (,g
`����
Print name: 84/,4_,,,z Plan review (25% of permit fee):
Date:
7 .,AV State surcharge (12% of permit fee): . ( , a_ ' ( g Authorized signature: TOTAL PERMIT FEE: IC /, ,
c This permit application expires if a permit is not obtained within 180
Print name: A ;EL st p f ey) Date: i z/i O / -, days after it has been accepted as complete.
• Number of inspections allowed per permit
` I:\ BuildingWermits�Et .C- PermitApp.doc 10/01/09 440- 4615T(I1 /05/COM/WEB
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CITY OF TIGARD ELECTRICAL PERMIT
Ili. COMMUNITY DEVELOPMENT Permit#: ELC2013 -00734
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/11/2013
Parcel: 1 S 133CC70024
Jurisdiction: Tigard
Site address: 14110 SW BARROWS RD 4
Project: Medina Subdivision: SCHOLLS VILLAGE CONDO STAGE 5 Lot: 4
Project Description: Reconnect only.
Contractor: Owner: MEDINA LIVING TRUST
BY MEDINA, LORI R TR
4826 NW 162ND TER
PORTLAND, OR 97229
PHONE: PHONE:
FAX
FEES
Quantity Description Date Amount
1 ea Reconnect Only 12/11/2013 $67.84
Specifics:
1 ea 12% State Surcharge - 12/11/2013 $8.14
Electrical
Type of Use: MF
Class of Work: OTR
Type of Const:
Occupancy Grp: R -2
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 Notificatio enter. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 50 ra • :7 or 1.800.332.2344.
Issued By: jR V Permittee Signature: � „ � qh
-
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 11)R (II 1 1(I I " l () \ l 1
City of Tigard Received PennitNo .
Ill
13125 SW Hall Blvd., Tigard,OR 97223 Plan Review �� �� /� —007 3
': s Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
I I I: I 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 7 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.
Q Multi - family ❑ Master builder ❑ Other: 0 Fire pump. ❑ Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition new of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: ((4 � 0 S t.0 A . I�., / 2 A �c p Six or or more. occupancy.
(---4 S 1 ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: 1 lJ t t 11 N D ,2 41 i Z. Z .-. ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ 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: S l O LL .5 VI Li— , ,< ∎ = (r �J✓l b Os Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'l 500 sq. ft. or portion 33.92 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
residential (with above sq. ft.)
Renewable Energy ❑ See Page 2
Services or feeders installation, alteration, and/or relocation
lg.-PROPERTY OWNER I ❑ TENANT 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name: Lo 12.4_, VYl `eci i Yt cam, 401 amps to 600 amps 200.34 2
Address: 9 62 Aj u) h 2_,i cc `re f- , —e" . ,e_ 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State /ZIP:
1 t"J. 4 1 t2 +1c( Q t2 ci '7 ZL Temporary services or feeders installation, alteration, and/or
Phone: (Sc 7 7) g 30 relocation L3 5 Z Fax: ( > 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 I ❑ CONTACT PERSON A. Fee for branch circuits with
above service or feeder fee,
7.42 2
Business name: each branch circuit
B. Fee for branch circuits without
Contact name: service or feeder fee, That 56.18 2
branch circuit
Address: Each add'I branch circuit 7.42 2
City/State /ZIP: Miscellaneous (service or feeder not included)
Each manufactured or modular 67.84 2
Phone: ( ) Fax: : ( ) dwelling, service and/or feeder
Reconnect only I 67.84 G 711,2
E - mail: Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: Signal circuit(s) or limited- energy See
panel, alteration, or extension. Page 2 2
Address: 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.: Electrical Lic.: Suprv. Lic.: specifically listed (% hr min)
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: 6 1
Print name: Date: Plan review (25% of permit fee):
State surcharge (12% of permit fee): <. l>-
Authorized signature: TOTAL PERMIT FEE: 76
This permit application expires if a permit is not obtained within 180
Print name: Date: 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- 461ST(11 /05 /COM/WEB
Electrical Permit Application — City of Tigard
Page 2 — Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
P RESIDENTIAL WORK 'ONLY: n _ i �„ .�;n. '. FEE ,SCHEDULE' . ; ; :a.7,.. ii ==::
Fee for all residential:systems combined ... $75.00 Description I oty. I Fee I 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
❑ Audio and ',Stereo Systems* .
15.01 to 25 kva 200.34 2
❑ Burglar Alarm Wind generation systems in excess of 25•kva:, ,
25.01•'to 50 kva' 301.04 2
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva (fee in accordance with 552.26 2
OAR 918- 309 -0040)
❑ Heating, Ventilation and Air Conditioning ':i
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:
Other: Each additional inspection is
. charged at an hourly (1 hr mm) 66.25/ hr I
Inspections for which no fee is 90.00/ hr
specifically listed (V hr min)
COMMERCIAL WORK ONLY: .ELECTRICAL ,PERMIT FEES ;4; I? ^ ;_' ; 'E. 6 :
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
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
❑ 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:\ BuildingWermits \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 Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10330 SW GREENBURG RD, TIGARD, OR,
97223
Commercial - Electrical
199 Electrical final
2013-12-13 00:00:00
ELC2013-00733
PASS - No C of O
Violation Summary:
Inspector Contractor