Permit CITY OF TIGARD ELECTRICAL PERMIT
11111 • COMMUNITY DEVELOPMENT Permit#: ELC2014-00036
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/04/2014
Parcel: 1 S134BC00300
Jurisdiction: Tigard
Site address: 12220 SW SCHOLLS FERRY RD
Project: Whole Foods Subdivision: GREENWOOD TERRACE CONDO Lot: 17
Project Description: Sign lighting for(2)wall signs
Contractor: SECURITY SIGNS INC Owner: FW OR-GREENWAY TOWN CENTER LLC
2424 SE HOLGATE BLVD PO BOX 790830
PORTLAND, OR 97202 SAN ANTONIO,TX 78279
PHONE: 503-546-7114 PHONE:
FAX: 503-230-1861
FEES
Quantity Description Date Amount
2 ea Sign or Outline Lighting 02/04/2014 $135.68
Specifics: 1 ea 12%State Surcharge- 02/04/2014 $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 rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. Yo .• •• • of es or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. •
Issued 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 ApplicatiRECEIVED FOR OFFICE USE ONLY
Receised
City of Tigard AN 27 2014 Date/B : / 4 7 _, Permit No.: e'i_e��o"y/�G,p,j ,
Er.. 13125 SW Hall Blvd.,Tigard,OR 972 Plan Review
Phone: 503.639.4171 Fax: 503.59 Date/By: Other Permit: /9,'p/41�4oZ f
TIGARD Inspection Line: 503.639.4175 (OFTIGARD Date Ready/By: lwis: Id See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: Supplemental Information
v
TYPE f'"'` i . 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 1011==1- exceeds 10,000 amps at 150 volts or El 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. ....
❑ Multi-family ❑ Master builder ❑Other: ['Fire pump. ❑Installation of 75 KVA or
❑Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑Addition of new motor load of ❑"A,°E',"1-2','1-3", wr
IOOHP or more. occupancy.
■
Job no.: Job site address: 1 0 Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal. O
Suite/bldg./apt.no.: Project name:r �n R I,ene ❑Service or feeder 600 amps or more
1.YtE 5f T 1il``* v� � 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: 1 Lot no.: 1,000 sq.ft.or less 168.54 4 CNIN
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.) 67.84 2
Limited energy,multi-family 67.84 2
— M
Services or feeders installation,alteration,and/or relocation
*Mount Only* 200 amps or less 100.70 2
❑ PROPERTY OWNER I 0 TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name:
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
City/State/ZIP: relocation
Phone:( ) 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
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7 42 2
each branch circuit
Business name: Security Signs B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Contact name:Melissa Hayden branch circuit
Each add'l branch circuit 7.42 2
Address:2424 SE Holgate Blvd Miscellaneous(service or feeder not included)
Each City/State/ZIP:Portland,OR 97202 dwelling,manufactured service and/or d/ r modular wider 67.84 2
dwelling,service and/or feeder
Phone:(503)546.7114 I Fax: :(503)230.1861 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E-mail:Melissa @SecuritySigns.com
Sign or outline lighting 67.84 f5" ( ' 2
CONTRACTOR Signal circuit(s)or limited-energy
Business name:Security Signs panel,alteration,or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address:2424 SE Holgate Blvd Additional inspection(1 hr min) 66.25/hr
City/State/ZIP:Portland,OR 97202 Investigation(1 hr min) 66.25/hr •
Industrial plant(1 hr min) 78.18/hr
Phone:(503)546.7114 I Fax:(503)230.1861 Inspections for which no fee is 90.00/hr
specifically listed(Si hr min)
CCB Lie.: 122809 I Electrical Lie.: 26560CLS Suprv.Lie.: 383SIG ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal: ()SrCaSf
Plan review(25%of permit fee):
Print name: Marc Linguist Date: State surcharge(12%of permit fee): /4>Ar
TOTAL PERMIT FEE: /5�I-�t6
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Melissa Hayden Date: * Number of inspections allowed per permit.
t:\Building\Permits\ELC-PermitApp.doc 10/01/09 440-4615T(I1/05/COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined ... $67.84
Check Type of Work Involved:
n Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating,Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $67.84
system
(SEE OAR 918-309-0000)
Check Type of Work Involved:
nAudio and Stereo Systems
n Boiler Controls
n Clock Systems
nData Telecommunication Installation
n Fire Alarm Installation
❑ HVAC
n Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
n 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
l:\Building\Permits\ELGPermitApp.duc 10/01/09
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12220 SW SCHOLLS FERRY RD, TIGARD, OR,
97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
May 12, 2014 at 8:49:55 AM
ELC2014-00036
Jeff Grove
Violation Summary:
Inspector Contractor