Permit rr
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2014-00111
Date Issued: 03/11/2014
TIGARD 13125 SW Hall Blvd..Tigard OR 97223 503.718.2439 Parcel: 25112DC00701
Jurisdiction: Tigard
Site address: 15975 SW 72ND AVE
Project: Pella Subdivision: FANNO CREEK ACRE TRACTS Lot: 39
Project Description: (1)sign lighting for new wall sign
Contractor: BEAVERTON NEON Owner: PACIFIC REALTY ASSOCIATES
17250 SW AUGUSTA LN ATTN N RIVEN
BEAVERTON, OR 97006 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-649-1544 PHONE
FAX:
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 03/10/2014 $67 84
Specifics:
1 ea 12%State Surcharge- 03/10/2014 $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. ATTEN • Oregon--1 w requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
952-001-0 through OAR 952-051-00 `You may obtain a copy of the rules or direct questions to OUNC by calling 503 232.19:7• B00 332234,
Issue y: Permittee Signature: i .
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended tor 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 Tigard o f A� Received
y. - - - Permit No.:e�"a�/t��0p//J
13125 SW Hall Blvd.,Tigard,
Plan Review
•
' Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit
Inspection Line: 503.639.4175 1 n 2014 Date Ready/By: )uric Fil See Page 2 for
Internet:rnet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK TAFIC PLAN REVIEW
New construction ❑Addition/alteration/replacemCitt•
Please check all that apply(submit/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
❑ I-and 2-family dwelling I CommerciaUindustrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A°,"E°,"l-2","l-3",
Job no.: Job site address: /Sy?S �tt f, 72 A I Six or or more. occupancy.
❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: IT is is 4, Oa 972 24 ❑Health-care facilities ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: it/(Ot ❑Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: C.CI^.~se.n a n-�Y 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 I
Tax map/parcel no.: Limited energy,residential
DESCRIPTION OF WORK (with above sq.ft.) 75.00 2
limited energy,multi-family
,Tr if 47(1(A+,`,,1 0 [7-f / _ n� residential with above ft. _ 75'00 2
,/J Renewable Energy ❑ See Page 2
YAn Lam.M a a / G -d fi`q n Services or feeders installation,alteration,and/or relocation
RI PROPERTY OWNER J I ❑ TENANT 200 amps or less 100.70 2
/` 201 amps to 400 amps _ 133.56 2
Name: IO,�;Yr'L 2c,«y his U t;A-f el / L . Pi 401 amps to 600 amps 200.34 - 2
Address: 1 S 3.5-6 5 , , s,.! ei 46 34 O 601 amps to 1,000 amps 301.04 2
"``J/�u `4 Over 1,000 amps or volts 552.26 2
City/State/ZIP: tip t"fj rd / 0 i12 7 Z y Temporary services or feeders installation,alteration,and/or
Phone:(rd7) 6 Z y- G 30 0 Fax:(.573) 62 y-7753' relocation
200 amps or less 59.36 I
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 ex-tension,per panel
0 APPLICANT 1 jEl CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,
7.42 2
Business name: each branch circuit
Ca✓Cr'�vvt t°d B.Fee for branch circuits without
Contact name: �real Af t,/r I/(•a f service or feeder fee,rust 56.18 2
W l branch circuit
Address: /7 f,G/ A 6 a,144 L la , Each add'I branch circuit ▪ 7.42 - 2
- _II �'✓`f Miscellaneous(service or feeder not included)
City/State/ZIP: ig�i!U'f-0 n pp 97O O t5 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Phone:(5J) 6 k9- /SY if Fax: :(53 ) SY y-6 z 7$ -
Reconnect only — 67.84 2
E-mail: G re,P b co„ve "n Co vs , C C.••-s Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting I 67.84 67,i* 2
Business name: �e�v C GO to Signal circuit(s)or limited-energy See
Tit I, panel,alteration,or extension. Page 2 2
Address: �l 11 Each additional inspection over allowable in any of the above
�7Z�Q �'l.,J. /4N sY3. �H Additional inspection(1 hr min) 66.25/hr
City/State/ZIP: d eAV,,..4,�H ``te t717o o. Investigation(1 hr min) 66.25/hr
Phone:(yap 6 if q _ As-if C Fax:(WI ) rig-6 278 Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is 90 00/hr
CCB Lie.: krat g I Elect�c7l Lic.:3tf-Z73(45 Suprv.Lic.: 4_lb JSFj specifically listed(Y:hr min) _
7 e /ley /e/t// ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: "2", Subtotal: J.' y
Print name: C�,� r /I t• vim.s Date: 3_fU _/Y Plan review(25%of permit fee):
State surcharge(12%of permit fee): 8-/e/
Authorized signature: / l�- TOTAL PERMIT FEE: 75 9 f
—� '
This permit application expires if a permit is not obtained within 1S0
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per rmit. j
t:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 05/21/2013 440.4615T(I I/05/COM/WEB ^ 1 ,�n I I I1 I
GHQfI-J t4 p
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 ... 575.00 Description 1 Qty. 1 Fee I Told 1 • ,
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*
1591 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
CI Heating, Ventilation and Air Conditioning OAR918-309-0040)
System* Solar generation systems in excess of 25 kva:
Each additional kva over25 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 min) 66.25!hr I
Inspections for which no fee is
90.00/hr
specifically listed(/ hr min) i
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system 575.00 Subtotal:
(SEE OAR 918-309-0000) Plan review,if required(25%ofpermit 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
E l Instrumentation
❑ Intercom and Paging Systems
n 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
I.\Buildin5\Pamih\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
15975 SW 72ND AVE, TIGARD, OR, 97224
Commercial - Electrical
199 Electrical final
2014-04-11 00:00:00
ELC2014-00111
PASS - No C of O
Violation Summary:
Inspector Contractor
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
15975 SW 72ND AVE, TIGARD, OR, 97224
Commercial - Electrical
140 Sign installation
2014-04-11 00:00:00
ELC2014-00111
PASS
Violation Summary:
Inspector Contractor