Permit CITY OF TIGARD ELECTRICAL PERMIT
1 1 COMMUNITY DEVELOPMENT Permit#: ELC2014-00397
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/24/2014
Parcel: 25101 BA00500
Jurisdiction: Tigard
Site address: 7600 SW DARTMOUTH ST
Project: Subway Subdivision: HERMOSO PARK Lot: 8
Project Description: Installation of(1)wall sign.
Contractor: YESCO LLC Owner: WAL-MART REAL ESTATE BUSINESS TR
PO BOX 988 BY PROPERTY TAX DEPT STORE 5935-00
MULINO,OR 97042 PO BOX 8050
ATTN MS 0555
BENTONVILLE,AR 72716
PHONE: 503-612-6672 PHONE:
FAX: 208-345-3064
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 07/23/2014 $67.84
Specifics: 1 ea 12%State Surcharge- 07/23/2014 $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. ATTENT s •r-e+ law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0011 through OAR 9 :-0r 00110 You may obtain a copy of the rules or direct questions to OUNC by call : +rx 32.1987 or 1.800.332.2344.
Issued B • � I Permittee Signatur 41/
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 Applicati RECEIVE') FOR OFFICE USE ONLY
Received /J/��J
City of Tigard 7 �� �y ' Permit No.: —4e /7
111 13125 SW Hall Blvd.,Tigard,OR 972� Date/By:• g �,1 Plan Review Other Permit: D '/
Phone: 503.7182439 Fax: 503.598.11Q 1 7 20 14 Date/By: _ /r7ev7-ev/o,3
I R.,A R[> Inspection Line: 503.639.4175 Date Ready/By: Juris 1 65 See Page 2 for
Internet: www.tigard-or.gov CITY OFTIGARD Notified/Method: Supplemental Information
TYPE (1)14G DIVISION 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:connect sign 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.
❑ Multi-family ❑Master builder ®Other:connect sign ❑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","1-2","1-3
Job no.: Job site address: 7600 SW Dartmouth Street IooHPormore. 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: ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site:Dartmouth&72nd Avenue 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.: Limited energy,residential
75.00 ,
DESCRIPTION OF WORK (with above sq.ft.)
Limited energy,multi-family 75.00
sign 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:WABIZ ENTERPRISES LLC 401 amps to 600 amps 200.34 2
Address:2410 SE 121st Avenue Suite 202 601 amps to 1,000 amps 301.04 . 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP:Portland,OR 97216 Temporary services or feeders installation,alteration,and/or
Phone:(503)866.6907 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 „t/ A.Fee for branch circuits with
lam'„/.J 1 above service or feeder fee,
7.42 2
Business name:YESCO LLC each branch circuit
,„,0J-4. rt,• B.Fee for branch circuits without
Contact name:SHARYL HERIGSTAD Lip( I j service or feeder fee,first 56.18 2
i branch circuit
Address:PO BOX 988 ��V" ,gyp Each add'I branch circuit 7.42 2
City/State/ZIP:MULINO,OR 97042
v r ,� Miscellaneous(service or feeder not included)
i IN Each manufactured or modular 67.84 2
Phone:(503)612.6672 Fax: :(208)345-3064 1 i �) Reconnect onlyeand/or feeder 67.84 2
E-mail:SHERIGSTAD @YESCO.COM Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting I 67.84 67.84 2
Business name:YESCO LLC Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 2
Address:PO BOX 988 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
City/State/ZIP:MULINO,OR 97042 Investigation(1 hr min) 66.25/hr
Phone:(503)612.6672 Fax:(209 3'Is- 3 OP/ Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lie.: 188015 Electrical Lic.: 37-51 CLS Suprv.Lic.: 5872S /4//0 specifically listed(%hr min)
�7/!/1 ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:
Subtotal: 67.84
Print name: BLAIR BEDS Date: 7/7/2014 Plan review(25%of permit fee): ttr96-&-
State surcharge(12%of permit fee): 8.14
/ i?��'
Authorized signature: .. ' 0 TOTAL PERMIT FEE: „s.94.
` '- u This permit application expires if a permit is not obtained within 180
Print name: Li- ( i, r�6 Date: ' T days after it has been accepted as complete.
v� * Number of inspections allowed per permit.
1:\Building\Permits\ELC_PermitApp_ R_ERE.doc Rev 05/21/2013 440.4615T(II/05/COM/WEB
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
7600 SW DARTMOUTH ST, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
August 7, 2014 at 9:47:40 AM
ELC2014-00397
Jeff Grove
Violation Summary:
Inspector Contractor