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Permit III _ p CITY OF TIGARD ELECTRICAL PERMIT ' COMMUNITY DEVELOPMENT Permit#: ELC2015 00119 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/17/2015 Parcel: 2S104BB07900 Jurisdiction: Tigard Site address: 14300 SW BARROWS RD Project: Haggen Subdivision: RUSSELL'S SCHOLLS FERRY Lot: 2,TRAC Project Description: Installing(1)internally illuminated wall sign. Contractor: E S&A SIGN&AWNING Owner: ABS OR-O LLC 89975 PRAIRIE RD 250 PARKCENTER BLVD EUGENE,OR 97402 BOISE, ID 83706 PHONE: 541-485-5546 PHONE: FAX: 541-485-5813 FEES Quantity Description Date Amount 1 ea Sign or Outline Lighting 03/17/2015 $67.84 Specifics: 1 ea 12%State Surcharge- 03/17/2015 $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 952-001-0010th • _• •AR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calli232.1987 or 1.8 0.332.23 4. Issued By I! 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. r Electrical Permit Application FOR OFFICE USE ONE) Received Permit No.: !,1 I Q City of Tigard Slg� DateB : .,t, , j�--t /�1 ff III • 13125 SW Hall Blvd.,Tigard,OR 97223 V1 Plan Review I Phone: 503.718.2439 Fax: 503.598.196 Date/By: , Other Permit: 1 5"---OW �� I I i A 1t 1 Inspection Line: 503.639.4175 Date Ready/By: /.� Juris: S See Page 2 for Internet: www.tigard-or.gov Notified/Method:. 7 �if <�/46 4 ar Supplemental Information TYPE OF WORK PLAN REVIEW R q 2019 Please check all that apply(submit 2 sets of plans w/items checked below): ❑New construction ❑Addition/alteration/rrr : elfll i ❑Service or feeder 400 amps or more ❑Building over three stories. ❑ Demolition ®Other:Sign •{ f`" �i i where the available fault current 0 Marinas and boatyards. CATEGORY OF CON T r i !' t Ll7 H exceeds 10,000 amps at 150 volts or ❑Floating buildings. ss!i u� �A.l ON� less to ground,or exceeds 14,000 ❑Commercial-use agricultural ❑ 1-and 2-family dwelling ®Commercial/in�ti, 1 Y Accessory nodding amps for all other installations. buildings. ❑Multi-family ❑ Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or ❑Emergency system. larger separately derived system. JOB SITE INFORMATION AND LOCATION ❑Addition of new motor load of ❑"A","E","1-2","I-3", I00HP or more, occupancy. Job no.: Job site address: 14300 Sw Barrows road ❑Six or more residential units. ❑Recreational vehicle parks. an City Ti d Oregon 97223 ❑Health-care facilities. ❑Supply voltage for more than ❑Hazardous locations. y g + re g on 600 volts nominal. Suite/bldg./apt.no.: Project name:Haggen ❑Service or feeder 600 amps or more FEE SCHEDULE Cross street/directions to job site:SW Walnut street Description I Qty. I Fee. Total (— 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')500 sq.ft.or portion 33.92 1 Tax map/parcel no.: Limited energy,residential DESCRIPTION OF WORK (with sq. ) 751x) with above ft. Limited energy,multi-family 7500 2 Install(I)internally illuminated wall 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: Haggen Northwest Fresh — amps to 600 amps 200.34 2 Address: 14300 SW Barrows road 601 amps to 1,000 amps 301.04 2 Over 1,000 amps or volts 552.26 2 City/State/ZIP:Tigard,Oregon 97223 Temporary services or feeders installation,alteration,and/or relocation Phone:( ) 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 Owner signature: Date: Branch circuits–new,alteration,or extension,per panel 0 APPLICANT ❑ CONTACT PERSON A.Fee for branch circuits with above service or feeder fee, 7.42 Business name: ES&A Signa and Awnings each branch circuit -- -- B.Fee for branch circuits without Contact name: Kaela Ouellette service or feeder fee,first 56.18 2 branch circuit Address:89975 Prairie road Each add')branch circuit 7.42 2 City/State/ZIP:Eugene,Oregon 97402 Miscellaneous(service or feeder not included) Each manufactured or modular 67.84 2 Phone:(541)485-5546 Fax: :(541)485-5813 dwelling,service and/or feeder Reconnect only 67.84 '_ E-mail:kouellette@esasigns.com Pump or irrigation circle 67.84 CONTRACTOR Sign or outline lighting I 67.84 2 Business name: ES&A Signs and Awnings Signal circuits)or limited-energy See panel,alteration,or extension. Page 2 _ Address:89975 Prairie road Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr City/State/ZIP: Eugene,Oregon 97402 Investigation(1 hr min) 66.25/hr Phone:(541)485-5546 Fax:(541)485-5813 Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lie.: 163470 Electrical Lic.: 20534CLS Su rv,Lic.: 514 SIG specifically listed(Y:hr min) //jj ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: �,LsL Subtotal: Print name: Gordy Roseboro `"' '' �� Date: 2/6/2015 Plan review(25%of permit fee): /�///�' State surcharge(12%of permit fee): Authorized signatureG�� /2 // TOTAL PERMIT FEE: `� hj� This permit application expires if a permit is not obtained within 180 Print name: Kaela Ouellette Date: 2/6/2015 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 440-46151(1I/05/COM/WEB • . 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 $75.00 Description I Qn• 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 OAR 918-309-0040) 552.26 ❑ Heating,Ventilation and Air Conditioning System* Solar generation systems in excess of 25 kva: Each additional kva over 25 7.42 ❑ Vacuum Systems* >100 kva—no additional charge 0.0 ❑ Each additional inspection over allowable in any of the above: - Other: Each additional inspection is 66.25/hr 1 charged at an hourly(I hr min) Inspections for which no fee is 90.00/hr specifically listed(7z hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES 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.\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 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 14300 SW BARROWS RD, TIGARD, OR, 97223 Commercial - Electrical 199 Electrical ﬁnal PASS - No C of O ELC2015-00119 Chip Barnett Violation Summary: Inspector Contractor