Permit CITY OF TIGARD ELECTRICAL PERMIT
- COMMUNITY DEVELOPMENT Permit#: ELC2015-00354
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/21/2015
TIGARD Parcel: 2S101AB02703
Jurisdiction: Tigard
Site address: 7450 SW BEVELAND RD 100
Project: Ameriprise Finacial Services Subdivision: HERMOSO PARK Lot: 27
Project Description: TI
Contractor: HANNAH SIGN SYSTEMS INC Owner: MCCAFFERY FAMILY TRUST
1660 SW BERTHA BLVD 7450 SW BEVELAND RD, STE 100
PORTLAND, OR 97219 TIGARD, OR 97223
PHONE: 503-946-8373 PHONE.
FAX: 503-206-4900
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 05/13/2015 $67.84
Specifics:
1 ea 12%State Surcharge- 05/13/2015 $8.14
Electrical
Type of Use:
Class of Work:
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
952-001-0010 through AFk 95 11 1190. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.8800.332.2344. ,, l
Issued By: 1-■ I / — Permittee Signature: / �/ •/C' �'' v
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 FOR OFFICE USE ONLI
City of Tigard °x Received
• 13125 SW Hall Blvd.,Tigard,OR 97 Date/B
Itli
/Ti Plan Review
• Phone: 503.718.2439 Fax: 503.598. , Date/B : Other Permit: I /;,'A 5-_ • if g
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Jura: RI See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
d�� 'fl'PE OF \%ORK PLAN REVIEW
❑New construction ❑Addition/altera1itrefl l 9 mgnt. Please check all that apply(submit 11 sets of plans w!items checked below):
1=1 Demolition Other: Sign ` r. ❑Service or feeder 400 amps or more ❑Building over three stories.
where the available fault current ❑Marinas and boatyards.
s a exceeds 10,000 sat 150 volts or Floating buildings.
�;A.T��QRY OF $� ��;: 0 �� � ❑Fl buildin
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ 1-and 2-family dwelling In Commercial/industrial ❑.1ccessor) 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","1-2'."I-3",
10OHP or more. occupancy.
Job no.: Job site address: 7450 SW Beveland St.
o Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: Tigard, OR 97223 ❑Health-care facilities. 0 Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: 100 Project name: Ameriprise Financial ❑Service or feeder 600 amps or more.
Cross street/directions to job site: SW 72nd Ave&SW Beveland St. Description Qty. 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'l 500 sq.ft.or portion 33.92 1
Tax map/parcel no.: 2S 101 AB02703 Limited energy,residential
DESCRIPTION OF WORK (with above sq.ft.) 75.00 2
Limited energy,multi-family
hook up one illuminated wall sign residential(with above sq.ft.) 75'00 2
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER ( In TENANT 200 amps or less 100.70 2
' 201 amps to 400 amps 133.56 2
Name: Ameriprise Financial 401 amps to 600 amps 200.34 2
Address: 7450 SW Beveland St. #100 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP: Tigard, OR 97223 Temporary services or feeders installation,alteration,and/or
Phone:( ) 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, •er panel
e ', ^ / s - e. , %' A.Fee for branch circuits with
1:/;;'/// / am w ha' zi?,,i% H � „,/i � �a� / above service or feeder fee,
Business name: Hannah Sign Systems, Inc.
each branch circuit 7.42 2
B.Fee for branch circuits without
Contact name: David P Lanphere service or feeder fee,first
branch circuit 56.18 2
Address: 1660 SW Bertha Blvd. Each add'l branch circuit 7.42 2
City/State/ZIP:
Portland,OR 97219 Miscellaneous(service or feeder not included)
Fach manufactured or modular
Phone:( 503)946 8373 Fax::(503 )206 4900 dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
F-mail: davel @hannahsignsystems.com Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 1 67.84 67.84 _ 2
•
Business name: Hannah Sign Systems, Inc. Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 2
Address: 1660 SW Bertha Blvd. Each additional inspection over allowable in any of the above_
City/State/ZIP: Portland,OR 97219 Additional inspection(1 hr min) 66.25/hr
Investigation(1 hr min) 66.25/hr
Phone:( 503 )946 8373 Fax:( 503 )206 4900 Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 203638 Electrical Lic.: CLS34 Suprv.Lic.: SIG676 s.- ificall listed('V2 hr min
Suprv.Electrician signature,required:di Subtotal: E
Print name: David P Demuth Date: 5 -'3 l , (--
Plan review(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE: —,
Print name: David P Lanphere Date: i'� — / This permit application expires if a permit is not obtained within 180
p s r days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:Bui ding Per sits\ELC_PernitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(11/05/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 Qty. I Fee I Total
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
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm -
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
Heating, Ventilation and Air Conditioning
OAR 918-309-0040)
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:
ri Other: Each additional inspection is
charged at an hourly(1 hr mm) 66.25/hr 1
Inspections for which no fee is 90.00/hr
specifically listed('%hr min)
COMMERCIAL WORK ONLY P .RciItIcaL 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
n Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
11Budding\PermitsELC_PermitApp_ELR_ERE.doc Rev 05/21/2013