Permit ry
CITY OF TIGARD ELECTRICAL PERMIT
1111 r, COMMUNITY DEVELOPMENT Permit#: ELC2015-00523
TIGARD 13125 SW Hall Blvd..Tigard OR 97223 503.718.2439 Date Issued: 07/28/2015
Parcel: 2S104BB07900
Jurisdiction: Tigard
Site address: 14350 SW BARROWS RD 2
Project: Mathnasium Subdivision: RUSSELL'S SCHOLLS FERRY Lot: A
Project Description: Sign lighting for(1)wall sign.
Contractor: SECURITY SIGNS INC Owner: SPIRIT SPE HG 2015-1 LLC
2424 SE HOLGATE BLVD BY HAGGEN OPCO SOUTH LLC
PORTLAND,OR 97202 2211 RIMLAND DR, STE 300
BELLINGHAM,WA 98226
PHONE: 503-546-7114 PHONE:
FAX: 503-230-1861
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 07/28/2015 $67.84
Specifics:
1 ea 12%State Surcharge- 07/28/2015 $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 • - • . e 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. • ENTION: Or •n law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-1.1-0010 through OAR•• %'1-.••e. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
1^
Is ued By: Permittee Signature: /x
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' e Y , �. 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 ApplicatiQp FOR OFFICE USE ONLY
City of Tigard RECEIVED Received p/ `/ ■ ) Permit No.: fi u„jls 6I 4
Date/By: S 7
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
II Phone: 503.718.2439 Fax: 503.598.19*L 8 2015 Date/By: Other Permit:
T I U.A RD Inspection Line: 503.639.4175 Date Ready/By: tune: ® Sec Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
TYPE 016 1itiNU LJIVISION PLAN REVIEW
agj New construction El 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 exceeds 10,000 amps at 150 volts or ❑Floating buildings.
less to ground.or exceeds 14,000 ❑Commercial-use agricultural
❑ 1-and 2-family dwelling gg 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",
Job no.: /m Job site address: /G1�j3'SQ — ` Q/J IOOHP or more. occupancy.
A-71461 /�Q J �`+� ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: 176 O \ 9722 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: I Project name: /7 0-17 /V/n/1Jm ❑Service or feeder 600 amps or more.
�, FEE SCHEDULE
Cross street/directions to job site: ea/pi— U/. mt./R Z/1y 4 Description I Qty. I Fee. I Total I
,,�n , 1c
New residential single-or multi-family dwelling unit.
t'RZAt)r ON Er 6/ g. 4f' f 7eiepit)S 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
75.00 2
DESCRIPTION OF WORK (with above sq.ft.)
n Limited energy,multi-family 7500 2
(i) L'./ n/f i r (I) 4100/02— J i daLL residential(with above sq.ft.)
l!�� [[ ���' !�" Services or feeders installation,alteration,and/or relocation _
S/4 N - / 2J,T on/LY *-- 200 amps or less 100.70 2
❑ PROPERTY OWNER 0 TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: Mit;i J/J(/�/i JM 601 amps to 1,000 amps 301.04 2
Address: iii 5S-0 vcs��/ /Pa if 2 Over 1,000 amps or volts 552.26 2
City/State/ZIP: �[�/J'/� 72�� `� Temporary services or feeders installation,alteration,and/or
v, relocation
Phone:()13 q to y Fax:( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation:This installation is being made on property that I own which is not
intended for sale,lease,ren ,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
rr'' Branch circuits—new,alteration,or extension,per panel
Owner signature: 11i ler Date: A.Fee for branch circuits with
.APPLICANT I CONTACT PERSON above service or feeder fee. 7 4� 2
each branch circuit
Business name:SESCURITY SIGNS,INC B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Contact name:CYNDI KRACKE branch circuit
Each add'I branch circuit 7.42 2
Address:2424 SE HOLGATE BLVD Miscellaneous(service or feeder not included)
Each manufactured or modular
City/State/ZIP:PORTLAND,OR 97202 dwelling,service and/or feeder 67.84 2
Phone: (503)546-7102 Fax: : (503)230-1861 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E-mail: permits @securitysigns.com Sign or outline lighting , 67.84 6, D7 - 2
CONTRACTOR Signal circuit(s)or limited-energy
Business name:SECURITY SIGNS,INC panel,alteration,or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 2424 SE HOLGATE BLVD Additional inspection(I hr min) 66.25/hr
Investigation(1 hr min) 66.25/hr
City/State/ZIP:PORTLAND,OR 97202 Industrial plant(1 hr min) 78.181 hr
Phone:(503)546-7102 I Fax:(503)230-1861 Inspections for which no fee is 90.00/hr
specifically listed(1/2 hr min)
CCB Lic.: 122809 Electrical Lic.: 26560CLS Suprv.Lic.: 383SIG ELECTRICAL PERMIT FEES
Subtotal: f17, $`/
Suprv.Electrician signature,required: .ter
JPlan review(25%of permit fee):
Print name: MARC LIND• (1ST �I Date: /�J//Y1�s State surcharge(12%of permit fee): if./V Ak
% V, "! TOTAL PERMIT FEE: 75.9s,
Authorized signature: /• This permit application expires if a permit is not obtained within 180
Print name: CYNDI K'ACKE Date: _7/! days has ees * Number of inspections after it allowed b per en acceptpermit.d as complete.
I:\BuildinglPermitsELC-PermitApp.doc 07/01/10 440-4615T(11/05/COM/wEB