Permit CITY OF TIGARD ELECTRICAL PERMIT
11111 COMMUNITY DEVELOPMENT Permit#: ELC2015-00713
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/02/2015
Parcel: 2S113AC01201
Jurisdiction: TIGARD
Site address: 17015 SW 72ND AVE
Project: MCCORMICK AND SCHMICKS Subdivision: COUNCIL VIEW ACRES(LOTS 1-20) Lot: 18
Project Description: Sign lighting for(1)internally illuminated wall sign.
Contractor: MEYER SIGN CO OF OREGON Owner: BV CENTERCAL LLC
15205 SW 74TH AVE ATTN: FRED BRUNING
TIGARD, OR 97224 7455 SW BRIDGEPORT RD
TIGARD, OR 97224
PHONE: 503-620-8200 PHONE:
FAX: 503-620-7074
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 09/02/2015 $67.84
Specifics:
1 ea 12%State Surcharge- 09/02/2015 $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 iss . .e, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notificat, e -r. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You m- •• • -co• • - • or direct questions to OUNC by calling % -:7 or 1.80 332.2344.
Issued By: _ - Permittee Signature: 7
I
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 ONLY
City of Tigard Recei,ed
y f g Date/8 : S • ��I A ..•
't 13125 SW Hall Blvd.,Tigard,OR 9722 r(���� . Plan Review
l 2 Phone: 503.718.2439 Fax: 503.598.19 ��/ Date/e : Related Permit#:
Inspection Line: 503.639.4175 Ready Date/By: _ HI See Page 2 for
1 IGARD Internet: www.tigard-or.gov SEP 2 2015 Notified/Method: Supplemental Information
HYPE OF WORK±{{ PLAN REVIEW
❑ New construction El Addition/alteratiolNtt; -t D IV I S I O N Please check all that apply(submit a sets of plans w/items checked):
BLit ❑Service or feeder 400 amps or more ❑Building over three stories.
❑ Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
!" r i i_ t, mps at 150 volts or
exceeds 10,000 a ❑Floating buildings.
❑ 1-and 2-family dwelling 0 Commercial/industrial El Accessory building less to ground.or exceeds 14.000 ❑Commercial-use agricultural
arr4s 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
Job#: I Job site address:17015 SW 72'd Ave. CI A HP on of new motor load of system.
IOOHP or more. ❑"A" "E" "1-2","1-3'•
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: I Project name:McCormick and Schmicks ❑Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE MN
Description I Qty. I Each Total •*
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: - •
Ea.add'l 500 sq.ft.or portion 33.92 I
DESCRIPTION OF WORK Limited energy,residential
Connect 1 internally illuminated wall sign after servicing of sign to existing
(with above sq.ft.) 75.00 2
Limited energy.multi-family 7500 2
electrical. residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
❑ PROPERTY OWNER 1 ® TENANT Services or feeders installation,alteration,and/or relocation
Name: McCormick and Schmicks 200 amps or less 100.70 2
Address: 17015 SW 72nd Ave. 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Tigard,OR 97224 601 amps to 1,000 amps 301.04 2
Phone:( ) I Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I
intended for sale,lease,rent,or exchange.according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
s Branch circuits—new,alteration,or extension,per panel
® APPLICANT CONTACT PERSON
r. - -- �-• -- A.Fee for branch circuits with
Business name: Meyer Sign Co.of Oregon above service or feeder fee.
7.42 2
each branch circuit
Contact name:Tony McCormick B.Fee for branch circuits without
Address: 15205 SW 74th Ave. service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP:Tigard,OR 97224 Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included) _
Phone:(503)620-8200 Fax: :(503)620-7074 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: permits @meyersignco.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Meyer Sign Co.of Oregon Sign or outline lighting I 67.84 6-7.8.49 2
Address: 15205 SW 74th Ave.
Signal alteration,or extension. ❑ See Page 2 2
panel,alteration,or extension.
City/State/ZIP:Tigard,OR 97224 Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
Phone:(503)620-8200 I Fax:(503)620-7074 Investigation(1 hr min) 90.00/hr
Email:Permits @meyersignco.com Industrial plant(1 hr rain) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 64014 Electrical 'v: 20-a'Oct Suprv.Lic.: 569 SIC specifically listed(�1hr min)
�� / ELECTRICAL PERMIT FEES
Suprv.Electrician signature,req ,, s7 y/.� ✓ Subtotal: 67,tom
Print name: Todd Barclay I Date: 9/2/15 ❑Plan Review Required(25%of permit fee):
L/ /� State surcharge(12rk,of permit fee): 57":141
Authorized signature p e l.�-t.� TOTAL PERMIT FEE: 17c;¶
!
This permit application expires if a permit is not obtained within 180
Print name: Anthony G McCormic Date: 9/2/15 days after it has been accepted as complete.
* Number of inspections allowed per permit.
l:\Building\Permits\F.I.C_PermitApp_ti1.R_ERE.doc Rev 06/17/21115 440-4615T(1l/05/COM/WEB