Permit r� CITY OF TIGARD ELECTRICAL PERMIT
II I - COMMUNITY DEVELOPMENT Permit#: ELC2015-00767
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/23/2015
Parcel: 1 S134BC00100
Jurisdiction: Tigard
Site address: 12122 SW SCHOLLS FERRY RD
Project: Scottys Subdivision: GREENWOOD TERRACE CONDO Lot: 17
Project Description: Sign lighting for(1)new 16 sq.ft.sign on south-facing wall.
Contractor: MEYER SIGN CO OF OREGON Owner: ATLAS GREENWAY LLC
15205 SW 74TH AVE 333 NW NINTH AVE, STE 1009
TIGARD, OR 97224 PORTLAND, OR 97209
PHONE: 503-620-8200 PHONE:
FAX: 503-620-7074
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 09/23/2015 $67.84
Specifics:
1 ea 12%State Surcharge- 09/23/2015 $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 Co.-s 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 is •a e, o if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notific. on Cen Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a co. • _ -s or direct questions to OUNC by calling .03. .2.1••• or 1 800 2.2344.
�
Issued By: tom_`. — _ _./ _��_ 'tee 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.
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard RECEIVED RDeed
• 13125 SW Hall Blvd.,Tigard,OR 97223�5'E P 2 3 2015 Plan Review A't
11111 a Phone: 503.718.2439 Fax: 503.598.1 Date/B : Other Permit: S6 v i S—00)/`
1 1 G A R l) Inspection Line: 503.639.4175 Date Ready/By: 1Z See Page 2 for
Internet: www.tigard-or.gov ^I i • Notitied/Method: Supplemental Information
V i ■: .
PF. OBWt1IWING DIVI ...R- '` PLAN REVD':
hernl iutt/reltlacen)ent I.I,.n: ,h.,I.all that apply(submit 1 sets of plans w/3tems checked below):
❑New construction ❑ Ad liliOn/a
❑Lei,ire ur feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: „here 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 ®Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑hire pump. ❑Installation of 75 KVA or
❑Emergency system. larger separately derived system
RMA ION ATIO ❑Addition of new motor load of ❑"A"."E","l-2","I-3",
Job no.: Job site address: 12122 SW Scholls Ferry Rd. l more. occupancy.
_ El Six
Six or or r more residential units. ❑Recreational vehicle parks.
City/State/ZiP:Beaverton,OR 97223 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: I Project name:Scottys ❑Sen ice or feeder 6(0 amps or more.
DULE ..
Cross street/directions to job site: Ik.criptinn 1 (Its. 1 Fee. f Total •
New residential single-or multi-fami■ dwelling unit.
Includes attached garage.
Subdivision: I Lot nu.. 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
DESCRIPTION OF WORK IIII (with above sq.ft.) 75.00 2
Limited energy.multi-family 7500 2
Connect 1 internally illuminated wall sign to existing electrical. residential(with above sq.ft.)
Services or feeders installation,alteration,and/or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER I ® TENANT 201 amps to 400 amps 133.56 2
Name:SCOths 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: 12122 SW Scholls Ferry Rd. Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
City/State/ZIP:Beaverton,OR 97223 relocation
Phone:( ) I 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
401 amps to 599 amps 168.54 2
intended for sale,lease.rent,or exchange.according to ORS 447,449,670,and 701.
Branch circuits–new,alteration,or extension,per panel
Owner signature: Date: A.Fee for branch circuits with
' ® APPLICANT --71 PERSON above service or feeder fee. 7.42 2
each branch circuit
Business name:Meyer Sign Co B.Fee for branch circuits without
service or feeder fee.first 56.18 2
Contact name:Tony McCormick _ branch circuit
Each add']branch circuit 7.42 _ 2
Address: 15205 SW 74th Ave Miscellaneous(service or feeder not included)
City/State/ZIP:Tigard,OR 97224 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Phone:(503)620-8200 Fax::(503)620-7074 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E-mail: rmits @me ersi nco.com -
y g Sign or outline lighting 1 67.84 6, l4 2
CONTRACTOR Signal circuit(s)or limited-energy
Business name:Meyer Sign Co panel,alteration,or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 15205 SW 74th Additional inspection(1 hr min) 66.25/hr
City/State/ZIP:Tigard,OR 97224 Investigation(1 hr min) 66.25/hr
Industrial plant(1 hr min) 78.18/hr
Phone:(503)620-8200 Fax:(503)620-7074 Inspections for which no fee is
90.00/hr
CCB Lie.: 64014 Electrical Lie.: 20-190CL Suprv.Lic.: 569 SIC I 2 h mini a ,s iftcli'.tcd ELECTRICAL
PERMIT FEES
Suprv.Electrician signature,requiredf� � Subtotal:
�L Plan review(25%of permit fee):
Print name: Todd Barcl Date: 9/23/15 State surcharge(12%%of permit fee): r-i7
6 '2 n — TOTAL PERMIT FEE: If
Authorized signature. '�/�'` This permit application expires if a permit is not obtained within 180
Print name: Tony Mc Date: 9/23/15 days after it has been accepted as complete.
y c ormc
Number of inspections allowed per permit.
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