Permit a CITY OF TIGARD ELECTRICAL PERMIT
s COMMUNITY DEVELOPMENT Permit#: ELC2016-00007
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/21/2016Parcel: 2S102AC00700
Jurisdiction: Tigard
Site address: 12540 SW MAIN ST 200
Project: CDS Complete Distribution Services Inc. Subdivision: BURNHAM TRACT Lot: 1
Project Description: Sign lighting for(1)sign.
Contractor: SIGNCRAFT SIGNS LLC Owner: DOLAN&CO LLC
8900 SW BURNHAM, E109 BY FLORENCE T DOLAN
TIGARD, OR 97223 4523 NE DAVIS ST
PORTLAND, OR 97213
PHONE: 503-639-4910 PHONE:
FAX: 503-639-4999
FEES
Quantity Description Date Amount
Specifics: 1 ea Sign or Outline Lighting 01/07/2016 $67.84
1 ea 12%State Surcharge- 01/07/2016 $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
952-001-0010 through OAR 952-001-0090. You may obtain a copyHlll+mleae direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: PermitteeSignature: S CixJ�'
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 lhejob site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
_tUMrical Permit Application
City of Tigard( (�� G Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 l.. 111
Phone: 503.718.2439 Fax: 503.598.1960 1Naffi!.d1Mfethod:
Other Permit: (�
Inspection Line: 503.639.4175 Ready/By: Imo: 0 See Page 2 for
Internet: www_tigardor.gov ,JAN 7 2 d 1 6 Sappkmental Infortetiso
TYPE OF WOW PLAN
❑New construction ❑Addition/alteratio(,)1[14' { rpyr Please check all that apply(submit F sets of pians mortems checked below):
❑ ilding own these smms
Demolition ❑Other: i)U ttUt�` DON ION ❑where the available faultS�or fieder 400�nmrwt ❑or more 0BMarinu and boatyards.
CATEGORY OF CONMUCTRIN exceeds 10.1100 amps at 150 woks or ❑Floating buildings.
❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessorybuilding less to ground,er exceeds ons. ❑commercial-rne ae<iooamnl
g amps for all Other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
SOB SITE INFORAUTION AND LOCATION ❑Emergencysystem. butic"A". separately derived system.
0 Addition of new motor load of ❑"A","E","1-2',"1-3",
100HP Of mo1e. occupancy no.: Job site address:
+ ❑Six in more residential units. ❑Recmatiooal w:hicle parks.
City/State/ZIP: T,,,.,4 0 Heauhcme facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts arrested.
Suite/bldgJapt.no.: !Moo Project name:4_bSCymI`+ k ❑Service mfeeder 600amps msince.
Cross street/directions to job site: - Desolation FEE
SCHEDULE
I Fes. I TaW
YM St
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.R or less 1 168.54 1 1 4
Tax map/parcel no.: Ea.add'[500 sq.R or portion 33.92 1
Limited energy,residential 75.00 2
DESCRIPTION OF WORK with above sq.R.
Limited energy,multi-family 75.00 2
residential with above .it
Reaeuable Energy ❑ See P e 2
51 n LtfY�...l' Services or feeders inst&&tioa alteration and/or mloeation
E9 PROPERTY OWNER ❑TMANT 200 amps or less 100.70 2
Name: 201 amps to 400 amps 133.56 2
k 401 amps to 600 amps 200.34 L]�f Address: 1,9%A w r 601 amps to 1,000 amps 301.04
Over 1,000 amps or volts 552.26
City/Stale/ZIP: `��,� ACC_ C(,�jp ct OTemporaryservices or feeders installation,alteration and/or
Phone:.(So3 Min- 2� Fax:( ) relocation
200 amps or less59.36 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 l6g sec 2
Owner signature: Date: Brancheireuits-new alteration,or"tendon.Per panel
0 APPLICAMF 0 CONTACT PERSON A.Fee f n-branch circuits wah
above service or feeder fee, 7.42 2
Business name: cus CO.ONLIle fxqrt6each branch circuit
B.Fee for branch circuits without
Contact name: service or feeder fee,fust
rr Manch circuit 56.18 2 i
Address: jk(Sp U �� Each add'l branch circuit 7.42 2
City/State/ZIP: t Miscellaneous service ar feeder not included
T G Each manufactured or modular 67.84 2
Phone:6393 ) ';y, Fax::( ) dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail: ,n Co f.. Pump or irrigation circle 67.84 2
CO OR Sign or outline lighting 67.84 (p), q 2
Business name: S 6c, uL Signal citmit(s)carlimited-energy See
L5 AI,alteration,or extension. 2 2
Address: O Each additional inspection over allowable in say of the above
City/State/ZIP:-T-1 -)
inspection(1 hr min) 66.25/hr
Z n-- -) g Investigation(I hr min) 6625/bit
Phone:(S-03) Fax:( ) industrial plant(I hr min) 78.IS/M
Inspections for which no fee is 90 Ops hr
CCB Lic.: Electrical Lic.: up".Lic.: — specifically listed %,M min
Suprv.Electrician signature,required:/ ELECTRICAL.PERMIT FEESSubtotal: g
Print name: Date: �, Plan review(25%of permit fee):
State surcharge(12%ofpermit feel: g.(
Authorized sign YaL TOTAL PERMIT FEE: 8
Print name.
Date` Toa pa,mit appMead.axph as ifs perish is not obtained within IN
I' - to days aaer it has been accepted as complete.
" Nwnbrs of inspwtions allowed per permit.
Ilauadigpl�m' PvmirAgi_ LR_ERE.doc Rev 05212013 NOA615T111Po5a:0aUWF8
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
12540 SW MAIN ST 200, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2016-00007
Chip Barnett
Violation Summary:
Inspector Contractor