Permit q CITY OF TIGARD ELECTRICAL PERMIT
i COMMUNITY DEVELOPMENT Permit#: ELC2016-00009
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/11/2016
Parcel: 2S102CC00500
Jurisdiction: Tigard
Site address: 13500 SW PACIFIC HWY 92
Project: Bon Baguette Subdivision: FREWING'S ORCHARD TRACTS Lot: 15
Project Description: (2)sign lighting
Contractor: VISION SIGNS LLC Owner: ROIC OREGON LLC
16127 NE THOMPSON ST 8905 TOWNE CENTRE DR, STE 108
PORTLAND, OR 97230 SAN DIEGO, CA 92122
PHONE'. 503-442-1195 PHONE:
FAX
FEES
Quantity Description Date Amount
2 ea Signor Outline Lighting 01/11/2016 $135.68
Specifics: 1 ea 12%State Surcharge- 01/11/2016 $16.28
Electrical
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $151.96
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 952-09J.QR90. ou may obtain a copy of the rules or direct questions to OUNC by calling 503 232 1987 or 1.800.3y 2344
ISE By: Permittee 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 SUER.ELEC' Date:
LICENSE NO.
Call 503.639.4176 by 7:00 a.m,for the nerd 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 RECEIVE
Received ,q �t
City of Tigard DateB �� �� permit p fd _®t%j9�
• 13125 SW Hall Blvd.,Tigard,OR 97223 JAN 11 2016 Plan Review A1,2016—ee00 3
Phone: 503.718.2439 Fax: 503.598.1960 Dat" Related Permit a
Inspection Line: 503.639.4175 CITY OF rIGAft Ready Dare/By. saris: ® See Page2 for
Internet: www.figard-or.gov BUILDING Notified/Method: Supplemental Information
FwcOnstmction ❑Addition/alteration/replacement Please check all that apply(submit j sets of plans whims checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Other: where the available fault current ❑Marinas and boatyards.
exceeds 10,000 amps at 150 volts or ❑floating buildings.
y dwelling Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑ Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
Emergency system. larger separately derived
o : lob site address:
Addition of new motor load of system.
I00HP or more. ❑"A" "E" "1-2","1 3"
Cit /State/ZIP: ❑Six or more residential units. occupancy.
City/State/ZIP: ❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name: ❑Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/dil-Wions to job site:
De ri tion Each I Tow
New residential single-or multi-family dwelling unit
Subdivision: Lot#: Includes attached garage.
1,000 sq,ft.or less 168.54 4
Tax map/parcel#: Ea.add'1500 sq.ft.or portion 33.92 1
Limited energy,residential 75,00 2
with above sq.R.
Limited energy,multi-family 75.00 2
�� residential with above sq,ft.
Renewable Energy ❑ See Pa e 2
Services or feeders installation,alteration,and/or relocation
Name: O 200 amps or less 1 100.70 2
Address: 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 411A 0", 601 amps to 1,000 amps 301.04 2
Phone:( Fax:( ) Over 1,000 amps or volts 55226 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 1
intended for sale,lease,rent,or exc ,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
Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: V above service or feeder fee, 7,42 7
each branch circuit
Contact name: Bryn B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address: branch circuit
City/State/ZIP: Each add']branch circuit 7.42 2
.Miscellaneous service or feeder not included
Phone:(Sj y Fax: :( ) Each manufactured or modular
67
dwelling,service and/or feeder .84 2
Email: S Reconnect only 67.84 2
Pump or imganon circle 67.84 2
Business name: IO'n Sign or outline lighting 67.84 2
Address: 6 panel Signal allteraton nor extennssioa limited-energy Seepage 2 2
City/State/ZIP: Cl Each additional inspection over allowable in any ofthe above
q Additional inspection(I hr min) 66.25/hr
Phone:( aL _ Fax:( ) Investigation(1 hr min) 90.00/hr
Indusmal plant(I hr min) 78.18/hr
Email: SS , c Inspections for which no fee is
90.0hr
CCB Lic.: Electrical Lic.: Suprv.Lie.:
hr
s ci Ica listed % min 0/
Suprv. Electrician signature,required: Subtotal:
Print time: Date: ❑Plan Review Required(25%ofpermit fee):
44
State surcharge permit fee)1PW : r
Authorized signature: TOTAL PERMIT FEE: �r (O
This permit application expires if a permit is not obtained within 180
Print name: Dale: days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:E3uild,,TU ,..wELC_Pcmii pp_EL oc aw-17/2015 a04615T(1II05IC0M/WEB
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
13500 SW PACIFIC HWY 92, TIGARD, OR,
97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2016-00009
Jeff Grove
Violation Summary:
Inspector Contractor