Permit (15) n CITY OF TIGARD ELECTRICAL PERMIT
111 ' COMMUNITY DEVELOPMENT Permit#: ELC2016-00167
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/03/2016
Parcel: 2S112DC00701
Jurisdiction: Tigard
Site address: 15957 SW 72ND AVE
Project: TAP Plastics Subdivision: FANNO CREEK ACRE TRACTS Lot: 39
Project Description: (1)sign lighting for new wall sign
Contractor: ELECTRIC AVENUE SIGN&LIGHTING Owner: PACIFIC REALTY ASSOCIATES
16005 NE 12TH ST ATTN: N PIVEN
VANCOUVER,WA 98684 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 360-903-5447 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 03/03/2016 $67.84
Specifics:
1 ea 12%State Surcharge- 03/03/2016 $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 pe •' ' ' • . ubject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be •. e in accordance ' 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
d--s. ATTENTION: Oregon I. requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
9'2-001-0010 through OAR 9400 -0.90. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.8.0.3 2.2344.
Is _•d °Ifrky0 Permittee Signature:
OWNER INSTALLATION ONLY v
The installation is being made on property I own which is not intended for sale,lease or rent.
OWNER'S SIGNATURE Date:
CONTCTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' Y Date:
� Jv
LICENSE NO. 67f/ 5(� •
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 Applicati p:O OI I l( I. I S11(Y1.1
� L,jI v Received 61:350m, ^ „/ / 7
City of Tigard Date/B • Permit#: �� �p t�
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
0 Phone: 503.718.2439 Fax: 503.598. /R Date/B : Related Permit#: 60,01,514_ 600/4,
Inspection Line: 503.639.4175 ^n n?6 Ready Date/By: Juris: ® See Page 2 for
I 1( l'1) Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE of "` I HJAKt3 'IAN AN REVIEW
❑New construction ❑AdditionBfilitilliKallAkhSlW Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition titer: where the available fault current 0 Marinas and boatyards.
CATEEI<OItf3F CONSTRUCTION exceeds 10.000 amps at 150 volts or 0 Floating buildings.
0 1-and 2-family dwelling ommercial/industrial 0 Accessory building less to ground,or exceeds 14.000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: Job site address: "'"93-7,511/ 7264 /41e... ❑Addition of new motor load of system.
I OOHP or more. ❑"A'"`E","1-2" "I-�"
City/State/ZIP: ......-.• ❑Six or more residential units. occupancy.
^n
/jet/` t t el 722-f 0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: n ❑Hazardous locations. 0 Supply voltage for more than
I T lr oar/.j C 600 volts nominal.
1 ❑Service or feeder 600 amps or more.
Cross street/directions to job site: ca./.a,,,e4 C - FEE SCHEDULE
Description I Qty. T Each I Total I *
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 sqft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy residential 75.00
/' n 1 / (with above sq.ft.)
/a p Plas- c 5)C{td JV /Ia7)Qe Limited energy,multi-family 75.00
-
/ J residential(with above sq.ft.)
PROPERTY OWNER ❑TENANT' Renewable Energy 0 See Page 2
Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 100.70 2
Address: 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) 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 1
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
Branch circuits-new,alteration,or extension,per panel
IIKPLICANT 0 CONTACT PERSON
A.Fee for branch circuits with
Business name: d �+ ) above service or feeder fee,
�leGfciL/ 1 e.044c Jiy h,�j,+�or 7.42 2
J each branch circuit
Contact name: �� GL B.Fee for branch circuits without
A/ . service it feeder fee,first 56.18 2
Address: /bOd ` {.(t/` s -- branch circuit
City/State/ZIP: \CIN co(Aver- I l�`z4 9'6gi Each add'I branch circuit 7.42 2
�j Miscellaneous(service or feeder not included)
Phone:(36o) 9o3_3- !-7 Fax: :(36O) '5-9,307 Each manufactured or modular
67.84 1
dwelling,service and/or feeder
Email: eo/ecf r ICAveci RI , 60 Reconnect only 67.84 2
_ Pump or irrigation circle 67.84 2
Business name: Sign or outline lighting 67.84 6,7:,6.54 2
1ec_frIc_ .4✓euuesj3a ¢f L..iitell J
L .1 Signal circuit(s)or limited-energy 2
Address: / oQ �1 `Z si— panel,alteration,or extension. 0 See Page 2
City/State/ZIP: 'fa / !?�`�� Each additional inspection over allowable in any of the above
Q�L �� l W 7 V Additional inspection(1 hr min) 66.25/hr
Phone:(360) 9o3, 3,9577 Fax:(366 ) gg�j-9-317 Investigation(1 hr min) 90.00/hr
Email: e eths Ve- 1avt f__,6,'0
Industrial plant(1 min) 78.18/hr -
Inspections
forr which no fee is 90.00/hr
CCB Lic.:g3Ti Electric Lic.: a-i_$2 Suprv. Lie.: 6/15-7 6- specifically listed(72 hr min)
ELECTRICAL PERMIT FEES
Suprv. Electrician signature,required: _ Subtotal: te?..
Print name:/ hizjt ( PQ )04-00 Date: 3 3_2016 0 Plan Review Required(25%ofpermit fee): �
Authorized signature:7J
l _,I,
State surcharge(12%of permit fee): g•(51
�� TOTAL PERMIT FEE: ---76:91
This permit application expires if a permit is not obtained within 180
Print name:illj Lk .t( PQM i . . Date: ,3._�`6 days after it has been accepted as complete.
* Number of inspections allowed per permit.
is Building Permits ELC_PermilApp_ELR_ERE.doc 6 17 2015 440-4615T(1 I 05 COM WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL..'WORK ONLY:. _ ',IEE'sCIIE .>i
Description I Qty. I Each I Total I *
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
H Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >100 kva(fee in accordance
2
with OAR 918-309-0040) 552.26
H Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 66.25/hr I
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed('/hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
(SEE OAR 918-309-0000) * Number of inspections allowed per permit.
Check Type of Work Involved:
❑ Audio and Stereo Systems
n Boiler Controls
Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
n Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
1 Building Permits ELC_PermitApp_ELR_ERE.doc Res 06 172015