Permit (65) ii CITY OF TIGARD ELECTRICAL PERMIT
a COMMUNITY DEVELOPMENT Permit#: ELC2016 00464
TtARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/06/2016
4
Parcel: 2S103DD00950
Jurisdiction: Tigard
Site address: 13855 SW PACIFIC HWY
Project: Tuality Community of Christ Subdivision: None Lot: None
Project Description: (1)sign lighting
Contractor: MEYER SIGN CO OF OREGON Owner: REORGANIZED CHURCH OF JESUS
15205 SW 74TH AVE CHRIST OF LATTER DAY SAINTS
TIGARD, OR 97224 BY COMMUNITY OF CHRIST
13855 SW PACIFIC HWY
TIGARD, OR 97223
PHONE: 503-620-8200 PHONE:
FAX: 503-620-7074
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 06/06/2016 $67.84
Specifics:
1 ea 12%State Surcharge- 06/06/2016 $8.14
Electrical
Type of Use: COM
Class of Work: OTR
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 issuanc- 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 - ter. Those rules are set forth in OAR
952-001-0010 ..•• OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503. 2. •87 or 1.800. 32.2344.
1
Issued Ek__ •
• Permittee Signature: I /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 ApplicitittElVED FOR OFFICE USE ONLY
City of Tigard I Permit#' `Et-Caoito-t�Qr{I/oli
NI a 13125 SW Hall Blvd.,Tigard,OR 9T6 2016 Plan Review
Phone: 503.718.2439 Fax: 503.594. ) (1 U DateB : Related Permit#:
.
Inspection Line: 503.639.4175 OF TIGAR�? Ready Date/By: furls: El See Page 2 for
TIGARD Internet: www.tigard-or.gov6CITYF�WO Notified/Method: Supplemental Information
TYPE� DIVISION PL
❑ New construction ® Addition/alteration/replacement I'Ir,ise check all that apply(submit2 sets of plans w/items checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑ Demolition ❑Other: where the available fault current D Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑Floating buildings.
❑ I-and 2-family dwelling ®Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
0 Multi-family ❑Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JO It ❑Emergency system. larger separately derived
0 Addition of new motor load of system.
Job#: Job site address: 13855 SW Pacific Hwy 1 ooHP or more. ❑"A^,..E°',"1-2", 1-3",
City/State/ZIP:Tigard,OR 97223 0 Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Tuality Community of Chris( 0 Hazardous locations. 0 Supply voltage for more than
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: IIIIIIIIPIIIIIIIIWW SCHEDULE
II
Description I Qtt. I I.aeh 1 total 1 *
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'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK 1 Limited energy,residential
Connect 1 Internally Illuminated Monument sign with Electronic
(with above sq.ft.) 75.00 2
Limited energy,multi-family
75.00 2
Message Center to existing electrical. residential(with above sq.ft.) _
Renewable Energy 0 See Page 2
® PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: Reorganized Church of Jesus Christ of Latter Day SAiii C- 200 amps or less 100.70 2
Address: 13855 Sw 74th Ave. 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Tigard,OR 97223 601 amps to 1,000 amps 301.04 2
Phone:( ) Fax: I 1 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
® NTACT )PRISON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:Meyer Sign Co.of Oregon above service or feeder fee,
each branch circuit 7'�
Contact name:Tony McCormick B.Fee for branch circuits without
service or feeder fee,first
Address: 15205 SW 74th Ave. branch circuit 56.18 -
City/State/ZIP:Tigard,OR 97224 Each add'I branch circuit 7.42
Miscellaneous(service or feeder not included)
Phone: (971)232-5021 Fax: :( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email:permits@meyersignco.com Reconnect only 67.84 2
MB CONTRACTOR Pump or irrigation circle 67.842 1
Business name: Meyer Sign('o.of Oregon Sign or outline lighting 1 67.84 , 2
Signal circuit(s)or limited-energy ❑ See Page 2 2
Address: 15205 SW 74th Ave. 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:(971)232-5021 Fax:( ) Investigation(I hr mint 90.00/hr
Email:permits@meyersignco.com Industrial plant I I hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lie.: 64014 Electrical Lie.: 20-190c15 Suprv.Lie.: 569SIG s cificall listed '/z hr min
Suprv.Electrician signature,required: Subtotal: Lo7- 1-1
Print name: Todd Barclay Date: 6/6/16 0 Plan Review Required(25%of permit fee):
/y�eCiState surcharge(12%of permit fee): e./4
/�,
Authorized signature: V %/< .`�_ TOTAL PERMIT FEE: 75-.9 g
This permit application expires if a permit is not obtained within 180
Print name: Tony McCormick Date: 6/6/16 days after it has been accepted as complete.
* Number of inspections allowed per permit.
lAtinilding Res 06/171.2015 44O4615T(11/05/COM/WED
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
13855 SW PACIFIC HWY, TIGARD, OR, 97223
Record Type:
Commercial - Electrical
Inspection Type:
199 Electrical final
Result:
PASS- NoCofO
Comments:
Violation Summary:
Inspector
Tel: 503.718.2439
Inspection Date:
Record ID:
ELC2016-00464
Inspector:
Herb Stabenow
Contractor