Permit (27) CITY OF TIGARD ELECTRICAL PERMIT
.14
COMMUNITY DEVELOPMENT Permit#: ELC2016-00539
TE.GA.RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/25/2016
Parcel: 1 S 135DD00900
Jurisdiction: Tigard
Site address: 11875 SW PACIFIC HWY
Project: Broadway Furniture Subdivision: None Lot: None
Project Description: (2)sign lightings
Contractor: MEYER SIGN CO OF OREGON Owner: PACIFIC HIGHWAY TIGARD LLC
15205 SW 74TH AVE 6859 S EASTERN AVE, STE 101
TIGARD, OR 97224 LAS VEGAS, NV 89119
PHONE: 503-620-8200 PHONE:
FAX: 503-620-7074
FEES
Quantity Description Date Amount
2 ea Sign or Outline Lighting 07/25/2016 $135.68
Specifics:
1 ea 12%State Surcharge- 07/25/2016 $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 t.d-- 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 '.suanc- •r if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the Hiles_adopted by the Oregon Utility Notifi :tion -n, 6. Those rules are set forth in OAR
952-001-0010 through OAR 9 -001-0090. You may o• .e rules or.'ect questions to OUNC by calling 03.23 9, or 1.808. 32.2344.6,;
i:
Issued By: G! ±' ' —r Permittee Signature: Ark 1 .
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
v r,, FOR OF'FICI?USE()NEN'
City of Tigard i Received _ //�
`z Date/B : 7 5 1t%p elik Permit#: 6,2,71o/1p-de 53 9
11 11 13125 SW Hall Blvd.,Tigard,OR 97223 e- '1� Plan Review
1 M Phone: 503.718.2439 Fax: 503.598.1960 ,"�l A ';? �� Date/B : Related Permit#: ,4�pl�Qpa/
Inspection Line: 503.639.4175 t�' s Ready Date/By: ]tris: ® See Page 2 for
T I G A R D Internet: www.tigard-or.gov Notified/Method: Supplemental Information
E Oi duo y
0 New construction ® Addition/alterationdent Please check all that apply(submit 2 sets of plans w/items checked):
'f'. ❑Service or feeder 400 amps or more ❑Building over three stories.
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
r.!,, CA TEGOR'Y ,:0:cCOfio,*::uTC TIos:: exceeds 10,000 amps at 150 volts or 0 Floating buildings.
El -and 2-family dwelling ®Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
0 Multi-family 0 Master builder ❑Other: ❑Fire pump. 0 Installation of 150 KVA or
,. J014 R ATyJN LOCA 'IQTNI ,. Emergency system.new motor load of larger separately derived
❑
❑Addition of system.
Job#: Job site address: 11875 SW Pacific Hwy IOOHP or more. ❑"A","F "1-2",°1-3",
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Broadway Furniture ❑Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site:
Fes'.,7**�31,ttti.i
<".
Description I Qty. I Each 1 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#:
w. .... ;, 1 SVLIOP#,ON<. I+ I 500portion 33.92 1
Ea.asq.ft.or
Limited energy,residential
Connect 2 internally illuminated neon signs to existing electrical.
(with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
i >.PR111i�ERTY OWNER,
enwe gy
' - - - � - 0�' Y .. Services
ablor feeders installation,alterat❑ Seeion,Page and/2or relocation
Name:Pacific Hwy Tigard LLC. 200 amps or less 100.70 2
Address:6859 S.Eastern Ave.Suite 101 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Las Vegas,NV 89119 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
— ice:,s alteration,or extension,per panel
s� :�CANI€' �E +r�1 � —0� , ranc ctrcmts n
`�^ � A.Fee for branch circuits with
Business name:Meyer Sign Co.of Oregon above service or feeder fee, 7.42 2
each branch circuit
Contact name:Tony McCormick B.Fee for branch circuits without
service or feeder fee,first
Address: 15205 SW 74th Ave. branch circuit 56.18 2
City/State/ZIP:Tigard,OR 97224 Each add'1 branch circuit 7.42 2
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
iie:.21. ,. ,:a: . .,.., z Pump or irrigation circle 67.84 2
Business name:Meyer Sign Co.of Oregon Sign or outline lighting 2 67.84 /36—.4.32
Address: 15205 SW 74th Ave. Signal circuit(s)or limited-energy ❑ See Page 2 2
panel,alteration,or extension.
Each additional inspection over allowable in any of the above
City/State/ZIP:Tigard,OR 97224
Additional inspection(1 hr min) 66.25/hr
Phone:(971)232-5021 Fax:( ) Investigation(I hr min) 90.00/hr
•
Email:permits@meyersignco.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lie.: 64014 Electrical Lic.: 20190CLS Suprv.Lic.: 569SIG specifically, .,,,!(„1(h/hr min)
Suprv.Electrician signature,required: Subtotal: ae/3 S 8.,
Print name: Todd Bard Date: 6/13/16 ❑Plan Review Required(25%of permit fee):
G � State surcharge(12% fee): ' .az
TOTAL PERMIT
FEE: ��'"� ,�
Authorized signature: (hp
This permit application expires if a permit is not obtained within 180
Print name: Tony McCormick Date: 6/13/16 days after it has been accepted as complete.
* Number of inspections allowed per permit.
1:A Building\Permits\El.C_PcrmitApp_I:LR_PRF..doc Rev 06/17/2015 440-4615T(11/05/COM/W1113