Permit (53) iL CITY OF TIGARD ELECTRICAL PERMIT
`< COMMUNITY DEVELOPMENT Permit#: ELC2016-00726
13125 SW Hall Blvd.,Ti Date Issued: 10/27/2016
T['fa1 and OR 97223 503.718.2439 9
Parcel: 1 S 135C 800600
Jurisdiction: Tigard
Site address: 11530 SW TIEDEMAN AVE
Project: Harris WorkSystems Sign Permit Subdivision: None Lot: None
Project Description: (2)illuminated wall signs.
Contractor: SECURITY SIGNS INC Owner: MCCALL PROPERTIES LLC
2424 SE HOLGATE BLVD BY NED MCCALL
PORTLAND, OR 97202 5480 NW FRONT AVE
PORTLAND, OR 97210
PHONE: 503-546-7114 PHONE:
FAX: 503-230-1861
FEES
Quantity Description Date Amount
2 ea Sign or Outline Lighting 10/06/2016 $135.68
Specifics:
1 ea 12%State Surcharge- 10/06/2016 $16.28
Type of Use: COM Electrical
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 throughro/OAR/952-001-0090. You may obtain a c P jes or direct questions to OUNC by calling 503.232'1987 or 1.800.332.2
Issued By:, ��'t7 "�'p C//�
Permittee Signature: c
d.
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 FOR OFFICE USE ONLY
City of Tigard Received
aateB : 4 ` �`� Permit No.:
114 . 411 13125 SW Hall Blvd.,Tigard,OR 97223RECEIVE ��� dF11 - - / 1 y /�
;P-lan Review , j J �4
Phone: 503.718.2439 Fax: 503.598.196 Date/B : Other Permit: i PAs'
T I GARD Inspection Line: 503.639.4175 Date Ready/By: ® See Page 2 for
Internet www.tigard-or.gov Notified/Method: �i Su
pplemental Information
it ? ;, iEGtlO�tnFno OK Z `. ,a ,e xs'Winkr g a.:-r N.
Y OIAl
aIli-NewVew construction 0 Addition/alteration/ y InGA Please check all that apply(submit 2 sets of plans w/items checked below):
❑Service or feeder 400 amps or more 0 Building over three stories.Demolition 0 Other: Jsi, GD ISION where the available fault current 0 Marinas and boatyards.
A CATRY Fs ` a exceeds 10,000 amps at 150 volts or0 Floating buildings.rjz, . x. . b !_= , _ .
less to ground,or exceeds 14,000 0 Commercial-use agricultural
❑ 1-and 2-family dwelling EKommercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: ['Fire pump. 0 Installation of 75 KVA or
Emergonencyof system.motor larger separately derived system.
JOIE SI7 -o:.ORMATION ASID LOCON
a_, --_ATI ❑❑Additinew load of
Job no.: 3 1/6-16,) 1 Job site address: //5354) 7y&-vermw -- looms or more. occupancy.
❑Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: T76alw 0� ei 7j-72 0 Health-care facilities. 0 Supply voltage for more than
77
I , //2lf i2/5 io`^� ❑Hazardous locations. p 600 volts nominal.
Suite/bldg./apt.no.: Project name: ill / / V r� e ice or feeder 600 amps or more.
Cross street/directions to job site: `v 4:401``io' �: ,F' y E °e. ,,of
Description I Qty. I Fee. I Total
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4
Ea.add'1500 sq.ft.or portion 33.92 1
Tax map/parcel no.: Limited energy,residential
DESy0. OFC_RIPTWORK t „ (with above sq.ft.) 75.00 2
;.
ly
_ L �.) /� /r cj L-e0Zziffti % 5
Limited energy,(with amultbove sq.
residential above sq.ft.) 75.00 2
S' f. / � NO-72.01-
/!-)„ 41 _ "52 SQ. � 200 or feeders installation,alteration,and/or relocation _
(N /�{ �J�� 200 amps or less 100.70 2
f Pn fRori<rRTY o
:-x �.,.._ � . ., a. VSt/ .,.,),,4 �. .�N.j.t�r'� T�+'NU ,F. �:�'� .t:, 201 amps to 400 amps 133.56 2
Name: thi79-2i /4)0�G-k-- cc7 �1 5 401 amps to 1,600 amps amps 200.3412
601 amps to 1,000 301.04 2
Address: `i 5-30 l/ 1 ,tai ..- Over 1,000 amps or volts 552.26 2
City/State/ZIP: �[J72c2:2 ---/-72,494/�� �1li�L Temporary services or feeders installation,alteration,and/or
relocation
Phone:( ) Fax:( ) 200 amps or less 59.36 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 change,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
/fid Branch circuits-new,alteration,or extension,per panel
Owner signature: 1f� Date: A.Fee for branch circuits with
,. # ].APPLICANTtamictil
s # tiA '* r 7 above service or feeder fee, 7.42 2
each branch circuit
Business name:SESCURITY SIGNS,INC B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Contact name: CYNDI KRACKE branch circuit
Each add',branch circuit 7.42 2
Address:2424 SE HOLGATE BLVD Miscellaneous(service or feeder not included)
City/State/ZIP:PORTLAND,OR 97202 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Phone: (503)546-7102 Fax: : (503)230-1861 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E-mail:permits@securitysigns.com Sign or outline lighting Z 67.84 37y ✓2
473.34SMSVORMDZIEXQOAA .;:tMiON: :,tVi.MalVMO
Signal circuit(s)or limited-energy
Business name:SECURITY SIGNS,INC panel,alteration,or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address:2424 SE HOLGATE BLVD Additional inspection(I hr min) 66.25/hr
City/State/ZIP:PORTLAND,OR 97202 Investigation(1 hr min) 66.25/hr
Industrial plant(I hr min) 78.18/hr
Phone:(503)546-7102 Fax:(503)230-1861 Inspections for which no fee is 90.00/hr
specifically listed(i/hr min)
CCB Lie.: 122809 Electrical Lic.: 2.5.IICLS _ Suprv.Lie.: 383SIG .ELECtRIGAL P FEES
Suprv.Electrician signature,required: ����� Subtotal: (pr
Plan review(25%of permit fee):
Print name: MARC LINDQUIST O ate: `/ //J 7// State surcharge(12%of permit fee): /C , )-i(
' TOTAL PERMIT FEE: t 'j', t'�(,
Authorized signature:
This permit application expires if a permit is not ob ined within 180
Date: 409//46/1
Print name: CYNDI KRACKE / days after it has been accepted as complete.
CJ * Number of inspections allowed per permit.
I:\Bsilding\Permits\ELC-Perm it App.doc 07/01/10 440-4615T(11/05/COM/WEB
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
11530 SW TIEDEMAN AVE, 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:
ELC2016-00726
Inspector:
Jeff Grove
Contractor