Permit (279) 'PICITY OF TIGARD ELECTRICAL PERMIT
.' COMMUNITY DEVELOPMENT Permit#: ELC2016-00929
T E G A RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/28/2016
Parcel: 1 S136CD00100
Jurisdiction: Tigard
Site address: 11705 SW PACIFIC HWY Z
Project: Papa Murphy's Pizza Subdivision: None Lot: None
Project Description: Sign lighting for(2)wall signs
Contractor: SECURITY SIGNS INC Owner: PACIFIC CROSSROADS PROPERTIES IN
2424 SE HOLGATE BLVD BY WYSE INVESTMENT SERVICES CO
PORTLAND, OR 97202 1501 SW TAYLOR ST STE 100
PORTLAND, OR 97205
PHONE: 503-546-7114 PHONE:
FAX: 503-230-1861
FEES
Quantity Description Date Amount
2 ea Sign or Outline Lighting 12/15/2016 $135.68
Specifics:
1 ea 12%State Surcharge- 12/15/2016 $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 OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: C-"'') (i ret-C-ytl,p-- f Permittee Signature: T Qc 2__ i es t_--
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
CityofTigard REIV: fqg r DateBy: ��C ! ��0�� Permit#:Gr�aQ���OQ7 t� /
irla 13125 SW Hall Blvd.,Tigard,OR 97223 / / , ,,/ Plan Review �/y�Phone: 503.718.2439 Fax: 503.598.196OCT (r^ Date/By: Related Permit#: &- 3q6
CJ
T I G A R D Inspection Line: 503.639.4175 O a ' 2 010 Ready Date/By: Juris: VI See Page 2 for
Internet: www.tigard-or.gov if Notified/Method: Supplemental Information
V ' 7---,P,..'";-::;:Z .-:4'1, <Sn Y
4 P,�-'i�yr{o, o->3�.a- v:E „�+�; "�-�rw�-,,, � � r�"�` �, �r� ,a-# w'-y � .: �""'3� i
���'�i �}� _ 7� r, � - t�a�r�� ,...,> � > e .. i_ d>�=,�fit°'- `��7�� A� _.4�'p 4 ',� �-' '�rs .�r�lk s.;:i
hew construction dition/alta t!r_1.,_......:1-1 :fit' IO j Please check all that apply(submit 2 sets of plans w/items checked):
El Demolition 111 Other:
1 ❑Service or feeder 400 amps or more ❑Building over three stories.
where the available fault current ❑Marinas and boatyards.
i a , . ' : t, � 3 ( 1?��' � ` .t<<, < �i, exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑ 1-and 2-family dwelling [ 6ommercial/industrial ❑Accessory building less to groans,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: 0 Fire pump. ❑Installation of 150 KVA or
" _;,IQB $:0,L+',':,7 2A *AO 10C,7 ( r 0 Emergency system. larger separately derived
sys
SGf/ P/J i tw! 0 Addition o of new.motor load of "A tem.
Job#: ?S02n, Job site address: `(7Q5' . loot-mor more. 0"A","E","1 z","1-3", li
❑Six or more residential units. occupancy.
City/State/ZIP: 7A'b S 1 7223 ❑Recreational vehicle
❑Healthcare facilities. parks.
Suite/bldg./apt.#: Z_, Project name: prA--anvtZ..Pjt f-C7,I S 0 Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more 600 volts nominal.
Cross street/directions to job site: t- q
' "
Description s ty. Each I
Total *
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
ig AP E D ! ,iwoar l t .211 , i . Limited energy,residential
(with above sq.ft.) 75.00 2
/Ai Sr-AL L (2') ���� ✓i4�. Ri ca) Limited energy,multi-family 75.00 2
mcu7-- ONLY residential(with above sq.ft.)
Renewable Energy"; I .. *' :1B «_ ,t .i $ AN e4,z Services or feeders installation,al❑trSteieoPnaagned2/o
r relocation
Name: 6q9- ela /!S
200 amps or less 100.70 2
Address: //706 s?e) Pci,� �j,jl� 201 amps to 400 amps 133.56 2
1!.`�/ 401 amps to 600 amps 200.34 2
City/State/ZIP: T/610 ,OY '722-3 601 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
NOwner signature: 19-- Date: 401 amps to 599 amps 168.54 2
E APPLIAI „ Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:SECURITY SIGNS,INC above service or feeder fee, 7.42 2
each branch circuit
Contact name:CYNDI STOCKS B.Fee for branch circuits without
service or feeder fee,first
Address:2424 SE HOLGATE BLVD branch circuit 56.18 2
City/State/ZIP:PORTLAND,OR 97202 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)546-7102 Fax: :(503)230-1861 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:permits@securitysigns.com Reconnect only 67.84 2
. ',AGR Pump or irrigation circle 67.84 2
Business name:SECURITY SIGNS,INC Sign or outline lighting , 67.84 /35' g2
Signal circuit(s)or limited-energy
Address:2424 SE HOLGATE BLVD panel,alteration,orextension. 0 See Page 2 2
City/State/ZIP:PORTLAND,OR 97202 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)546-7102 Fax:(503)230-1861 Investigation(1 hr min) 90.00/hr
Email:permits@securitysigns.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 122809 Electrical Lic.: 26- 660CL Suprv.Lic.: 383-SIG specally listed(i/z hr min)
Suprv.Electrician signature,required: / tiva 4wwww,P$R"MJT PEE :.` 's
,,,,„,.--
Subtotal: A,%.4 Q
Print name: MARC LINDQUIST Date: f yo 6 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): /6,016'
Authorized signature: / TOTAL PERMIT FEE: /6-7,`f/o
/ / This permit application expires if a permit is not obtained within 180
Print name: CYNDI STOCKS
Date: Z// 2//6 days after it has been accepted as complete.
* Number of inspections allowed per permit.
1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB