Permit (18) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2017-00190
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/20/2017
[GARD L� g Parcel: 1 S135DD03301
Jurisdiction: Tigard
Site address: 11945 SW PACIFIC HWY 209
Project: Just Kids Subdivision: METZGER ACRE TRACTS Lot: 9
Project Description: Sign lighting for(1)56 square feet wall sign located on the east facade.
Contractor: INTEGRITY SIGNS OREGON Owner: COMMERCIAL ENTERPRISES LLC
PO BOX 88 8320 NW HWY 99
HUBBARD, OR 97032 VANCOUVER,WA 98665
PHONE: 503-981-3743 PHONE:
FAX: 503-982-8153
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 03/20/2017 $67.84
Specifics:
1 ea 12%State Surcharge- 03/20/2017 $8.14
Electrical
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $75.98
Required Items and Reports(Conditions)
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This
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all oth> applicable I. . All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issue ce, o f 0 'is suspend for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification - e T %se rules - e set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain apy o rules or direct questions to OUNC by calling 503. //{'•';7 or .8��x.332.234•.
Issued By: �\ Permittee Signature: // , .��'
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()1 41( F. I SF.Oy1.1
City of Tigardivy / II.._, Permit No.:
DateB : S 1
1114 " 13125 SW Hall Blvd.,Tigard,OR 97223 * ,- '! ') plan Review
II Phone: 503.718.2439 Fax: 503.598.1960 . ' . Other Permit: 5(/V, --i,, r
Date/B r 1
1 IG ARD Inspection Line: 503.639.4175 w x `` Date Ready/By. ® See Page 2 for
Internet: www.tigard or.gov ,\\"\ Notified/Method: M Supplemental Information
TYPE OF WORK gkr''' ` . , PLAN REVIEW,
Please check all that apply(submit 2 sets of plans w/items checked below):
❑New construction ❑Addition/alteratlon/replaCe[tltitll
❑Demolition Other: (( k7 0 Service or feeder 400 amps or more 0 Building over three stories.
where the available fault current 0 Marinas and boatyards.
CATEGORY OF c T'R 'k.1 �, ,: exceeds 10,000 amps at 150 volts or 0 Floating buildings.
1-and 2-familyless to ground,or exceeds 14,000 0 Commercial-use agricultural
El dwelling Commercial/industrial 0 Accessory building amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
SITE LOCATION ❑Emergency system. larger separately derived system.
JOB 0 Addition of new motor load of 0
Job no.: Job site address: ` i u ( P u w 100HP or more. occupancy.
1 q ` 5�'` ` , c i - 1 c " 0 Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: "44 Acket 1.1 6 0 e.. 91 22.6 ❑Health-care facilities. 0 Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: '"3_f 5--r Kl 0 s 0 Service or feeder 600 amps or more.
Cross street/directions to job site: q c't k A-(A(( -, r. Description I E I Qty.. I E ;
� 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
Tax map/parcel no.: Ea.add'1500 sq.ft.or portion 33.92 1
Limited energy,residential 75.00 2
Bj011I (j '. (with above sq.ft.)
Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
Renewable-Energy 0 See Page 2
Services or feeders installation,alteration,and/or relocation
j PROPERTY-owN a I1 TENANT.% 200 amps or less 100.70 2
Name: I VL A L- .S 104 t 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Address: 1( r q4 j 5 t•-ti 04-4....1 A L, i-1(—fir" 41 to? 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP: b / c R Gt- .2 2 -. Temporary services or feeders installation,alteration,and/or
Phone:(505) ate-clq 55 I Fax:( ) relocation
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 exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits—new,alteration,or extension,per panel
0 APPLICANT ,0 CONTACT..tatsON' A.Fee for branch circuits with
above service or feeder fee, 7.42 2
Business name: BE.AvEartAS ik 5 46 1-m, u%e, each branch circuit
B.Fee for branch circuits without
anitald name. i -' v yvs jr-,--N sewli,c or leedet lee,lust
56.18 2
branch circuit
Address: .3 g 7'' 5 .4-(IAF 11 6 L%0 Each add'l branch circuit 7.42 2
City/State/ZIP: Di—y ifj/1 e)IL 1-1 0 G 5 Miscellaneous(service or feeder not included)
Each manufactured or modular
67.84 2
Phone:
(5b3) CO 2 Z"7o 3 Fax:
I ( ) dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail: M IV t. t 0 L At. L.f1 rem 5t e #1 S r CO i'vr Pump or irrigation circle 67.84 2
` ;CONTRACTOR Sign or outline lighting i 67.84 Z,ri 2
Business name: �Nj-
' -(„,(2rtj'I f iu j 0124-6. Signal circuit(s)or limited-energy See
I, panel,alteration,or extension. Page 2 2
Address: 8 9?2.. u 00&'(L W At- ti j Each additional inspection over allowable in any of the abovAde
City/State/ZIP: L t i 6 a [ 7 30 5 Investigation
g inspection O hr min) 66.25/hr
Investigation(1 hr min) 66.25/hr
Phone:(501 ) 4 g(- •7 Li'3 I Fax:( ) Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: ICH(S S Electrical Lic.: $ - 'ib I Suprv.Lic.: c1:5_ 2.c? specifically listed('A hr min) 90.001 hr
Suprv.Electrician signature,requiredr' �/, ELECTRICAL PERMIT'.FTS
i f�► ��� Subtotal: "4;,-7 `g"il
Print name:9gt, pvl.0rj DDate: '3•-?? (7 Plan review(25%of permit fee):State surcharge(12%of permit fee): )�r-/4-/Authorized signature:
p h% TOTAL PERMIT FEE: ie.7 5-,,ted
' This permit application expires if a permit is not obtained within 180
Print name: ��>� l(,T� Date:`�j ! days after it has been accepted as complete.