Permit (31) CITY OF TIGARD ELECTRICAL PERMIT
IN2. . COMMUNITY DEVELOPMENT Permit#: ELC2017 00376
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/08/2017
T ja1 }d° g Parcel: 2S102CC00700
Jurisdiction: Tigard
Site address: 13599 SW PACIFIC HWY
Project: Cola Cove Farms Subdivision: None Lot: None
Project Description: Sign lighting for(1)freestanding sign.
Contractor: E S&A SIGN&AWNING Owner: HORTON, DENNIS M &ELISABETH A
89975 PRAIRIE RD 19220 VIEW DR
EUGENE, OR 97402 WEST LINN, OR 97068
PHONE: 541-485-5546 PHONE:
FAX: 541-485-5813
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 06/08/2017 $67.84
Specifics:
1 ea 12%State Surcharge- 06/08/2017 $8.14
Electrical
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $75.98
Required Items and Reports(Conditions)
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 ma ob=in a co. of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ift cei.c", Permittee Signature: �" � ✓,Y(.� s;1— ..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 ApplicatiQi ECEIVED FOR OFFICE USE ONLY
City of Tigard Received n q 7— 3 7
1111 M 2017 Dateiv Permit#: ELC-c / C3O
13125 SW Hall Blvd.,Tigard,OR 9722MAY 2 2 L / Plan Review
g: Phone: 503.718.2439 Fax: 503.5A.1960 Related Permit#:
Date/B 7-' /5
Inspection Line: 503.639.4175GARD Ready Date/By: Juris: 'BI See Page 2 for
tItsARt1 i�OF r�
m Internet www.tigard-or.gov BUILDING D c n`' Notified/Method: Supplemental Information
Please check all that apply(submit 2 sets ofplans w/items checked).
❑New construction 0 Addition/alteration/replacement
❑Demolition 0'Other: �t 11 ❑Service or feeder 400 amps or more ❑Building over three stories.
where the available fault current 0 Marinas and boatyards.
t, 2'. ® ,> ;aQ, , - 10 y ,y exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑1-and 2-family dwelling Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑Multi-family Master builder ❑Other: amps fora other installations. buildings.
Fire pump! Installation of 150 KVA or
. , - .t � ! a .,mg, /µr Q01l� g ,, -' 0 Emergency system. 0 larger separately derived
Job 4:Zii S 3-3- Job site address: I C/�A co (� v ❑Addition of new motor load of system.
� 1 JT ( S W �'rtC(�JY 100HP or more. 0••A' "E","1-2","1-3",
City/State/ZIP: / 74 a (n O� Q-3--ZZ 3 ❑Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.4: `�Project name: �� 601x, ❑Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal
Cross street/directions to job site:
Description f Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
_ Ea.add'l 500 sq.ft.or portion 33.92 1
s.....:. �-440:014IL�,TI,PN05f ? n' . ...�; , Limited energy,residential
r f +1" (with above sq.ft.) 75.00 2
ftS�l►e� Gvl'7� sly? �w/r! )v( �� Limited ener y
residential(with above sq.ft.) 75.00 2_
y t %altHair
+ a' . '1I J " '"a E:,0,4T Itt, Services oe Eneedregrys installation,a❑raSteieonPaagnd2/o
r relocationName.
200 amps or less 100.70 2
Address: 201 amps to 400 amps 133.56 2
City/State/ZIP: - 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Phone:
( ) Fax:( ) Over 1,000 amps or volts 552.26 2
Email: Temporary services or feeders installation,alteration,and/or
relocation
Owner installation:Thi installation is being ade 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
P wro*:: � (1NTtvA Branch circuits-new,alteration,or extension,per panel
Business name: •� -T-711.4)4A0 ----
A.Fee for branch circuits with
S S -T 4A0� above service or feeder fee,
each branch circuit 7.42 2
Contact name: 2 .4_,,„A_ B.Fee for branch circuits without
Address: R Lq ��ra r<-r service or feeder fee,first
branch circuit 56.18 2
City/State/ZIP: 'are /j1Z , r,,,
Z Each add']branch circuit 7.42 2
Phone: �°' vv LL !! Z� Miscellaneous(service or feeder not included)
(5qj) S Fax::( ) Each manufactured or modular
Email: " e_Qs ed1 e Ca ,, 5 OW' dwelling,service and/or feeder
67.84 2
eS CJ Reconnect only 67.84 2
... 4r ; ai= ..qtr .. 6: ,; Pump or irrigation circle 67.84 2
Business name: kS• ,4- `S( ,1'Aja t a,� Sign or outline lighting I 67.84 6.7.s.4( 2
Address: ? i7rt�rt �// J"`� Signal circuits)orlimited-energy 0 See Page 2 2
L� r I�-e9 panel,alteration,or extension.
City/State/ZIP: [ Each additional inspection over allowable in any of the above
61.E D- qito p
Phone:(54( Additional inspection(1 hr min) 66.25/hr
) .g6 Z� I Fax:( ) ` ap Investigation(1 hr min) 90.00/hr
Email: S^}- O�as C��S �� 31 ll` t0111/I Industrial plant(1 hr min) 78.18/hr
/ ? / Inspections for which no fee is
CCB Lie,: (6 J I Electrical Lic.: -S �GSsupr ic.:�„ f specifically listed(''/z hr mm 90 00/hr
ffi
Suprv.Electrician signature,required. .Ll kE' ....._ -„ �.e;M _biles_.
Subtotal: ��
Print name: 60 e � Date: S fh 0 Plan Review Required(25%of permit fee):
State surcharge(12%ofpe3.0i_____
rmit fee): $,1 t(
Authorized sign
ature: TOTAL PERMIT FEE: 2- !1'4?/ 7._ This permit application expires if a permit is not obtained within 180
Print name: 5,1—o�,,L I Date: 5/fhdays after it has been accepted as complete.
J ` ` Number of inspections allowed per pemrit.
I/Builds/Pei mits\ELC_Pe _ELR_ERE.doe Rev 06/17/2015 440-4615T(]l/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited� Energy Permit Fees: Renewable Energy Permit Fees:
RY+SIDEI t „ ' - aro.v rx I M: Aziarcl
Fee for all residential systems combined: $75.00 Description Qty. Each Total
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
IWind generation systems in excess of 25 kva:
Burglar Alarm 25.01 to 50 kva 301.04 2
U Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
Heating, Ventilation and Air Conditioning
System*
Solar generation systems in excess of 25 kva:
Each additional kva over 25 7.42 3
U Vacuum Systems* >100kva-noadditional charge 0.0 3
❑ Each additional inspection over allowable in any of the above:
Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(Ya hr min)
C'OMMERCIA'm ° .. m,1. 'A . l.. a ..mow. .a'
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
(S r E OAR 918-309-0000) * Number of inspections allowed per permit.
Check Type of Work Involved:
Audio and Stereo Systems
Boiler Controls
n Clock Systems
Data Telecommunication Installation
j Fire Alarm Installation
HVAC
Instrumentation
Intercom and Paging Systems
Landscape Irrigation Control*
Li Medical
Nurse Calls
Li Outdoor Landscape Lighting*
❑ Protective Signaling
j Other:
Total number of commercial systems:
*No ;ceases are required. Licenses are required for all
other installations
I:\BuiIJ�.,'.PerInas\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015