Permit (107) CITY OF TIGARD ELECTRICAL PERMIT
111,1,
p'y COMMUNITY DEVELOPMENT Permit#: ELC2017-00866
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/20/2017
T[C : g Parcel: 25101 DA00104
Jurisdiction: Tigard
Site address: 13333 SW 68TH PKWY
Project: Conduent Subdivision: VARNS ACRES Lot: 9
Project Description: Sign lighting for a new 55 sq.ft.wall sign.
Contractor: MEYER SIGN CO OF OREGON Owner: TRIANGLE POINTE TWO LLC
15205 SW 74TH AVE 901 NE GLISAN ST, STE 100
TIGARD, OR 97224 PORTLAND, OR 97232
PHONE: 503-620-8200 PHONE:
FAX: 503-620-7074
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 11/20/2017 $67.84
Specifics:
1 ea 12%State Surcharge- 11/20/2017 $8.14
Electrical
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $75.98
Required Items and Reports(Conditions)
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 iss ce, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the - -••• -• lthe Oregon Utility Notifi - '•n Ce-ter. Those rules are set forth in OAR
952-001-0010 through 0 952-001-0090. You may obtainacop of the rules or direct questions to OUNC by calling :03.232. •87/r 1.800.3 .2344.y10)) , c
4.
Issued By: ✓ Permittee Signature: Iii _ .
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 RECEIVE FOR OFFICE USE Oyl.I
City g of TI aPCl Received
Date/BLe.n.Mbifi/VIIMOIMPAMIll
111 111 13125
✓SW Hall Blvd.,Tigard,OR 97223 Plan Review
N O V y
Phone: 503.718.2439 Fax: 503.598.1960 2 ® 2017 Date/B : Related Permit# t9
: V A i 7 -g -.101
inspection Line: 503.639.4175 Ready Date/By: Iuris: RI See Page 2 for
f t GA RD Inteniet: www.tigard-or.gov CITY OF TIG.AR t; otified/Method: Supplemental Information
T!'PE.QT ' CITY
• P 1 - . E
❑ ' at �� Please check all that apply p . plans ) '
New construction AddltlOn/alteratl ep acemellt (submit 2 sets of lens vv nems checked
❑ Demolition ❑Other: ❑Service or feeder 400 amps or more ❑Building over three stories.
where the available fault current ❑Marinas and boatyards.
-j cA ' F,CONST .—Wf Q1 . j exceeds 10,000 amps at 150 volts or 0 Floating buildings.
1-and 2-familydwelling Commercial/industrial less tv ground,or exceeds 14,000 ❑Conmiercial-use agricultural
❑ g ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑ Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
{B .r IN V*100 N AND f.00A I 0 Emergency system. larger separately derived
Job#: 1 Job site address:/3333 c d 8 Y^ ,iE. 0
AdI OOdition of new motor load of ❑ `A sys"tem.
HP or more. ,"G","1-2-,"1-3",
❑Six or more residential units. occupancy.
City/State/ZIP: 1- / Ok. 9 7�/q ❑Recreational vehicle arks.
❑Health-care facilities. P
Suite/bldg./apt.#: 1 Project name: ��
&1 O(/t&J r" ❑Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site:
SEE$:011.1l7rl<7�.C,
Description I Qty. I Each f Total s 1
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#:
dd'1500 ft 33 92
Ea.a sq. .or portion 1
t f' . _ ) .f pO-N7 iO' WO /f n': ""' Limited energy,residential
/Ails,
,774:1_4_,
� { 5C-T �/ /N �1-..4/A-/iy / ivitt J d1`/t% f (with above sq.ft.) 75.00 2
/ Limited energy,multi-family 75.00 2
f/4-1)A.tet-- L -Tz-yu 116 e tin' '�Z'mjj .SItl ,c��1 iidential(with above sq.ft.)
Rene
able Energy ❑ See Page 2
erg-- 0W* -,'::: :"::1: ''''''-';:':,4'571';',43': ;-,,` ' 0-TENA _' Services or feeders installation,alteration,and/or relocation
Name: -" /� 6 L 0;#JT '��'o ,e, 200 amps or less 100.70 2
Address: ! 4 e/ dhlid,s (r 1N I 'O 201 amps to 400 amps 133.56 2
x 401 amps to 600 amps 200.34 2
City/State/ZIP: f�IVIJh UI., 174)02. 601 amps to 1,000 amps 301.04 2
Phone:( ) I 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
Branch circuits-new,alteration,or extension,per panel
Business name: A.Fee for branch circuits with
f /' above service or feeder fee,
7.42 2
each branch circuit
B.Fee for branch circuits without
service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP: J GikAf) pt 1 zd.,) Each add'1 branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(i7
/ )45 2 — 5-0 ,/ Fax: :( ) Each manufactured or modular 67.84 2
Email: e m./-(f ,f/6hJ ea/U connec o e and or feeder
VV - / � r ly 67 84 2
��, -,,; �� � Re ng t
n
w- - ... Aim �. ,. „?; Pump or irrigation circle 67.84 2
Business name: Altatk 060 Ce. iii /`'`eQ� Sign or outline lighting i 67.84 /',7,... f 2
g !4 r Signal circuit(s)or limited-energy Y
Address: / S {ls panel,alteration,or extension.
0 See Page 2 2
City/State/ZIP: --/-7-6,/ b Dt_ 97;,2. Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(p7/ ) 232, , / Fax:( ) Investigation(1 hr min) 90.00/hr
Email: 6 ,t-j j, j e.D /t� jo il�rl tt Industrial plant(I hr min) 78.18/hr
/06,u,-1-5 0`�' Inspections fat which no fee is
st '/z hr min) 90.00/hr
CCB Lic.: 41p,/�i Electrical Lic.: X),-- I 70[�L� �
uprv.Lic.: �f j/6 specificall lied Y �
/ ll EE '`
Suprv.Electrician signature,required:
Subtotal: e.67.1ii
Print name: 0 6 Date: u6/i Vj 7 ❑Plan Review Required(25%of permit fee):YState surcharge(12%ofpennit fee): 7-/"1
Authorized signet re: li/ TOTAL PERMIT FEE: 75`sf
This permit application expires if a permit is not obtained within 180
Print name: i k y ItAi t Date: 16/ -7 days after it has been accepted as complete.
✓/ * Number of inspections allowed per permit.
1.ABuilding,Permits\ELC_PermitApp_ELR_ERE.doc Res 06/17/2015 440-4615T(11/05/COM/WEB
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13333 SW 68TH PKWY, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical ELC2017-00866
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor