Permit (285) 71CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Permit#: 6/13/2 7-00352
k E 0" Date Issued: 06/13/2017
Parcel: 2S115BA02500
Site address: 16200 SW PACIFIC HWY W1 Jurisdiction: Tigard
Project: Dirty Dog Day Spa
Project Description: Sign lighting for(1)new wall-mounted sign for dogSubdivision: 2004-015 PARTITION PLAT
9 grooming business Lot: 1
Contractor: MEYER SIGN CO OF OREGON
15205 SW 74TH AVE Owner: SN PROPERTIES PARTNERSHIP
TIGARD, OR 97224 1121 SW SALMON ST
PORTLAND, OR 97205
PHONE: 503-620-8200 PHONE
FAX: 503-620-7074
Quantity Description Date
Amount
Specifics: 1 ea Sign or Outline Lighting 06/13/2017
1 ea 12%State Surcharge- $67.848
g 06/13/2017 $8.14
Type of Use: COM Electrical
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 is -nce, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notifi ion Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. Y in a co of the rules or direct questions to OUNC by calling 03.. 2 987 or 1. 0.332.2344. L'
Issued By: r= �
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 Appli ENE FOR OFFICE LSF:ONLY
City of Tigard �,•�V,/ Received _� �4 CZC+ � /7-00 115,
III Date/B Gj Permit#: G /r/ J✓
a 13125 SW Hall Blvd.,Tigard,OR i]� 1 6 2017 Plan Review
Phone: 503.718.2439 Fax: 503.59960 Date/B : Related Permit#:
Inspection Line: 503.639.4175 l i l ��'TIGtARD Ready Date/By: Jwn: RI See Page 2 for
T I G A RD, G D1VLS�QN Notified/Method: Supplemental information
Internet: www.tigard or.gov �j 1.I
TYP> �tlC(3RK PLAN REVIEW
❑New construction �Add lti011/alterahOn/l'eplaCement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or 0 Floating buildings
less to ground.or exceeds 14.000 0 Commercial use agricultural
❑ l-and 2-family dwelling [Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑ Multi-family ❑Master builder ❑Other: ❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATWN IDEmergency system. larger separately derived
� p /�
0 Addition of new motor load of system.
Job#: Job site address: i�Ld O 14, e.411 e lr 100HP or more. ❑ A" `E 1-2" °°1-s'
Y occupancy.
City/State/ZIP: (j� t �� 172.24 ❑Six or more facilities. units.
y ❑Health-care facilities.
0 Recreational vehicle parks.
❑Hazardous locations. ❑Supply voltage for more than
Suite/bldg./apt.#: Project name: /)/Ary / si / ) ��1� 600 volts nominal.
- - / � �� '�'/ ❑Service or feeder 600 amps or more.
Cross street/directions to job site: FEE SCHEDULE ''
Description I Qty. I Each I Total I
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'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy.residential 75.00 2
el :i:i- 1 1 LI A_i l y {1 /I'A,t i Nt`M0 J&r of .�l/Itif„..4ut.,_, (with above sq.ft.)
N� Limited energy,multi-family 75.00 2
i . 4 P A049 1461)) rb fiUfn,06 ,bl e (A-4_ residential(with above sq.ft.)
'G�"'� Renewable Energy ❑ See Page 2
�tePROPERTYOWNER 0 TE�NA,NT Services or feeders installation,alteration,and/or relocation
Nameei,p(,�f 5 air,us /lie i ,e((..yi ZrO200 amps or less 100.70 2
Address 1 / /�� ��^/ 201 amps to 400 amps 133.56 2
�r yea L�t1 �(�/�bs � tt401 amps to 600 amps 200.34 2
/�
City/State/ZIP: 0,04 h/it_s ell- gz 5 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
Owner signature: Date: 401 amps to 599 amps 168.54 2
Branch circuits-new,alteration,or extension,per panel
['APPLICANT + q CONTACT PERSON A.Fee for branch circuits with
Business name: 1 r�J a' 3f 6AJ 0,. i/ I d above service or feeder fee,
7.42 2
,, '7 each branch circuit
Contact name: -"�;:u `(iG' I( ,, B.Fee for branch circuits without
/.5-2.,6
� /4/414
branche it feeder fee,first 56.18 2
Address: qE. branch circuit
City/State/ZiP: 76,4A.6 ik 97114-1
Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone: (M ) VZ,.' Fax: :( ) Each manufactured or modular 67.84 2
Email: /Coe/y1.1.7-f e A4j 6/-.516� . �d dwelling,service and/or feederReconnect only 67.84 2
CONTRACTORPump or irrigation circle 67.84 2
,, lL ,--
Business name: J J 6, ii / /Q kj Sign or outline lighting i 67.84 2
j5�5 Signal alteration,
or eionergy ❑ See Page 2 2
Address: -7444 _ panel,alteration,or extension.
y Each additional inspection over allowable in any of the above
City/State/ZIP: rGR �� /1r� Additional inspection(1 hr min) 66.25/hr
Phone:(17/ ) 2,34.- 50�I Fax: ( ) Investigation(1 hr min) 90.00/hr
" p �J /f/ htdustrial plant(1 hr min) 78.18/hr
Email: f�6L�� / J� �'JV (� •M Inspections for which no fee is
/ specifically listed('/z hr min) 90.00/hr
CCB Lie.: /4t /4 Electrical Lic.:2:-44 &5 Suprv.Lie.: 61(7 j16
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: i� ► Subtotal: --6 7. 01
� � 0 Plan Review Required(25%of permit fee): '—'--
Print name: ate: .57/5A. 1
d O(� / /� State surcharge(12%of permit fee): 5' t{
/ 27 e TOTAL PERMIT FEE: -Ts.
Authorized signature: !� / , !
This permit application expires if a permit is not obtained within 180
Print name: f)di e�jc•� I Date: ���`�l days after it has been accepted as complete.
', Number of inspections allowed per permit.
1:03uildingVPer0i6.0,I,C_PcrmitApp_I t R_1:12F.doc Ecu 06/1.7/2015 440-46 15T(1.1/05/COM/wtil3
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16200 SW PACIFIC HWY W1 , TIGARD, OR,
97224
Record Type: Record ID:
Commercial - Electrical ELC2017-00352
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor