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Permit (53) CITY OF TIGARD ELECTRICAL PERMIT a' COMMUNITY DEVELOPMENT Permit#: ELC2018-00422 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/02/2018 T r c;;t! Dg Parcel: 1 S136CD00100 Jurisdiction: Tigard Site address: 11705 SW PACIFIC HWY X Project: Aywa! Subdivision: None Lot: None Project Description: Sign lighting for(1)new 81 sq.ft.wall sign. Contractor: ELECTRIC AVENUE SIGN&LIGHTING Owner: PACIFIC CROSSROADS PROPERTIES IN 16005 NE 12TH ST BY WYSE INVESTMENT SERVICES CO VANCOUVER,WA 98684 810 SE BELMONT ST#100 PORTLAND, OR 97214 PHONE: 360-903-5447 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Sign or Outline Lighting 08/02/2018 $67.84 Specifics: 1 ea 12%State Surcharge- 08/02/2018 $8.14 Electrical Type of Use: Class of Work: Type of Const: Occupancy Grp: Total $75.98 Required Items and Reports(Conditions) I This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all of -r appli !ble law. All w. will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if kis susp ded for .= - the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. I. rule re 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.;,i.I.1 .4 Issued By: dry- Permittee Signature: lii.L_�f 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. 4 - Electrical Permit Application FOR O11.l( E i SE ON LI City of Tigard E ` � i� Permit No.: is r 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ' ' g Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Other Permit . I `of i, --/ . tf I(,A R n Inspection Line: 503.639.4175 JuN 2 , 1'4 pgady/By: H See Page 2 for Internet: www.tigard-or.gov Rill/Method: PM Supplemental Information TYPE OF WORK un OF TIGARDPLAN REVIEW. . ❑New construction 0 AdditlOn/alteration/repl t 1 Please check all that apply(submit 2 sets of plans w/items checked below): G DIVISION 0 Service or feeder 400 amps or more 0 Building over three stories, p Demolition I Other: S L SCJ Rook-0 where the available fault current 0 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 ❑ 1-and 2-family dwelling 0 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 JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system. ❑Addition of new motor load of ❑"A","E","1-2","1-3", Job no.: Job site address: j I'7d 5 - PSC j 47, N.� Six or or more. occupancy. ©� (� ❑Six or more residential units. 0 Recreational vehicle parks. City/State/ZIP: '' 7 i-D f I ?zz3 ❑Health-care facilities. 0 Supply voltage for more than 1/ 0 Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: Project name: /4)"/V4 ( 0 Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: 2/) 16. / 9. Description i Qty. I 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 Ea.add'l 500 sq.ft.or portion 33.92 1 Tax map/parcel no.: Limited energy,residential 75.00 2 DESCRIPTION OF WORK (with above sq.ft.) Limited energy,multi-family 5/6 �C� i---_ residential(with above sq.ft.) 75.00 2 Renewable Energy 0 See Page 2 Services or feeders installation,alteration,and/or relocation 7iPROPERTY OWNER 0 TENANT 200 amps or less 100.70 2 ' �)/ E1� / 201 amps to 400 amps 133.56 2 Name: V 6 4' L 5- 7-A-7-6-- /Aiirw� Aiwa f 401 amps to 600 amps 200.34 2 Address: Qr [ i �, ttt�s,�„'/1 / 601 amps to 1,000 amps 301.04 2 Aro Q Over 1,000 amps or volts 552.26 2 City/State/ZIP: pD) CW T-2 219. Temporary services or feeders installation,alteration,and/or Phone:O3) drag``/'/q, r / 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 'APPLICANT 0 CONTACT PERSON A.Fee for branch circuits with / above service or feeder fee, 7.42 2 Business name: ig .5/60 5 each branch circuit B.Fee for branch circuits without /y. Contact name: service or feeder fee,first ®���€ �Ufi�1�� branch circuit 56.18 2 Address: `6 hq// A Each add'l branch circuit 7.42 2 City/State/ZIP: Miscellaneous(service or feeder not included) ty �� QX 'j6O5 Each manufactured or modular 67.84 2 Phone:50 )&72.)&772' 903.7 Fax::( ) dwelling,service and/or feeder Reconnect only 67.84 2 E-mail: o- 6,exg., Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 1 67.84 2 Business name: / `" e-,..5Y4.0 Signal circuit(s)or limited-energy See panel,alteration,or extension. Page 2 2 Address: /G ZO5 VE /2.tr 57 Each additional inspection over allowable in any of the above City/State/ZIP: C � } e 4 ''/' 9�b� Additional inspection( hr min) 66.25/hr Investigation(1 hr min)) 66.25/hr Phone:c /')93 —5-4,z7.7 Fax:( ) Industrial plant(1 hr min) 78.18/hr • Inspections for which no fee is 90.00/hr CCB Lic.:/1j73, E�lj/ Electrical Lic.:g,— ii/ Suprv.Lic.: •2'5 specifically listed(%2 hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: ....0.,,,...00 Print name:/o/�Ch� A / 27 Date: OA/4 Plan review(25%of permit fee): State surcharge(12%of permit fee): Authorized signature* .�� TOTAL PERMIT FEE: Print name: ely/ ,`ts),� t !l Date p This permit application expires if a permit is not obtained within 180 F � � days after it has been accepted as complete. Number of inspections allowed per pemnit. I:\Building\Pennits\ELC_PerniltApp ELR_ERE,doc Rev 05/21/2013 440-4615T(11/05/COM/WEB Electrical Permit Application-City of Tigard Page 2-Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Fee for all residential systems combined $75.00 Description I Qty. I Fee 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 0 Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 ❑ Burglar Alarm Wind generation systems in excess of 25 kva: 25.01 to 50 kva 301.04 2 n Garage Door Opener* 50.01 to 100 kva 552.26 2 >100 kva(fee in accordance with 552.26 2 Heating,Ventilation and Air Conditioning OAR 918-309-0040) System* Solar generation systems in excess of 25 kva: Each additional kva over 25 7.42 3 n Vacuum Systems* >100 kva-no additional charge 0.0 3 Each additional inspection over allowable in any of the above: E Other: Each additional inspection is 66.25/hr charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(%hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system $75.00 Subtotal: (SEE OAR 918-309-0000) Plan review,if required(25%of permit fee): State surcharge(12%of permit fee): Check Type of Work Involved: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 nAudio and Stereo Systems days after it has been accepted as complete. * Number of inspections allowed per permit. ❑ Boiler Controls n C• lock Systems ❑ Data Telecommunication Installation ❑ F• ire Alarm Installation • HVAC E Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical f l Nurse Calls r O• utdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Pemits\ELC_PermitApp ELR_ERE.doc Rev 05/21/2013