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Permit (87) CITY OF TIGARD ELECTRICAL PERMIT • COMMUNITY DEVELOPMENT Permit#: ELC2019-00046 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02!19/2019 T r C.A It.l, 9 Parcel: 2S112DD00800 Jurisdiction: Tigard Site address: 15670 SW UPPER BOONES FERRY RD Project: Chevron Extra Mile Subdivision: None Lot: None Project Description: Sign lighting for(1)wall sign. Contractor: MEYER SIGN CO OF OREGON Owner: ABS HOLDING LLC 15205 SW 74TH AVE 15670 SW UPPER BOONES FERRY RD TIGARD, OR 97224 LAKE OSWEGO, OR 97035 PHONE: 503-620-8200 PHONE: FAX: 503-620-7074 FEES Quantity Description Date Amount 1 ea Sign or Outline Lighting 01/28/2019 $67.84 Specifics: 1 ea 12%State Surcharge- 01/28/2019 $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 rulesleare forth in OAR 952-001-0010 through OAR 92.01-00•• You /-y obtai ��/py of�✓'es or direct questions to OUNC by calling 503.232.1987 or 1 0.333 lr Issued By: �j" / Permittee Signatur 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. y Electrical Permit Application l O R 01,1-1( i. I SI: 0\1.1 City of Tigard rzi..:: , q ! Received �� • 13125 SW Hall Blvd.,Tigard,OR 97223 t i"°' Plan Review C Phone: 503.718.2439 Date/B : Related Permit#: Email: TigardBuildingPermits@Tigard-or gov I' 'Beady Date/By: Juris: ® See Page 2 for I I G A R D Inspection Line: 503.639.4175 Internet: www.tigard-or.gov .tified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW 0 New construction dAddition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): 0 Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ❑ 1-and 2-family dwelling [7"Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived f� U/ t7L /nI N /b6 100Addition of new motor load of system. Job#: Job site address:/f�76 /�'J J� re-kat looHP or more. ❑"A","E","1-2","1-3", City/State/ZIP: �6 0/t- 9 7a) /��. ❑Six or more residential units. R occupancy. / ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: Project name: tkixda m, [,,E 0 Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. 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 WpRK Limited energy,residential ©4)An.cr /rJ rt`/t--,0'A'1 1 y /"/'t m/K1A IA)A- -/ (with above sq.ft.) 75.00 2 Limited energy,multi-family iv �^ residential75.00 2 kJ/6"J / G I�/S j7,�� ft(-,C,T/l./4-IIL - (with above sq.ft.) [PROPERTY O R 0TENANT Renewable Energy 0 See Page 2 /� ( Services or feeders installation,alteration,and/or relocation QW„/ Name: / etmp r.5 Lte 200 amps or less 100.70 2 Address: /� • n t f d� ii0t/e-- � d61/J6.j* AtityA201 amps to 400 amps 133.56 2 1 401 amps to 600 amps 200.34 2 City/State/ZIP: I6 4L, A 6L 91�.)1/ 601 amps to 1,000 amps 301.04 2 Phone:( ) �'�"'� t 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 7 Wi APPLICANT CONTACT PERSON Branch circuits—new,alteration,or extension,per panel �I G it, /iC 0 a ® l A.Fee for branch circuits with Business name: J t d above service or feeder fee, each branch circuit 7'42 2 Contact name: /11 4GfS� / B.Fee for branch circuits without put. / P c service or feeder fee,first Address: 1 5 ft • /[/n'ff branch circuit 56.18 2 City/State/ZIP: /14A-m, 1,7A__ Cf 7t)4 Each add'I branch circuit 7.42 2 yMiscellaneous(service or feeder not included) Phone:(q 1) ) 2j` - 6-4)1 Each manufactured or modular t co. dwelling,service and/or feeder 67.84 2 Email: �t! �I �r/J( . C !f/LA Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: ,yf� t5j b i' 5/1E5(k_i Sign or outline lighting 1 67.84 2 Address: i 5 240 J. ' 1 Signal circuit(s)or limited-energy ❑ See Page 2 2 l .1 ' � panel,alteration,or extension. City/State/ZIP: / ' b �� 7?-0141 �� Each additional inspection over allowable in any of the above f ' Additional inspection(1 hr min) 66.25/hr Phone:(t1, ) 2.."2,- 5-0,1../ Investigation(1 hr min) 90.00/hr Email: pe-AA AT5` (0) iJ i A., ee /L� Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: 6 $o 1 if Electrical Li :t;D-176 . Suprv.Lic.: 9 (1/(j specifically listed('h hr min) P 't /l---/136.,c.„42-Ni fj 6.,c.„2 ELECTRICAL PERMIT FEES Suprv.Electrician si ature, d: /�� Subtotal: Print name: dhD e: 0 Plan Review Required(25%of permit fee): (//./. State surcharge(12%of permit fee): Authorized signa TOTAL PERMIT FEE: eckThis permit application expires if a permit is not obtained within 180 Print name: b to .41 e ,tm/eicDate: ay/0 /y / ? days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC_Perm/App_ELR_ERE.,.c Rev 10/26/2017 40-4615 (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 DescriptionI Qty. I Each I TotalI �' 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 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 kva(fee in accordance 552.26 2 with OAR 918-309-0040) ❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 ❑ Vacuum Systems* >100 kva—no additional 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('A hr min) COMMERCIAL ELECTRICAL PERMIT FEES t' Fee for each commercial system: $75.00 Subtotal(Enter on Page 1). (SEE OAR 918-309-0000) * Number of inspections allowed per permit. Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 10/26/2017