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Permit (33) CITY OF TIGARD ELECTRICAL PERMIT 1111 YI COMMUNITY DEVELOPMENT Permit#: ELC2019-00187 T I t_.;.1 R[7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/28/2019 Parcel: 2S113AD01700 Jurisdiction: Tigard Site address: 16850 SW 72ND AVE Project: Bridal Exclusives Subdivision: ROSEWOOD ACRE TRACTS Lot: 26-34,P Project Description: Sign lighting for(2)wall signs. Contractor: E S&A SIGN&AWNING Owner: BRIDGEPORT LAND LLC 89975 PRAIRIE RD 3939 NW ST HELENS RD EUGENE, OR 97402 PORTLAND, OR 97210 PHONE: 541-485-5546 PHONE: FAX: 541-485-5813 FEES Quantity Description Date Amount 2 ea Sign or Outline Lighting 03/28/2019 $135.68 Specifics: 1 ea 12%State Surcharge- 03/28/2019 $16.28 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $151.96 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 OA 52-00 90. may obtai a copy of e rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: /00 Permittee Signature: cjf/i/eGj75 / V 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 1:012 OVER L t 1/4I 0y 1 l Ci ho Ti andECEIVED Received 3 dfiall1 Permit uEZ Gr l "._r f !43' Date/6 : ; • 13125 SW Hall Blvd.,Tigard,OR 9ii Plan Review i Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit 70/9•--iOO�,7 Inspection Line: 503.639.4175 MAR 18 2019 Ready Date/By: Anis: See Page 2 for 'IGAt:n Internet: www.tigard-or.gov p±gty Not iled/Method: Supplemental Information TYPE OF %1 )kkY Of- i'1GARDD PLAN REVIEW ❑New construction 0 AddltlOn/al p I N�efTE VIS I0.,7 N) Please check all that apply(submit 2 sets of plans wtitems checked): ❑Demolition "Other: 'S+ 0 Service or feeder 400 amps or more 0 Building over three stories. where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION 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 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family 0 Master builder 0 Other: ❑Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived Job#: Job site address: 0 Addition of new motor load of system. '( 0 p 50 SJ ")]N4� Av4. I00HP or more. ❑ A E„ l_2 1.3 'r wn� ` ❑Six or more residential units. occupancy. City/State/ZIP: i k.i7Ic4J v' 1-7.1.1y1 J S`J � ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: C d ❑Hazardous locations. 0 Supply voltage for more than +�� „ 1- Qsc 0 Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE 5; \ '\ Description I Qty. I Each I Total I • l 3 (-�Jr 1,1cr....'N New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.A.or less 168.54 4 Tax map/parcel#: Ea.add'I 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 4 75.00 2 C1��A (2) fiA10 1 S,.,y L� (with above sq. lti `W `� 7�+ Limited energy,multi-family 75.00 2 .5.A-2, nci 42-ier a residential(with above sq.ft.) Renewable Energy 0 See Page 2 0 PROPERTY TYNER igt TENANT Services or feeders installation,alteration,and/or relocation Name: Br d 1 x:e1 Js V S 200 amps or less 100.70 2 Address ti L� i� 1 amps to 400 amps 133.56 2 �J Ave_f-1401 amps to 600 amps 200.34 2 City/State/ZIP: /Raid 0 f sr? .22y 601 amps to 1,000 amps 301.04 2 Phone:( ) 7 Fax:( ) Over 1,000 amps or volts 552.26 2 Email: Temporary services or feeders installation,alteration,and/or relocation Owner installation:This instal . '•- ' .-Ing made on property that I own which is not 200 amps or less 59.36 1 intended for sal' _. ,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 O. signature: Date: 401 amps to 599 amps 168.54 2 APPLICANT ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel •n • A.Fee for branch circuits with Business name: C S PY c CD/ above service or feeder fee, 7.42 2 CD/ each branch circuit Contact name: Marc: B.Fee for branch circuits without i3197,5" V t ` service or feeder fee,first 56.18 2 Address: [ RCJ ro r branch circuit City/State/ZIP: /y Each add'I branch circuit 7.42 2 ty �>J��� D R ����� Miscellaneous(service or feeder not included) Phone:(G 1) (0(42‘4. (0222_ Fax::(rjC(g) 4.1g5 5e'8-13 Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: 1�1A,retita e i„1iar2 + 9n S, coin Reconnect only 67.84 2 RCONTRA(x'OR Pump or irrigation circle 67.84 Business name: g S A 6 i'[;i /?,'i r- Sign or outline lighting ,2 67.84 j)j 2 / �•v Signal circuit(s)or limited-energy ID See Page 2 2 Address: 84:19 75 Pro it i e panel,alteration,or extension. City/State/ZIP: ©n r��it0 2 Each additional inspection over allowable in any of the above �) �� 1� Additional inspection(I hr min) 66.25/hr Phone:( ) 5 5,514 4.eFax:(5L O Lilts -58-/3 Investigation(I hr min) 90.00/hr Industrial plant(I hr min) 78.18/hr Email: 3/ft vci C.— b 1 awe s i cj As• Inspections for which no fee is 90.00!hr CCB Lic.: jt' N 10 Electrical Lic.:c2,__5�3 _ _..rv.Lic.: Si Li sit,(� specifically listed(%hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: / • r , I Subtotal: /3S,bg Print name: 60,,`A ..7--- c,‘ rO Date: 3 (Lt 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): .. j Authorized signature: A ., A.e TOTAL PERMIT FEE:? 151 e ���p This permit application expires if a permit is not obtained within 180 Print name: M Cit 'a I 11e. ;-� Date: 3 I i 41 Ci 9 days after it has been accepted as complete. 11YYhh���---iii ( • Number of inspections allowed per permit. L`•Buitdtng=Permits'-ELC PormitApp_ELR_ERE.doc Rev 00'17 20d 440-4615TI 11:05'COM'WEB City of Tigard Tel: 503.718.2439 Location: Inspection Date: 16850 SW 72ND AVE, TIGARD, OR, 97224 Record Type: Record ID: Commercial - Electrical ELC2019-00187 Inspection Type: Inspector: 199 Electrical final Jeff Grove Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor