Permit (49) CITY OF TIGARD ELECTRICAL PERMIT
!. COMMUNITY DEVELOPMENT Permit#: ELC2019-00381
Date Issued: 06/06/2019
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S103DC01100
Jurisdiction: Tigard
Site address: 11075 SW GAARDE ST A
Project: Grace Point Community Church Subdivision: None Lot: None
Project Description: Sign lighting for(1)internally illuminated monument sign.
Contractor: MEYER SIGN CO OF OREGON Owner: FIRST BAPTIST CHURCH OF TIGARD
15205 SW 74TH AVE 11075 SW GAARDE
TIGARD, OR 97224 TIGARD, OR 97223
PHONE: 503-620-8200 PHONE:
FAX: 503-620-7074
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 06/06/2019 $67.84
Specifics:
1 ea 12%State Surcharge- 06/06/2019 $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 Cod:_ an. 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 —rice, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notific- on Cent . Those rules areset forth in OAR
952-001-0010 through OAR 952-001-0090. You may o • e rules or direct questions to OUNC by callin• 03.232.1*: or 1.80 .33 e 1
Issued By: tip Permittee Signature: - / . ., -
111
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 FOR OFFICE USE ONLY
City of Tigard 1.,Receiate/Bved: / Cl :fr Penni"' �i`et ` 6 - r
111 q 13125 SW Hall Blvd.,Tigard,OR 97223 aEE�VE t Ian Review
S Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#:
Inspection Line: 503.639.4175 Ready Date/By: ® See Page 2 for
T I G A R O 6 2019 Notified/Method: Supplemental Information
BEM
Internet: www.tigard-or.gov JUN
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Please check all that apply(submit 2 sets of plans w/items checked):
El New construction [t7Addition/alteration/'j� � DIVISION v
El Service or feeder 400 amps or more 0 Building over three stories.
El Demolition ❑Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRICTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
0 1-and 2-family dwelling Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
0 Multi-family 0 Master builder ❑Other: ❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address: //id 75' it) MA-44e if-, 100HP or more. ❑"A","E","1-2","l-s",
Q p J 4 ❑Six or more residential units. occupancy.
City/State/ZIP: /G� ,6/1-- / /L El facilities. ❑Recreational vehicle parks.
T ❑Hlocations. 0 Suvoltage more than
Suite/bldg./apt.#: Project name: A A T ��„
❑Service azardous or feeder 600 amps or more. 600
pply volts nominforal.
Cross street/directions to job site: ' FEE SCHEDULE
Description 1 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']500 sq.ft.or portion 33.92 1
' `ISt2Ri1PTIO$ff' WORK f'-''''''''17-
, `' ` ' , '. Limited energy,residential
{ (with above sq.ft.) 75.00 2
fid/4t-er //h1T� /4-I/ //km /� � /f f 0A-A1/l4.1�"T Limited energy,multi-family
c1 b ( j 15-riot)
�,p 6 .,-E c-77/ !Lf it residential(with above sq.ft.) 75.00 2
LJ !� N "-/ Renewable Energy ElSee Page 2
rii7V.PROPERTY OWNER . s I . -, 0 TENANT, Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Address:
401 amps to 600 amps 200.34 2
City/State/ZIP: 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-c new,alteration,or extension,per panel
( AP*>"CANT ONTrkL PERSON A.Fee for branch circuits with
BuSitteSs name: yJ �jt6� d/�6tr/__) above service or feeder fee,
7.42 2
each branch circuit
Contact name: 6 C6/.J111 61-- B.Fee for branch circuits without
Address: fit f A J. 7f I re � branservche it feeder fee,first 56.18 2
F branch circuit
City/State/ZIP: k/4"/(-/) _ 9 7,?;"--/ Each add'l branch circuit 7.42 2
i. Miscellaneous(service or feeder not included)
Phone:(1 7/) 2.3 . ie / Fax: :( ) Each manufactured or modular 67.84 2
�
+ dwelling,service and/or feeder
Email: �' l C.�AA j i t et). i e - Reconnect only 67.84 2
'---«...a..tet "- ' ' 5-" s- .>..- Pump or irrigation circle 67.84 2
Business name: /Va/f/_, /61J j, / 6A,(7izj Sign or outline lighting i 67.84 67 2
` I! l (� /�)�r' Signal circuit(s)or limited-energy ❑ See Page 2 2
Address: /� • Ifv' . 1 I v/l V; . panel,alteration,or extension.
City/State/ZIP: �� �, 7.�� 1� Each additional inspection over allowable in any of the above
y Additional inspection(1 hr min) 66.25/hr
Phone:(?7/) 7 31 - ✓egx./ Fax:( ) Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email: /J( •{TS e AA E` j 6 t3 66, et
Inspections for which no fee is
90.00/hr
CCB Lic.: 4,iit 1 L-/- Electrica 4,.:26 .-/ 6 4 yuprv.Lic.: S6 (5/6specifically listed('/s hr min)
< '_. .», . :',..:—..''''',r-'77'
Suprv.Electrician si ature,req . ed: jx).40dt I Subtotal: :`7,
�y
lr
Print name:---7 dh 6 g� of ,I Date: ,570 ❑Plan Review Required(25%of permit fee):
17-1/3 State surcharge(12%of permit fee): , /I
Authorized signature: TOTAL PERMIT FEE: 73-,
r ` This permit application expires if a permit is not ohtained within 180
Print name: •✓ /`�C t��/ I Date: L / // days
pe aver la has been a e it..l as. ...r lrh.
d� * Number of inspections allowed per permit.
I:ABuilding\Pelmits\ELC_PermitApp LR_ERE.doc Re'06/17/2015 440-4615T(11/05/COM/WEB
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
11075 SW GAARDE STA, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical ELC2019-00381
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor