Permit (155) CITY OF TIGARD ELECTRICAL PERMIT
IN -e. COMMUNITY DEVELOPMENT Permit#: ELC2019-00548
T I G A u r) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/19/2019
Parcel: 1 S 136DA02400
Jurisdiction: Tigard
Site address: 11123 SW 68TH PKWY
Project: Extra Space Storage Subdivision: WAY LEE Lot: 1
Project Description: Installing(5)sign circuits.
Contractor: VANCOUVER SIGN COMPANY INC Owner: RPC TIGARD 68 LLC
2600 NE ANDRESEN RD#50 2101 CEDAR SPRINGS RD STE 1600
VANCOUVER,WA 98661 DALLAS, TX 75201
PHONE: 360-693-4773 PHONE:
FAX: 360-693-2747
FEES
Quantity Description Date Amount
Specifics: 5 ea Sign or Outline Lighting 08/19/2019 $339.20
1 ea 12%State Surcharge- 08/19/2019 $40.70
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $379.90
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 t i follow the rules adopted by the Oregon Utility Notification Center. Those rules are et forth in OAR
952-001-0010 through OAR 01-0090. You ma o ain a copy of e rules or direct questions to OUNC by calling 503.232.1987 or 1.800.33 .23.
- gnatu- ....,, f
Issue-day: /f Permittee Signature:
r o
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.
1
Electrical Permit Application '. FOR OFFICE ESE ONLY
pli City of Tigard I�� i Received
a 13125 SW Hall Blvd.,Tigard,OR 97223 '� Plan R : �� � Py� — 4I Plan Review
Phone: 503.718.2439 Fax: 503.598.1.960 Date/B : Related Permit#:
T I G ARD Inspection Line: 503.639.4175 F_. Ready Date/By: funs: ® See Page 2 for
Internet www.tigard-or.gov Notified/Method: Supplemental Information
❑New construction ®Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 Demolition 0 Other: ❑Service or feeder 400 amps or more ❑Building over three stories.
where the available fault current ❑Marinas and boat ards.
a/�r.:�adi�ii� .meq iia a�azaa y
� 1:' "" � " exceeds 10,000 am sat 150 volts or g g
r �,/�iri iaw.d� iii p ❑Floatfn buildin s.
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder D Other: 0 Fire pump. 0 Installation of 150 KVA or
t >" ❑Emergency system. larger separately derived
Job#: Job site address: 11123 SW 68th Pkwy ❑Addition of new motor load of system.
IOOHP or more. ❑"A","E","1-2","1-3",
City/State/ZIP:Tigard OR 97223 ❑Six or more residential units. occupancy.
0 Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: I Project name:Extra Space Storage ❑Hazardous locations. El Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site:
Description Qty. Each Total *
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
Tax map/parcel#: 1S136DA02400 1,00o sq.ft.or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 1
i% yf .;., Limited energy,residential
Install(5)sign circuits. (with above sq.ft.)
75.00 2
Limited energy,multi-family
75.00 2
residential(with above sq.ft.)
t '�� Renewable Ener
f sst ' a v a yr gY ❑ See Page 2
` "� {r�'a, .A,%��� �' . "� " . . Services or feeders installation,alteration,and/or relocation
Name:Extra Space Storage 200 amps or less 100.70 2
Address: 11123 SW 68th Pkwy 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Tigard OR 97223 601 amps to 1,000 amps 301.04 2
Phone:(360)6934773 I Fax:(360)6932747 Over 1,000 amps or volts 552.26 2
Email: Temporary services or feeders installation,alteration,and/or
relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 1 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
l f x -" ' 4 „ Branch circuits new,alterationor extensioner anel
� , r A.Fee for branch circuit:with , ,pp
Business name:Vancouver Sign Group above service or feeder fee,
each branch circuit
7.42 2
Contact name:Chris Brown B.Fee for branch circuits without
Address:2600 NE Andresen Rd Ste 50 service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP:Vancouver,WA 98661 Each add'l branch circuit 7.42 2
Phone:(360)693-4773 I Fax: : 360 693-2747 Miscellaneous(service or feeder not included)
( ) Each manufactured or modular 67.84 2
Email:Cbrown@vansignco.com dwelling,service and/or feeder
Reconnect only 67.84 2
o�" �� 1 Pump or irrigation circle 67.84 2 _
Bttaluwa-name':Vancouver �Cr _. r or 3.7/.2.D�2._
Sign or outline lighting 5 67.84
Address:2600 NE Andresen Rd Ste 50 Signal circuits)orlimited-energy
panel,alteration,or extension. ❑ See Page 2 2
City/State/ZIP:Vancouver,WA 98661 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(360)693-4773 I Fax:(360)693-2747 Investigation(1 hr mi ) 90.00/hr
Email:Cbrown@vansignco.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: 63951 I Electrical Lic.: 37-46CLS Suprv.Lic.: 648SIG s.ecificall listed(1 hr min) 90.00/hr
Suprv.Electrician signature,required: A 4 -' `� 2.0Subtotal:
Print name: Adam Wallis 4--
Date ��3 ii9 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): Z 5 7D
�`��G v
Authorized signature: TOTAL PERMIT FEE: 3-7,41
d
Ag)—(4 This permit application expires if a permit is not obtained within 180
Print name: s i 11,-(4( Dater k3 j/9 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:ABuilding\PermitsAELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(1 l/05/COM/WEB