Permit (2) CITY OF TIGARD ELECTRICAL PERMIT
1111
COMMUNITY DEVELOPMENT Permit#: ELC2019-00705
T I c,A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/28/2019
Parcel: 2S115BA02600
Jurisdiction: Tigard
Site address: 16230 SW PACIFIC HWY 140
Project: HomeStreet Bank Subdivision: 2004-015 PARTITION PLAT Lot: 2
Project Description: Sign lighting for(2)new signs.
Contractor: TUBE ART SIGNS&SPORTS DISPLAYS Owner: SN PROPERTIES PARTNERSHIP
4243-A SE INTERNATIONAL WAY 1121 SW SALMON ST
MILWAUKIE, OR 97222 PORTLAND, OR 97205
PHONE: 503-653-1133 PHONE:
FAX: 503-659-9191
FEES
Quantity Description Date Amount
2 ea Sign or Outline Lighting 10/28/2019 $135.68
Specifics:
1 ea 12%State Surcharge- 10/28/2019 $16.28
Electrical
Type of Use: COM
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 -xpire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law r-• ires you . follow t'a rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-00 .s i90. •u may,'stain a .py of, e rules or direct questions to OUNC by calling 0 .23 .1987 or 1.8 .332.2
Issued By: / /I/r 4 Permittee Signature: fl /
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 R .,_I ' FOR OFFICE USE ONLY
City of Tigard OCT 1 2019 Date/BReceive� I{%Y/ro„ •/)' # U_ ,
'4 13125 SW Hall Blvd.,Tigard,OR 97223rririff
Plan Review ,�
Phone: 503.718.2439 Fax: 503.598.1960 CI('�'C)S= ! AR Date/B : 111
`�i� �i��
Inspection Line: 503.639.4175 BUILDING DIVI31 Ready Date/By: See Page 2 for
TIGARD Internet: www.tigard-or.gov Notified/Method: �� ®Supplemental Information
TYPE OF WORK PLAN REVIEW
E New construction ❑Addition/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 ®Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑ Multi-family ❑Master builder ❑ Other: 0 Fire pump. 0 installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Addof
Job#: Job site address: 16230 SW Pacific HWY ❑100HP 0HP o or moew motor load of system.
more. ❑"A» "E" "1-2" "1-3"
City/State/ZIP:Tigard,OR 97224 0 Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: 140 Project name:HomeStreet Bank 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:SW Durham Rd FEE SCHEDULE
Description I Qty. j Each I Total
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 WORK Limited energy,residential
Connect Two(2)New Electricals For Signage (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
0 PROPERTY OWNER ® TENANT Services or feeders installation,alteration,and/or relocation _
Name:HomeStreet Bank 200 amps or less 100.70 2
Address: 16230 SW Pacific HWY 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Tigard,OR 97224 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
® APPLICANT ® CONTACT PERSON Branch circuits--new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:Tube Art Group above service or feeder fee,
7.42 2
each branch circuit
Contact name:Haley Arnell B.Fee for branch circuits without '
serAddress:4243-A SE International Waybranchce i feederstfee,first 56.18 2
branch circuit
City/State/ZIP:Milwaukie,OR 97222 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(971)205.7780 Fax: :(503)659.9191 Each manufactured or modular 67.84 2
Email:harnell@tubeart.com dwelling,service and/or feeder
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Tube Art Group Sign or outline lighting 2 67.84 2
Address:4243-A SE International Wa Signal Merurcut(s)or limited-energy
y panel,alteration,or extension. ❑ See Page 2 2
City/State/ZIP:Milwaukie,OR 97222 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)653.1133 Fax:(503)659.9191 Investigation(1 hr min) 90.00/hr
Email:harnell@tubeart.com Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 70956 Electrical Lic.: 37554CLS Suprv.Lic.: 601-SIG specifically listed(/z hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: �, Subtotal:
Print name: David Jaque Date: 10/15/19 0 Plan Review Required(25%of permit fee):
////""""���� State surcharge(12%of permit fee):
Authorized signature TOTAL PERMIT FEE:
— 1 This permit application expires if a permit is not obtained within 180
Print name: Haley Arnell Date: 10/15/19 days after it has been accepted as complete.
* Number of inspections allowed per permit.
C\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(I1/05/COM/WEB
Electrical Pernik 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 QEEachITotn,
Renewable electrical energy systemm s:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
H 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
H Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance 552.26 2
with OAR 918-309-0040)
n H• eating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
n V• acuum Systems* >100 kva-no additional charge 0.0 3
Each additional inspection over allowable in any of the above:_
n Other: Each additional inspection is 66.25/hr 1
charged at an hourly(I hr min)
Inspections for which no fee is 90.00/hr
specifically listed(/2 hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
* Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
n B• oiler Controls
n Clock Systems
H Data Telecommunication Installation
Ti F• ire Alarm Installation
❑ H• VAC
n Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control*
❑ Medical
n Nurse Calls
n O• utdoor Landscape Lighting*
n Protective Signaling
H Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I:\Building\Perniits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015