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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2019-00833 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/27/2019 Parcel: 2S112DC00701 Jurisdiction: Tigard Site address: 15965 SW 72ND AVE Project: Fit Alliance Subdivision: FANNO CREEK ACRE TRACTS Lot: 39 Project Description: Hooking up new sign to designated sing circuit. Contractor: SIGNCRAFT SIGNS LLC Owner: PACIFIC REALTY ASSOCIATES 8900 SW BURNHAM, E109 ATTN: N PIVEN TIGARD, OR 97223 15350 SE SEQUOIA PKWY#300 PORTLAND, OR 97224 PHONE: 503-624-7787 PHONE: 503-639-4910 FAX: 503-639-4999 FEES Quantity Description Date Amount 1 ea Sign or Outline Lighting 11/27/2019 $67.84 Specifics: 1 ea 12%State Surcharge- 11/27/2019 $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 ' expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon I uire ou to fo w he rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 9 - -00 c ou may ob n copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: 36-S 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 O11 ICI: t'SI:ON1,1 City of Tigard Receivedae // ? 7 4< a2/7—UC - 4 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review a Phone: 503.718.2439 Fax: 503.598.1960IN Date/By: Related Permit 4: Inspection Line: 503.639.4175 Ready Date/By: Iuris: H See Page 2 for T I GA R D. Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ®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 0 Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or p Floating buildings. ❑ I-and 2-family dwelling ®Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Cormnercial-use agricultural amps for all other installations. buildings. ❑Multi-family 0 Master builder 0 Other: ❑Fire pump. ❑installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived Sob#: lob Site address: ❑Addition of new motor load of system. �.S e i( 5 i,-' --) (ve 100HP or more. ❑"A","E","1-2","1-3", City/State/ZIP: a (j C #'i ❑Six or more residential units. occupancy. 15 t".'r e- 1'A a l 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bld ! t.#: Project name: ❑Hazardous locations. 0 Supply voltage for more than g J 1 t_l_I N ❑Service or feeder 600 amps or mom. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE 72 1")! Description I Qty. C Each I Total 4 C 4rr.,=r. D.- 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#: ,. i ,2 n'1 t - 7 e i Ea.add'1500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 Hookup new sign to designated sign curcuit (with above sq.ft.) Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 iZI PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name: Pea-t Vs,a.,t ASSPt,, 200 amps or less 100.70 2 Address: 201 amps to 400 amps 133.56 2 i.�,3 S-D ej u) �,�. r to v Pc.; $...:re.' 4:x. _2c G 7 401 amps to 600 amps 200.34 2 City/State/ZIP: f©+"�1,,�cz tX`:__ di J of 601 amps to 1,000 amps 301.04 2 Phone:(c,S ) (4,L 4, -12 7 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 El CONTACT PERSON Branch circuits—new,alteration,or extension, r panel A.Fee for branch circuits with Business name: P 1-r ll U-10(t3 t- above service or feeder fee, each branch circuit 7.42 2 Contact name: rr)a,-, (5I5e,'LA.pi_ ,Sip,,) B.Fee for branch circuits without Address: L' c" % service or feeder fee,first 56.18 2 �Z !4 1 > 1.-, 7 ��, t�• {, branch circuit City/State/ZIP: t s,,r..., L , ei-)a Each add'l branch circuit 7.42 2 Phone: 1,4 Miscellaneous(service or feeder not included) ( •y ) t e"ye,-c{c I, Fax::( )yEach manufactured or modular Email: dwelling,service and/or feeder 67.84 2 A f1�'� S+Srttrt..t r--- ..ic.r Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name:SignCraft Signs Ilc Sign or outline lighting t 67.84 to Zj,(r 2 Signal circuit(s)or limited-energy Address:PO Box 23636 panel,alteration,or extension. 0 See Page 2 2 City/State/ZIP:Tigard OR 97281 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 6625/hr Phone:(503)639-4910 Fax:(503)620-9568 Investigation(1 hr min) 90.00/hr Email:info@signcraftpdx.com Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: 155420 Electrical Lic.: 724SIG Suprv.Lic.:34.ip 74 OS specifically listed(%z hr min) ELECTRICAL PERMIT FEES Supn.Electrician signature,require Subtotal: L 7.3'-( Print name: Keith Cox I Date: t 11 Z s1/ ❑Plan Review Required(25%of permit fee): ((t , ! ; State surcharge(12%of permit fee): i 9 Authorized signature l dirttl. i+ TOTAL PERMIT FEE: 7S,jj S This permit application expires if a permit is not obtained within f80 Print name: John Sc ,l Date: t i IZf,11 a) days after it has been accepted as complete. 1 * Number of inspections allowed per permit. I:\Building\Petmits\ELC PemdtApp ELR ERE.doc Rev 66/17/2015 440-4615T(11/05ICOM/WEB