Permit CITY OF TIGARD ELECTRICAL PERMIT
1111
1` ' COMMUNITY DEVELOPMENT Permit#: ELC2020-00117
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/27/2020
T E G:\ Parcel: 1 S126CA00900
Jurisdiction: Tigard
Site address: 9009 SW HALL BLVD 200
Project: Macy's Furniture Gallery Subdivision: None Lot: None
Project Description: Sign lighting for(1)illuminated monument sign.
Contractor: MEYER SIGN CO OF OREGON Owner: HUDESMAN TIGARD LLC
15205 SW 74TH AVE BY MACY'S INC
TIGARD, OR 97224 ATTN TAX DEPARTMENT
7 WEST SEVENTH ST
CINCINNATI, OH 45202
PHONE: 503-620-8200 PHONE:
FAX: 503-620-7074
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 02/27/2020 $67.84
Specifics:
1 ea 12%State Surcharge- 02/27/2020 $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 es 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 ' uance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Noti ation Center. Those rules are et forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by ca g 503.232.1987 or 1.8 .332.2344. f
Issued By: �+ -. -.. - Permittee Signatu
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 RECEIVE s Reece ved
.✓I g Date/B / �"7 : rev '� � � .a
ILIII
i - 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 FEB 7 Date/B : Related Permit#:
Inspection Line: 503.639.4175 2 i 2070 Ready Date/By: IIMMI El See Page 2 for
i 1 t q R 1) Internet: www.tigard-or.gov i _ Notified Method: Supplemental information
�/TYPE OF 'i I f tt ; .:fool�Rs, PLAN REVIEW
U❑New construction Addition/alteration/repiaceinent N Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
CATE9ORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
❑ 1-and 2-family dwelling [� Commercial/industrial ❑Accessory building less o ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: 0 Fire pump. ❑Installation of 150 KVA or
JOB S T LOCATION 0 Emergency system larger separately derived
❑Addition of new motor load of system
Job#: LJo�1b site address: 0 el 5-(J. / U. /3&Ito . loOHP or morn ❑ A,uE^,uI-2 ,`l-3 ,
C1ty/State/ZIP: . a'A t. �1/` //I q ,d/ ❑Six or more residential units. occupancy.
, V/�- / / 8 t/ /�^, ( 0 Health-care facilities. ❑Recreational vehicle parks.
Smte/bldg./apt.#: Project name: /" i(//(•,J/y'1/15 i�l/C ardour locations. ❑Supply voltage for more than
��/" ❑ rwce or(ceder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Each I Total
New residential single-or multi-family dwelling uniL
Subdivision: I Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'I 500 sq.ft.or portion 33.92 1
' '''ttEscRwi OF WORK . . Limited energy,residential
(e.Ai'1 L1 / !f 6/i ///61/641 nd1-r,l /i�7 6.L�, �r (with above sq.ft.) 75.00 2
/', Limited energy,multi-family
//E/) 10 64/57/hie [ L e C%Iu riv,-(....._ residential(with above sq.ft.) 75.00 2
' .. 'R ""°.'=. . 4 - ' 11 TENANT Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
Name: J/ t1 1Il �firr/1,4 l�i/ /YJ/kAJ S I Lt'_- 200 amps or less 100.70 2
Address: 1 A) .7" S r. 201 amps to 400 amps 133.56 2
[ /4,/ 401 amps to 600 amps 200.34 2
City/State/ZIP: (7/A) C/,1J,u ftT1/ P H L 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
leAPPLIC CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
_ _ ` A.Fee for brooch circuits with
Business name: 1) �Q (J/G,J / // ,0/-1 above service or feeder fee,
e A each branch circuit 7.42 2
Contact name: ��' /?�/6L B.Fee for branch circuits without
,� Ip /�,,,/ service or feeder fee,first 56.18 2
Address: / f !L!, ? /I LrF branch circuit
City/State/ZIP: 17b/-/(5 (7/1.. 9 7))..L L Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:I7/) Z3L - (62.1 Fax::( ) Each manufactured ormodular
67.84 2
® �8 M / ! dwelling,service and/or feeder
Email: / L"Jl/l ,,,,- /r`�yFj_fief)ef) ee G21 Recomect only 67.84 2
CONTRACT9R IMINIIIIIII r Pump or irrigation circle 67.84 2
Business name: /)je j/Clni C. ,1 //7/U Sign or outline lighting 1 67.84 2
!
/ Signal circuits)or limited-energy IDSee Page 2 2
Address: rj 2(/ �,((� , panel,alteration,or extension.
City/State/ZIP: /e-tl/1-H)` di_ 97a n4 Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
Phone:(p 7/) �,3L- 5.01-/ Fax:( ) Investigation(1 hr min) . 90.00/hr
Email: paki-1 ,j 6 //04C,f/0/ - /A/^ Industrial plant(I hr min) 78.18/hr
�1 sI //I (:� fN [ Inspections for which no fee is 90.00/hr
CCB Lic.: 4lid I / Electric ic.:) _/ 1V 11prv.Lic.: c4,1-516 specifically listed(1 hr min)
I. ELECTRICAL PERMIT FEES
Suprv.Electrician signature, // 4\, /i /ii
Subtotal
t ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permitTOTAL PERMIT FEE:
fee):: -7 c
Authorized signature. /J• °t
AI
This permit application expires d a permit is not obtained within 110
Print name: 1 ,,,, /ac Date: �3 ot0 days after It hos been accepted as complete.
• Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_EL _ERE.doe ay 06/17/2015 440-9615T(11/05/COM/WEB