Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2013 -00311
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503 718.2439 Date Issued: 06/04/2013
Parcel: 2S113AA00100
Jurisdiction: Tigard
Site address: 16358 SW 72ND AVE
Project: Pacific Realty Associates Subdivision: ROSEWOOD ACRE TRACTS Lot: PTS A,B
Project Description: Electrical service and branch circuits for new sign face
Contractor: DAVID STUCK ELECTRIC LLC Owner: PACIFIC REALTY ASSOCIATES
PO BOX 2582 ATTN• N PIVEN
EUGENE, OR 97402 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE' 541 - 542 -0618 PHONE
FAX:
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 06/04/2013 $100.70
Specifics: amps or less
4 crt Branch Circuits w /Purchase 06/04/2013 $29 68
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 06/04/2013 $15.65
Electrical
Type of Const:
Occupancy Grp:
Total $146.03
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. ATTENTIO •regon -w requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
952- 001 -0010 -.ugh OAR 952-0:1-0 ou obtain a copy of the rules or direct questions to OUNC by calling 503;32 1987 or 1 800 332.2344
Issued By: - t Permittee Signature:
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' � �U � �� Date:
LICENSE NO.
Call 503.839.4175 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 i= 111 IVED Dateed //NA //NA L A � ✓ /
Q _� /,
(Wry, Permit No.
13125 SW Hall Blvd., Tigard, i 'I_ ',: Plan Review
14 ° Phone: 503.718.2439 Fax: 5c -'`:'.' •'. Date/B Other Permit
11 G A R D Inspection Line. 503.639.4175 JUN - 4 2013 Date Ready/By tens Iil See Page 2 for
Internet: www.tigard- or.gov Notified/Method Supplemental Information
TYPE ocipti@FTIGARD PLAN REVIEW
❑ New construction ® Additiol�ln itt 1,1: INN Please check all that apply (submit 2 sets of plans w /items checked below).
❑ Service or feeder 400 amps or more 0 Building over three stories
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations buildings
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately derived system
A
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: 16358 SW 72" IOOHP or more occupancy
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: Tigard, Oregon 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more
FEE SCHEDULE i
Cross street/directions to job site: 1000' South of Upper Boones Ferry Road Description I Qty. I Fee. I Total I
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 00100 1,000 sq. ft or less 168.54 4
Ea. add'I 500 sq ft. or portion 33.92 1
Tax map /parcel no.: 2S113AA00100 Limited energy, residential 75 00 2
DESCRIPTION OF WORK (with above sq ft )
__ r Limited energy, multi - family 75 00 2
I., 514 Ili it '`:tct p i t - _- b rn..e . k c I P c ur /3 - - S t r` residential (with above sq. ft.)
Renewable Energy ❑ See Page 2
Services or feeders installation, alteration, and/or relocation
❑ PROPERTY OWNER ® TENANT 200 amps or less / 100.70 / u, 74 2
201 amps to 400 amps 133.56 2
Name: Lamar Advertising 401 amps to 600 amps 200 34 2
Address: 29345 Airport Road, Suite B 601 amps to 1,000 amps 301 04 2
Over 1,000 amps or volts 552 26 2
City/State /ZIP: Eugene, Oregon 97402 Temporary services or feeders installation, alteration, and /or
Phone: (541 )684 7939 Fax: (541)684 3212 relocation
200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125 08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168 Sa 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
® APPLICANT I ❑ CONTACT PERSON A Fee for branch circuits with
above service or feeder fee, 7 42 2
Business name: Lamar Advertising each branch circuit
B. Fee for branch circuits without
Contact name: 29345 Airport Road, Suite B service or feeder fee, first 56.18 2
branch circuit
Address: 29345 Airport Road, Suite B Each add'I branch circuit 7.42 2
City/State/ZIP: Eugene, Oregon 97402 Miscellaneous (service or feeder not included)
ty g , g Each manufactured or modular
Phone: (541) 684 7939 Fax: : (541) 684 3212 dwelling, service and/or feeder 67 84 2
Reconnect only 67.84 2
E - mail: jripp @lamar.com Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67 84 2
Business name: 4-0,0 IP'.STiicl(' FG40 -, ILc Signal circult(s) or limited-energy See
panel, alteration, or extension Page 2 2
Address: j0c 4 c , >q , . z ,-- 6 . Z Each additional inspection over allowable in any of the above
Additional inspection (I hr min) 66 25/ hr
City/State /ZIP: - 04 9 7ti0 2 Investigation (1 hr min) 66 25/ hr
Phone: (S'11/ ) .S ^ v6 / f Fax: ( 1 1t , Ott 1 t 47 Industnal plant (1 hr mm) 78 18/ hr
11 t Inspections for which no fee is 90.00 / hr
CCB Lic.: / / 7 \ L Electrical Lic.: 2. – S"/3c Suprv. Lic.: 3 2.5' specifically listed (%] hr mm)
( ` " ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: . �� Subtotal' 130_38
Print name: Jr9 - / S rvGt Date: x 73/ ky Plan review (25% of permit fee). . 2. Co - --
State surcharge (12% of permit fee)' /5, t+ 6
Authorized signature ' � g �,� TOTAL PERMIT FEE. - 3 —
This permit application expires if a permit is not obtained within 180
Print name: o/J id' f _5"7L-ce' Date: 3 - 1y / days after it has been accepted as complete. �� /U
• Number of inspections allowed per permit d _ -
I \Building\Permits\ELC PermitApp_ELR_ERE doe Rev 05/21/2013 440- 4615T(11/05/COM/WEB [f/ (C1
Electrical Permit 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 I Qty. I Fee I Total I
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100 70 2
5.01 to 15 kva 133 56 2
❑ Audio and Stereo Systems* 15 01 to 25 kva zoo 34 2
111 Burglar Alarm Wind generation systems in excess of 25 kva:
25 01 to 50 kva 301 04 2
❑ Garage Door Opener* 50.01 to 100 kva 552 26 2
>100 kva (fee in accordance with 552 26 2
111 Heating, Ventilation and Air Conditioning OAR 918- 309 -0040)
System* Solar generation systems in excess of 25 kva:
Each additional kva over 25 7 42 3
n Vacuum Systems* >100 kva— no additional charge 00 3
Each additional inspection over allowable in any of the above:
El Other: Each additional inspection is
charged at an hourly (1 hr mm) 66 25/ hr 1
Inspections for which no fee is 90 00/ hr
specifically listed (%: hr min)
COIVIlVIERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system $75.00 Subtotal:
(SEE OAR 918- 309 -0000) Plan review, if required (25% of permit fee):
State surcharge (12% of permit fee):
Check Type of Work Involved: TOTAL PERMIT FEE.
This permit application expires if a permit is not obtained within 180
❑ Audio and Stereo Systems days after it has been accepted as complete.
• Number of inspections allowed per permit
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
n L andscape Irrigation Control*
n M edical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1 \Buildmg\Permits\ELC PermitApp_ELR_ERE doc Rev 05/21/2013