Permit •
CITY OF TIGARD ELECTRICAL PERMIT
a COMMUNITY DEVELOPMENT Permit#: ELC2013-00514
T f C;ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/28/2013
Parcel: 1 S 135DC00200
Jurisdiction: TIGARD
Site address: 11825 SW GREENBURG RD
Project: Goddard Subdivision: TIGARDVILLE PARK Lot: 8
Project Description: Sign lighting.
Contractor: VAST ELECTRIC Owner TWO G'S REAL ESTATE LLC
1525 SEATTLE SLEW DR. SE 18395 WOOD THRUSH ST
SALEM,OR 97317 LAKE OSWEGO,OR 97035
PHONE: 503-566-7274 PHONE:
FAX: 503-585-8828
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 08/28/2013 $67.84
Specifics:
1 ea 12%State Surcharge- 08/28/2013 $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 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 to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 9 - 01-0090. You m • pyeti s or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. S
Issued By. 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' 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 ApplicatiorRECElVE i FOR OFFICE USE O\L1
ri g AUG 2 7 2013 �e VAX /3 /�iT ) ,3—�siy
Ci of Ti ar Pvtnit►yo-:
` 13125 SW FiaIJ Blvd,Tigard,OR 97223 Plan Review
' 1. Phone: 503.718.243 Fax:
503.598.1 of TIGARD D13, Other Permit:
Inspection Line: 503.639.4175 Date Ready/Hy. Ot See Page 2 for
T(C'A R D
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Metitod: / Supplemental Information
I ' TYPE OF WORK i PLAN REVIEW
❑New construction ®Addition/alteration/replacement Please check all that apply(submit 2 sets of plans writeins checked below):
❑Service Of feeder 400 amps or more ❑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 an for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other. ❑Fire pump. ❑Installation of 150 K VA or
JOB SITE INFORMATION AND LOCATION Addili
❑Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A" 1" I-2" "1-�'
Job no.: I Job site address:11825 SW'Greenburg Rd lrioPormore. occupancy.
❑Six or more residential units. ❑Recreational vehicle parks.
City/StatelZTP:Tigard OR ❑Healthcare facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: I Project name: ❑service or feeder 600 aatpa or more.
Cross street directions to job site: needm�a FEE SCHEDULE
J 144. I Fee. I Total I •
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: 1 Lot no.: 1.000 sq.R or less 168.54 4
Ea.add'I 500 sq.R.or ponion 33.92 I
Tax map/patccl no.: Limited
eneigy,residenoal 75.00 2
DESCRIPTION OF WORK • (with above sq.ft.l
Limited energy,multi-family 7500 2
Street sign residential(with above sq.Il.)
Renewable Energy ❑ See Page 2
Services or feeders installation.alteration,andlor relocation_
❑ PROPERTY OWNER I ❑ TENANT 200 amps or Ica, 100.70 2
201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
Address: 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/T.IP: Temporary services or feeders installation,alteration,and/or
Phone:( ) Fax:( ) relocation
200 amps or less 59.36 1
Owner installation:This installation is being made on property that 1 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 168.54 2
Owner signature: Date: Braneb circuits-new,alteration,or extension,per panel
® APPLICANT I ❑ CONTACT PERSON A.Fix for branch circuits with j
above service or feeder fee,
7.42 2
Business name: each branch circuit
B.Fee for branch circuits without
Contact name: service or feeder fee.first 56.18
branch circuit 2
Address: Each add'l branch circuit 7.42 2
Miscellaneous City/State./ZIP: Each anufachued or(service not included)
modular
Phone:( ) Far. :( )
dwelling,service and/or feeder 67'34 2
Recoruxxtonly 67.84 2
E-mail: Pump or irriP7ation circle 67.84 2
CONTRACTOR Sign or outline lighting 1 67.84 67.84 2
Business name:Vast Electric,Inc. Signal circuit(s)or limited-energy See
panel.alteration,or extension. Page 2 _ 2
Address: 1525 Seattle Slew DR SE Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.251 hr
City/State/ZIP:Salem,OR 97317 Investigation(I hr min) 66.251 hr
• Phone:(503)799-5627 Fax:(503)585-8828 Industrial plant(I hr min) 78.181 hr
pections for which no fee is 9000/hr
CCI3 I.ic.: 175531 Electrical Lie.: C-280 Su /prv.Lie.: 5186S C sieciftcally listed(A hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required. 1-� '1 Subtotal: 67.84
Print name: Tim Vander Stoep Date: 8/27/2013 Plan review(25%of permit fee):
State surcharge(12a/oofpermit fee): 8.14
Authorized signature: TOTAL PERMIT FEE: 75.98
Print name: f ate: This permit application expires if a permit is not obtained within 180
I days after it has been accepted as complete.
• Number of imupections allowed per permit
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