Permit y CITY OF TIGARD ELECTRICAL PERMIT
IN c, COMMUNITY DEVELOPMENT Permit#: ELC2013 00649
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/29/2013
Parcel: 1S135DD03301
Jurisdiction: Tigard
Site address: 11945 SW PACIFIC HWY 121
Project: Archers Afield Subdivision: METZGER ACRE TRACTS Lot: 9
Project Description: (1)sign lighting for wall sign
Contractor: SIGNCRAFT ELECTRICAL ADVERTISING LLC Owner: COMMERCIAL ENTERPRISES LLC
8900 SW BURNHAM, E109 8320 NW HWY 99
TIGARD,OR 97223 VANCOUVER,WA 98665
PHONE: 503-639-4910 PHONE:
FAX: 503-639-4999
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 10/29/2013 $67.84
Specifics:
1 ea 12%State Surcharge- 10/29/2013 $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 perm' s issued subjec • the re!. '•ns contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be don in accordance with app'•ve• 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 -quires yo o follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-0 1-0010 t tLugh OAR 952-0• •r•• u obtain a copy of e rules or direct questions to OUNC by calling 503.232.198 or 1.800.332.2344.
�, ,/ 1
Issu d By: I` Lr . -`�� - Permittee Signature: /'
.tr•
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 usi:ONLY
1 ,.,�( �
City of Tigard ' h r ( ;! Date/B /0 A%O/A� Ilia,. II Permit No.:E /5' _Oa
• 13125 SW Hall Blvd.,Tigard,OR 97223 `"' ''' -. Plan Review
C Phone: 503.639.4171 Fax: 503.5981�. 60 Date/B : Other Permit: igudo90/3-104.9
T I c.A I(D Inspection Line: 503.639.4175 U 9 2 013 Date Ready/By: Juris: El See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
frr os t, .fa r;. PLAN REVIEW
TYPE OF iVVOR tv.cAn r.1:',r`ift.
'"d :r c ' " -":`i°ii'" Please check all that apply(submit 2 sets of plans w/items checked below):
❑New construction �Additiorl[erahon/replacement
❑Service or 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 X Commerciallindustrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
/� ❑Addition of new motor load of ❑"A","E","I-2","1-3",
Job no.: Job site address:/)q L/5 �a� J}�,/.t , I Six or or more. occupancy.
r !`/ //,TT►vVV� ❑Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: evo--� 7�
❑Health-care facilities. ❑Supply voltage for more than
I
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name:A ra,Q•s A -e.l 0 Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single-or multi-family dwelling unit.
a C (,k 4Z4 Includes attached garage.
Subdivision: jj i� Lot no.: 1,000 sq.ft.or less 168.54 4
�® C1 8 � Le-� Q- Ea.add'I 500 sq.ft.or portion 33.92 I
Tax map/parcel no.: Limited energy,residential -
DESCRIPTION OF WORK (with above sq.ft.) 67.84 2
`_ Limited energy,multi-family 67.84 2%a\< u? S\C �� l�X(S�l I N!'� residential(with above sq.fl.)
\ Services or feeders installation,alteration,and/or relocation
1c .� G\ rcc.)(, '( 200 amps or less 100.70 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
~ _1 � � 401 amps to 600 amps 200.34 2
Name: ` `���(%\
� 601 amps to 1,000 amps 301.04 2
Address: 1,/a 5" Pat( c_t G }k(4),.../ Over 1,000 amps or volts 552.26 2
City/State/ZIP:l /I a e— 6✓ '') 3 Temporary services or feeders installation,alteration,and/or
relocation
Phone:(60 V -7 4 to i 5 a,41 Fax:( ) 200 amps or less 59.36 l
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 168.54 2
Owner signature: Date: Branch circuits-new,alteration,or extension,per panel
,_ __ A.Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee,
7.42 2
Business name: ,4rcJ e rS i f■ each branch circuit
1 r� 13.Fee for branch circuits
without service or feeder fee,
Contact name: �l 1t� A�� /\ 56.18 2
first branch circuit
Address: /9'y p Each add'I branch circuit 7.42 2
u�, , c
I �Lid Miscellaneous(service or feeder not included)
City/State/ZIP: I `lard ,q L 7-d 3 // Each manufactured or modular 67.84 2
f (/ dwelling,service and/or feeder
Phone:( c,3 Loa q- 3 c. Fax: :( ) Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67. 2
CONTRACTOR Sign or outline lighting l 7:84 4,7,9¢2
Business name: l Signal circuit(s)or limited-
Business Gel C. �(/l(� • C.` energy panel,alteration,or
Address:61'09 5,1.3 e?).,rr c a kA-- if ®ci extension.Describe: Page 2 2
City/State/ZIP:'�'1 to rt( q '��a3 Each additional inspection over allowable in any of the above
�3) f 31- 2f ‘t t l�C ( -� Per inspection 66.25
Phone: 6 Fax:sd� cAo 5.6
Investigation per hour(1 hr min) 66.25
CCB Lie.: /5.6.-2/alp I Electrical Lie- -v, k 7qe 3uprv. 'c.: 7c & 5r 6 Industrial plant per hour 78.18
I ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:• Subtotal: aD7.9g' -
Print name: l Date: (V," ✓4 _ 1 Z Plan review(25%of permit fee):
t / State surcharge(12%of permit fee): 8. P/
Authorized signatu TOTAL PERMIT FEE: 9�'
This permit application expires if a permit is not obtained within 180
Print name: r. a .I Date:a _v 6— /3 days after it has been accepted as complete.
' Number of inspections allowed per permit.
I:\Building\Permits\ELC-PermitAppdoc 10/01/09 440-4615T(l1/05/COM/WEB
•
Electrical Permit Application - City of Tigard
Page 2- Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $67.84
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
nGarage Door Opener*
❑ Heating,Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $67.84
system
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\Building\Permits\ELC-PermitApp.doc 10/01/09
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11945 SW PACIFIC HWY 121, TIGARD, OR,
97223
Commercial - Electrical
140 Sign installation
2013-11-21 00:00:00
ELC2013-00649
PASS
Violation Summary:
Inspector Contractor