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Permit CITY OF TIGARD ELECTRICAL PERMIT 11111 2_ -. COMMUNITY DEVELOPMENT Permit#: ELC2013 00673 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/13/2013 Parcel: 2S 1048808000 Jurisdiction: TIGARD Site address: 14200 SW BARROWS RD Project: Godfather's Pizza Subdivision: RUSSELL'S SCHOLLS FERRY Lot: 3 Project Description: Installing(1)circuit for a new wall sign. Contractor: RAMSAY SIGNS INC Owner: ALULI REAL ESTATE HOLDINGS LLC 9160 SE 74TH AVE 415-C ULUNIU ST PORTLAND, OR 97206 KAILUA OAHU, HI 96734 PHONE: 503-777-4555 PHONE: FAX: 503-777-0220 FEES Quantity Description Date Amount 1 crt Branch Circuits wo/Purchase 11/13/2013 $56.18 Specifics: Service or Feeder 1 ea 12%State Surcharge- 11/13/2013 $6.74 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 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 952-001-0090. You may obtain a co ules or direct questions to OUNC by calling 503.23 t t 7 or 1.800.332.2344. )(I - Issued By: Permittee Signature: i ://�� 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 Received /� III City g DateBy, '/I to ii --7,-- Permit No.: F'� (�i vii'13 13125 SW Hall Blvd.,Tigard,0 3 Plan Review �-LJ10 Phone: 503.718.2439 Fax: 503.598.1960 01'� Date/By: Other Permit: /f�t Ap 2.�13. 17 T l G n R n Inspection Line: 503.639.4175 V 6 2 Date ReadyBy: / >,ais: �El See Page 2 for Internet: www.tigard-or.gov N0 Notified/Method: / /3 /,� O', • imp Supplemental Information TYPE OF t C0�' i`•`" CD0 PLAN REVIEW ®New construction ❑Add►tion/allttetoollAc al �J Please check all that apply(submit 2 sets of plans w/items checked below): U 1�V""- ❑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. El 1-and 2-famil dwellin less to ground,or exceeds 14,000 ❑Commercial-use agricultural y g ®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", 1-2","1-3", 1 100HP or more. occupancy. Job no.: I Job site address:iyZO 0 S W Bo vto uP S g6,, ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP:Tigard,OR 97223 ❑Health-care facilities. ❑Supply voltage for more than ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: Project name:e'>ad 41 f i ❑Service or feeder 600 amps or more. 1 ` �Z� FEE SCHEDULE Cross street/directions to job site: - Description I Qty. I Fee. I Total I • New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4 Ea.add'I 500 sq.ft.or portion 33.92 1 Tax map/parcel no.: Limited energy,residential 75.00 2 DESCRIPTION OF WORK (with above sq.ft.) Limited energy,multi-family 75.00 2 Instal 1 circuit residential(with above sq.ft.) Services or feeders installation,alteration,and/or relocation 200 amps or less 100.70 2 0 PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2 Name:See Attached 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or City/State/ZIP: . relocation Phone:( ) Fax:( ) 200 amps or less 59.36 1 201 amps to 400 amps 125.08 2 Owner installation:This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. Branch circuits—new,alteration,or extension,per panel Owner signature: Date: A.Fee for branch circuits with ® APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7.42 2 each branch circuit • Business name:Ramsay Signs Inc R Fee for branch circuits without service or feeder fee,first Contact name:Garrett Gibson branch circuit ( 56.18 S i,, - 2 Each add'I branch circuit 7.42 2 Address:9160 SE 74th Ave Miscellaneous(service or feeder not included) City/State/ZIP:Portland,OR 97206 Each manufactured or modular 67.84 2 dwelling,service and/or feeder Phone:(503)777-4555 Fax: :(503)777-0220 Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E-mail:GarrettG @RamsaySigns.com Sign or outline lighting 67.84 2 CONTRACTOR _ ., . Signal circuit(s)or limited-energy Business name:Ramsay Signs Inc panel,alteration,or extension. Page 2 2 Each additional inspection over allowable in any of the above Address:9160 SE 74th Ave Additional inspection(1 hr min) 66.25/hr Investigation(1 hr min) 66.25/hr City/State/ZIP:Portland,OR 97206 Industrial plant(1 hr min) 78.18/hr Phone:(503)777-4555 Fax:(503)777-0220 Inspections for which no fee is 90.00/hr specifically listed(h hr min) CCB Lic.: 63422 Electrical Lic• 106CLS rv.Lic.: 493Sig ELECTRICAL PERMIT FEES ....--- Subtotal: Vp•it Suprv.Electrician signature,required: Plan review(25%of permit fee): Print name: Phil Steiger e: 11.(0,(? State surcharge(12%of permit fee): 6;��/ Authorized signature: r TOTAL PERMIT FEE: 6^.q,4 erl e,, ° '.',_ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Garrett Gibson Date: 11. 6, (3 • Number of inspections allowed per permit. 1 Building\Permits\ELC-PermitApp doc 07/01/10 440-46151(11/05/COM/WEB 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 14200 SW BARROWS RD, TIGARD, OR, 97223 Commercial - Electrical 199 Electrical final 2013-12-30 00:00:00 ELC2013-00673 PASS - No C of O Violation Summary: Inspector Contractor