Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2013 -00688
1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/03/2013
T r i; ,� It. n 9 Parcel: 2S102AC00700
Jurisdiction: Tigard
Site address: 12550 SW MAIN ST 110
Project: Pacific Parkway Center Subdivision: BURNHAM TRACT Lot: 1
Project Description: Sign lighting for (2) wall signs.
Contractor: E S & A SIGN & AWNING Owner: DOLAN & CO LLC
89975 PRAIRIE RD BY FLORENCE T DOLAN
EUGENE, OR 97402 4523 NE DAVIS ST
PORTLAND, OR 97213
PHONE: 541 -485 -5546 PHONE:
FAX: 541 -485 -5813
FEES
Quantity Description Date Amount
2 ea Sign or Outline Lighting 12/02/2013 $135.68
Specifics:
1 ea 12% State Surcharge - 12/02/2013 $16.28
Electrical
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $151.96
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 - . -- • : - - 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. A ' ENTION• Oreg• law r- •uires you to follow the rules adopted by the Oregon Utility Notifica • Center Those rules are set forth in OAR
952 -001 0010 through OAR 95 •0 •0• • may obtain a copy of the rules or direct questions to OUNC by callin• '3.232 1987 or 1.800.332 2344.
Issue • = l / ��� Permittee Signet re: " V» � _ , � 11//MJ7'
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 503.639.4176 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
' 1
H VE J I Received City of Tigard -. , i - a � , Date/By II / / // , ? � -� Permit No —
1111 13125 SW Hall Blvd., Tigard, OR 97223 ' ;,:.- Plan Review
. q ti Phone: 503.718 2439 Fax 503 598. Date/By Other Permit gulA 1 '' _ 0 ?F
Inspection Line. 503.639.4175 N 0 V 14 201 Date Ready/By Jam El See Page 2 for
I' l G A K D Notified/Method Su
Internet. www.tigard-or gov Supplemental Information
TYPE OF WO ' =VISION + i p I1I q ` � °' / ARD q • PLAN REVIEW
❑ New construction ❑ Addition/alter: � s
WO N
� Please check all that apply (submit 2 sets of plans w /items checked below)
❑ Service or feeder 400 amps or more ❑ Building over three stories
❑ Demolition Other: 5' 164 ti Gj/d'TI �tle where the available fault current ❑ Marinas and boatyards
CA )(other:
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 ACommercial/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 denved system.
❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "I -3 ",
Job no.: Job site address: /2E31, stn/ M/9 1/0 IOO or more occupancy
❑ Six o or r more residential units ❑ Recreational vehicle parks
City/State /ZIP: 774 friZ4) P2 '' 72-0- 3 ❑ Health -care facilities ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal
Suite /bldg. /apt. no.: //0 Project name: - j2ffyLf 71./7724'L- ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: Description I Qtr. 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
Tax map /parcel no.: Ea add'I 500 sq ft. or portion 33 92 I
Limited energy, residential 75 00 2
DESCRIPTION OF WORK (with above sq ft.)
Limited energy, multi - family
gag -(1 p ) JT 7 j f C j 4 Z f) ( /1.1, residential (with above sq ft) 75.00 2
Renewable Energy ❑ See Page 2
a/ r9 - !1L — 576,di (C (1c.ca- t 7 7C( 577 4 /L Services or feeders installation, alteration, and/or relocation
• ❑ PROPERTY OWNER 1. MI TENANT 200 amps or less 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 /ZIP: 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 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
APPLICANT ❑ CONTACT PERSON A Fee for branch circuits with
above service or feeder fee, 7 42 2
Business name: f.4 / I- S fL Al d , . /,v MI6 each branch circuit
B Fee for branch circuits without
Contact name: service or feeder fee, first
8�� /1 ��� branch circuit 56.18 2
Address: ? 1 5 7" pa A-7 /1/ t 1 /) Each add'I branch circuit 7 42 2
City/State/ZIP: t 4 /7 /J 7� /Q� Miscellaneous (service or feeder not included)
{ilig i - g- '7 / Each manufactured or modular
Phone: ( 93 ) /c6 7- - 7 7 / Fax: : ( )
dwelling, service and/or feeder 67.84 2
Q /-j e esas 5 yt Pump nor only 67 84 2
E - mail: �• L- t7��'
/1'W I Pump or imgation circle 67 84 2
CONTRACTOR Sign or outline lighting Z 67 84 `35 ( p$ 2
Business name: S74,ltiLc Signal circuit(s) or limited- energy See
panel, alteration, or extension Page 2 2
Address: Jet Q Each additional inspection over allowable in any of the above
City/State /ZIP: __S 0,02- Additional inspection (1 hr min) 66 25/ hr
Investigation (I hr min) 66 25/ hr
Phone: ( ) _ `ijj ?--e- Fax: ( ) Industrial plant (I hr min) 78 18/ hr
Inspections for which no fee is 90 00/ hr
CCB Lic.: /( .3 / �0 Electrical Lic.:ap _ 5 c_5 Suprv. Lic.: 7 / 7 S /C specifically listed (IA hr min)
. ELECTRICAL PERMIT 'FEES
Suprv. Electrician signature, required: Subtotal: f 35, (1
Print name: Wa 1 Hto, P{ )! ys4-7,1 Date: Plan review (25% of permit fee) -4.—.._.
State surcharge (12 /o of permit fee)• 7, a
Authorized signature: TOTAL PERMIT FEE. F I -
` ( vV✓ �% � / /11—`3 This permit apycati chasb if a permit is nco , i IQ
Print name: �
L ' /` �J D ate: j days s after r it has bee en accepted as complete. plete. I
• Number of inspections allowed per permit.
t \ Building \Permits\ELC_PermitApp_ELR_ERE doe Rev 05/21/2013 440- 4615T(11/05/COM/WEB
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
El 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
El Heating, Ventilation and Air Conditioning OAR918- 309 -0040)
System* Solar generation systems in excess of 25 kva:
Each additional kva over25 7.42 3
❑ Vacuum Systems* >100 kva — no additional charge 0 0 3
E1 Other: additional inspection over allowable in any of the above:
Other: Each additional inspection is
charged at an hourly (1 hr min) 66.25/ hr 1
•
Inspections for which no fee is 90.00 / hr
specifically listed (%] hr min)
COMMERCIAL 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
El Audio and Stereo Systems days after it has been accepted as complete.
' Number of inspections allowed per permit.
El Boiler Controls
El Clock Systems
El Data Telecommunication Installation
El Fire Alarm Installation
❑ HVAC
El Instrumentation
El Intercom and Paging Systems
El Landscape Irrigation Control*
El Medical
El Nurse Calls
El Outdoor Landscape Lighting*
El Protective Signaling
El Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1•\ Building \Permns\ELC_PermitApp_ELR_ERE doc Rev 05/21/2013
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
12550 SW MAIN ST 110, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
2013-12-30 00:00:00
ELC2013-00688
FAIL
No disconnect found on the sign--no response from a phone call
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12550 SW MAIN ST 110, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
2014-01-07 00:00:00
ELC2013-00688
PASS - No C of O
Violation Summary:
Inspector Contractor