Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2014-00228
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/21/2014
Parcel: 1 S135DD01000
Jurisdiction: Tigard
Site address: 11760 SW HALL BLVD
Project: Wells Fargo Subdivision:\RBER TRACTS NO.16 TO NO.40 INCL Lot: PTS 19
Project Description: (3)sign lighting for(1)freestanding sign,(1)canopy sign and(1)wall sign.
Contractor: VANCOUVER SIGN COMPANY INC Owner: WELLS FARGO BANK NA
2600 NE ANDRESEN RD#50 BY DELOITTE TAX LLP
VANCOUVER,WA 98661 PO BOX 2609
CARLSBAD, CA 92018
PHONE: 360-693-4773 PHONE:
FAX: 360-693-2747
FEES
Quantity Description Date Amount
3 ea Sign or Outline Lighting 05/08/2014 $203.52
Specifics:
1 ea 12%State Surcharge- 05/08/2014 $24.42
Electrical
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $227.94
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 accord 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. ATT ON: Oregon w requir you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0 0 through OAR 952-0 1- 0. o y obtain a copy f the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.33 .2344.
Issued y: / - 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' Pr"' Date: //
LICENSE NO. �CF g 5 a C!
/
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 RECEIVE I FOR OFFICE USE ONLY
City of Tigard ve Received Art (V '' Permit N,ecc j �
y_elora ?
Date/By:
13125 SW Hall Blvd.,Tigard,OR 97223 MAY De 2014 ae Review
I Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Pert�//PaO./L,f�000 9Q
I I R I, Inspection Line: 503.639.4175 CITY OFTIGARD Date Ready/By: ! I i fG''`�® See Page 2 for
Internet: www.tigard-or.gov Notified/Method•a �s /(� Supplemental Information
TYPE OF VA L8IA1G DIVISIO �� PLAN REVIEW
❑New construction ❑Addition/alteration/replacement
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: 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.
❑Addition of new motor load of ❑"A","E","I-2","1-3",
\ p f IOOHP or more. occupancy.
Job no.: Job site address:
17�u 0 c5 W H all a(v d. ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: �� Q c -7 ❑Health-care facilities. 0 Supply voltage for more than
l 1 Qt�rl� 0 fl ! ! Z Z ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: I Project name: w el)S Fa.f cO ❑Service or feeder 600 amps or more.
Cross street/directions to job site: Description FEE SCHEDULE
J i Qt,. [ 1•ee. 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
DESCRIPTION OF WORK (with above sq.ft.)
Limited energy,multi-family 2
(3) ;i l l.l'llfil VICI'1'oL.!'it c5 I can 5 residential(with above sq.ft.) 75.00
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
IE PROPERTY OWNER I ,E TENANT 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name: we,ll Fa.t u I 401 amps to 600 amps 200.34 2
Address: 11760 61.0 Hall BI vd(. 601 amps to 1.000 amps 301.04 2
p Over 1,000 amps or volts 552.26 2
City/State/ZIP:
Tec0..ed, OA 1 71Z:21 Temporary services or feeders installation,alteration,and/or
Phone:( ) I 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 I ® CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,
7.42 2
Business name: Vancouver Sign each branch circuit
•
B.Fee for branch circuits without
Contact name:Reid Storm service or feeder fee,first 56.18 2
branch circuit
-
Address:2600 NE Andresen Rd#50 Each add'l branch circuit 7.42 2
City/State/ZIP:Vancouver WA 98661 Miscellaneous(service or feeder not included)
_ Each manufactured or modular 67.84 2
Phone:(360)693-4773 I Fax: :(360)693-2747 dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail:reids @vansignco.com Pump or irrigation circle (3) 67.84 2
CONTRACTOR Sign or outline lighting 6784 2
Business name:Vancouver Sign Signal circuit(s)or limited-energy See
panel,alteration,or extension. _ Page 2 2
Address:2600 NE ANdresen Rd#50 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
City/State/ZIP:Vancouver WA 98661 Investigation(1 hr min) 66.25/hr
Phone:(360)693-4773 Fax:(360)693-2747 /0/(//y Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90,00/hr
CCB Lic.: 63951 Electrical Lic.: 37-46CLS Suprv.Lie.t/y�6/4, specifically listed(1/2 hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal: 010„3. 5.2.
Plan review(25%of permit fee):
Print name: /A„)A L L.!5 Date: State surcharge(12%of permit fee): p.9 y, tic,—
Authorized signature: / TOTAL PERMIT FEE: .2,2 7, qy
This permit application expires if a permit is not obtained within 180
Print name: Reid Storm Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
tABuilding\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 3-t()-45ISTI I I/1151(11St/Wi:It