Permit CITY OF TIGARD ELECTRICAL PERMIT
IN $ COMMUNITY DEVELOPMENT Permit#: ELC2014-00310
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/12/2014
T[t";1 K O g Parcel: 2S103DD00800
Jurisdiction: Tigard
Site address: 13815 SW PACIFIC HWY 40
Project: Tapphoria Subdivision: MELROSE Lot: 7-8
Project Description: Sign lighting for(1)wall sign.
Contractor: SECURITY SIGNS INC Owner: D W SIVERS CO
2424 SE HOLGATE BLVD 4730 SW MACADAM AVE#101
PORTLAND,OR 97202 PORTLAND,OR 97239
PHONE: 503-546-7114 PHONE:
FAX: 503-230-1861
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 06/12/2014 $67.84
Specifics:
1 ea 12%State Surcharge- 06/12/2014 $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 952-001-0090. You may obtain a co,, .t the .-or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. -y
Issued By: t. -.- - Permittee Signature:
/i .�1
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 I tih1 0y1.1
City of Tigard ��Y Received ����� Permit No.:e �! 'Yi0
1111111 "
l Received
13125 SW Hall Blvd.,Tigard,OR 9 Plan Review Other Permit: QQ JP,* "�
Phone: 503.718.2439 Fax: 50 . bt Date/B : /ol(.[ Y•�10/
T 1 G A R D Inspection line: 503.639.4175 �Q� Date Ready/By: turfs: H See Page 2 for
Internet: www.tigard-or.gov yy i t3 QQo Notified/Method: Supplemental Information
TYPE OF WORK" "So.- �`Q� PLAN REVIEW
❑New construction (�;Addition/alteration/ lN. 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: 4� where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONS1v ION 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 WCommercia1industrial ❑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",
Job no.: Job site address: I?Jg i s SW Six or or more. occupancy.
H(wy ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:, ❑Health-care facilities. ❑Supply voltage for more than
- ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.Yc-TE £4Q Project name: -r-App-go R IA ❑Service or feeder 600 amps or more.
Cross street/directions to job site:L Description FEE SCHEDULE
J 7W �/Vi�t'TLLI tt..fS �►VE I Qty. I Fee. I Total I *
New residential single-or multi-family dwelling unit.
AV
Includes attached garage.
ra
Subdivision: Lot no.: 1.000 sq.ft.or less 1 68.54 4
Ea.add'/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
ON Ci IL.LuM 10 t s:Pm \A/AA-L. S 1Ga 114 residential(with above sq.ft.)
Services or feeders installation,alteration,and/or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER H TENANT 201 amps to 400 amps 133.56
Name: ` 401 amps to 600 amps 200.34
• (. WPST�ArI.V 601 amps to 1,000 amps 301.04
Address: Over 1,000 amps or volts 552.26 2
135 t 5 six, Poc,+Fi c. +�w y , 5-r��-#0
City/State/ZIP: c0,004/47 • �� Temporary services or feeders installation,alteration,and/or
relocation
Phone: 1 c J 797. (0 175 73 Fax:( ) 200 amps or less 59.36 I
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
la APPLICANT I ® CONTACT PERSON above service or feeder fee, 7 42 2
each branch circuit
Business name: 5..cid ez.` 1 g t� B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Contact name: EL r r +,Al^ branch circuit
l �`'� V Each add'I branch circuit 7.42 2
Address: �4 au' 5 0L Gj zis _V Miscellaneous(service or feeder not included)
�+G f Each manufactured or modular
City/State/ZIP: PO% T L.A 4I K. q1 Z.oa dwelling,service and/or feeder 67.84
Phone: ;t403) 5144 •'j u c4.
Fax: :Sob .p3 D•mg.I Reconnect only 67.84 '—
Pump or irrigation circle 67.84 2
E-mail:infle,11 S(SG2 S re r I i'( ., S. 2 m4i Sign or outline lighting '
67.84 67$y 2
CONTRACTO Signal circuit(s)or limited-energy
Business name: t �M I` S I�f t S panel,alteration,or extension. Page 2 2
J Each additional inspection over allowable in any of the above
Address: a4 at.' c e +lc L .41i I vc> Additional inspection(1 hr min) 66.25/hr
City/State/ZIP: �0R.1 'LlC/4b �R `�I 7 ado
Investigation pl (1 hr min) 66.25/hr
Industrial plant(1 hr min) 78.18/hr
Phone: 31 54(o _' 7g 4 Fax:503 0 j , %go,I Inspections for which no fee is 90.00/hr
specifically listed(5h hr min)
CCB Lic.:1 -a$C6101 Electrical Lic • ` Iprv.Lic.: ?j$2)514 • ELECTRICAL PERMIT FEES
Subtotal: 6 7,S'y
Suprv.Electrician signature,required:
Plan review(25%of permit fee):
Print name: L A i C ier LA 1,3 Qu -r Date:UN State surcharge(12%of permit fee): ?./41
_ {' TOTAL PERMIT FEE: 75,5,g
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name:MIE 1 „�Aa"D�1 Date:43/ k_j, * Number of inspections allowed per permit.
I:\Building\Permits\ELC-PerLmitAVpp..ddoc 117/01/10 `r `+1" _1440-4619TI 11/n5/C•O_TM/WEB
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
13815 SW PACIFIC HWY 40, TIGARD, OR,
97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2014-00310
Chip Barnett
Violation Summary:
Inspector Contractor