Permit p CITY OF TIGARD ELECTRICAL PERMIT
s • COMMUNITY DEVELOPMENT Permit#: ELC2014-00354
TI G,,, D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/26/2014
Parcel: 2S 112 DA00300
Jurisdiction: Tigard
Site address: 15230 SW SEQUOIA PKWY 100
Project: North Coast Lighting Subdivision: PACIFIC CORPORATE CENTER Lot: PTS 6-7
Project Description: Sign lighting for(2)wall signs.
Contractor: VANCOUVER SIGN COMPANY INC Owner: PACIFIC REALTY ASSOCIATES
2600 NE ANDRESEN RD#50 ATTN: N PIVEN
VANCOUVER,WA 98661 15350 SW SEQUOIA PKWY#300
PORTLAND,OR 97224
PHONE: 360-693-4773 PHONE:
FAX: 360-693-2747
FEES
Quantity Description Date Amount
2 ea Sign or Outline Lighting 06/26/2014 $135.68
Specifics:, 1 ea 12%State Surcharge- 06/26/2014 $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 a ante with a.•••ved 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 TION: Oregon law r- ui - you to follow the rules adopted by the Oregon Utility NotificatiofV Center. Those rules are set forth in OAR
952-00 010 through OAR 952-001-01:r. Yo ma obtain a copy of the rules or direct questions to OUNC by g 503.232.1987 or 1.800.332.2344
Is ed By: 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' 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 Applicatiatun FOR OFFICE USE ONLY
City of Tigard CEIVEI� Received ��
11111 Y g Date/B : l�,'lv��Gl��J ' ..r/ ,JS-
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
• = Phone: 503.718.2439 Fax: 503.598.
Date/B : Other Permit: ,�a�j� _�/
,} 2 6 2014
T 1 GARD Inspection Line: 503.639.4175 Date Ready/By: luriti: 65 See Page 2 for
Internet: www.tigard-or.gov ., Notified/Method: Supplemental Information
a
TYPE a •- PLAN REVIEW MEM
O i. n o re lacement • Please check all that apply(submit j sets of plans w/items checked below):
❑New construction ❑Additio
❑Service or feeder 400 amps or more ❑Building over three stories.
❑ Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
"
l TEGORY OF CONSTRUCTIO exceeds 10,000 amps at 150 volts or ❑Floating buildings.
CALY":,
less to ground,or exceeds 14.000 ❑Commercial-use agricultural
1:1 -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","1-2","I-3",
Job no.: 1 Job site address: /SZ3 o �4 A < ( fl 1/ lOOHPor more. occupancy. p
eQ to f f 1/iy ❑Six or more residential units. ❑Recreational vehicle arks. �S
City/State/ZIP: i�� yy���Q (/ ❑Health-care facilities. ❑Supply voltage for more than O't
cd V f 1 �Z Z ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: 3700 Project name: ❑Service or feeder 600 amps or more.
�lor t C o tas l 1 J(� I t l FEE SCHEDULE
Cross street/directions to job site:
Description I oft. I Fee. I Total
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: 1 Lot no.: 1,000 sq.ft.or less 168.54 4
Ea.add'/500 sq.ft.or portion 33.92 1
Tax map/parcel no.: Limited energy,residential
DESCRIPTION OF WORK (with above sq.ft.) 75.00 2
(Z) I] J / Limited energy,multi-family
!11 UM i &.•lf pa 1 f c5/ 5 residential(with above sq.ft.) 75.00 2
1 Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER IV TENANT -a- 200 amps or less 100.70 2
n 1 201 amps to 400 amps 133.56 2
Name: i ght LI n 401 amps to 600 amps 200.34 2
Address: / 0. 601 amps to 1,000 amps 301.04 2
/SZ3o st eguQI0.
G Over 1,000 amps or volts 552.26 2
City/State/ZIP: 7.74 tisk Q Q 77ZZ 1/ Temporary services or feeders installation,alteration,and/or
Phone:( ) J 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
Business name: Vancouver Sign each branch circuit
B.Fee for branch circuits without
Contact name:Reid Storm service or feeder fee,first 56.18
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
Phone:(360)693-4773 Fax: :(360)693-2747 dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail:reids @vansigneo.com Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 1zj,coif 2
r Business name:Vancouver Sign Signal circuit(s)or limited-energy g 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(I hr min) 66.25/hr
City/State/ZIP:Vancouver WA 98661 Investigation(1 hr Irvin) 66.25/hr
Phone:(360)693-4773 Fax:(360)693-2747 Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is 90,00/hr
CCB Lie.: 63951 Electrical Lie.: 37-46CLS Suprv. 'c.:5,2(o' $1'6, specifically listed(1/2 hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,require:: / Subtotal: 6;to
/ ,�� Plan review(25%of permit fee): _
Print name: V / Date:
State surcharge(12%of permit fee): /4i..2g
Authorized signature: TOTAL PERMIT FEE: /57.5'
This permit application expires if a permit is not obtained within 180
Print name: Reid Sto ?etd, C c Date. — days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(I1/05/COM/WEB