Permit CITY OF TIGARD ELECTRICAL PERMIT
s • COMMUNITY DEVELOPMENT Permit#: ELC2014-00393
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/23/2014
Parcel: 2S103DD01201
Jurisdiction: Tigard
Site address: 13880 SW PACIFIC HWY
Project: Tigard Premier Auto Subdivision: MELROSE Lot: 7-8
Project Description: Sign lighting for(1)wall sign
Contractor: ELECTRIC AVENUE SIGN & LIGHTING Owner: GOODWILL INDUSTRIES OF THE
16005 NE 12TH ST COLUMBIA WILLAMETTE
VANCOUVER, WA 98684 1943 SE 6TH AVE
PORTLAND, OR 97214
PHONE: 360-903-5447 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 07/23/2014 $67.84
Specifics:
1 ea 12%State Surcharge- 07/23/2014 $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 wi - work is not started within 180 days of issuance, or if irk s suspended for more the 180
days. ATTENTION: Oregon law requires you to folio the rules atippted by the Oregon Utility Notification Cent-r. y • e rules are set forth in OAR
952-001-0010 through OAR 952-001-0090 Yo •• ••-in a opy of the rules Or direct questions to OUNC by calling 503.232.1•• i:4151,A
1 !,—
Issued By: Permittee Signature: x1
--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.
f
Electrical Permit Applicatio nCEIVED I ()I: Iii I I( I 1 ,1 I I.I 1
ved Recei
City of Tigard 7 orll
� i Permit No.: E J 10/ -QO •3
III13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
I Phone: 503.718.2439 Fax: 503.598.196 L 21 2014 Date/B : Other Permit:
II ,�li I Inspection Line: 503.639.4175 Date Ready/By: Juria: B See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYO�FTIGAcR
TYPE OF 11.11s 0 i 1NG DIVISION REVIEW
❑New construction ❑Addition/al 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.
El Demolition ®Other: 9;(:,0 1-10314- OP 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 IN Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
.1011 SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
0 Addition of new motor load of ❑"A" °E„,"1-2„,"1-3„,
Job no.: Job site address: 13g8a , P fle. 4c .J. Six or or more residential occupancy.
ff�.''�- ' -'o ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: Trp O K. `-) z2-.. ❑Health-care facilities. ❑Supply voltage for more than
`y A R(, ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: -rib M,p pit j ra ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total 1 •
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 l
Tax map/parcel no.:
Limited energy,residential 75.00 2
I.DESCRIPTION OF WORK (with above sq.ft.)
Limited energy,multi-family 75.00 2
(,�— residential(with above sq.ft.)
l� ( . l k-C ln1
Renewable Energy ❑ See Page 2
J Services or feeders installation,alteration,and/or relocation_
R PROPERTY OWNER I jo TENANT 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name: p401._ writs u 614 401 amps to 600 amps 200.34 2
Address: `3 9 so w pp�1.A f,V r 601 amps to 1,000 amps 301.04 2
r (J Over 1,000 amps or volts 552.26 2
City/State/ZIP: Trbii-kb ®Q 9'747 3 Temporary services or feeders installation,alteration,and/or
Phone:(50 ) 4, -4 Op
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
in APPLICANT I ❑ CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,
7.42 2
Business name: D p won 5/6N f each branch circuit
B.Fee for branch circuits without
Contact name: Mike.. i4,0 l rn service or feeder fee,first 56.18 2
branch circuit
Address: 4, 3®n Q g w Hall a4i V P Each add'l branch circuit 7.42 2
City/State/ZIP: NAV upt-on 6 t q y 019-3” E Each manufactured(service u feeder not included)
Each manufactured or modular
67.84 2
Phone:(rte)) 49 7 2.90 3 7 Fax::( ) dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail: In tee y oG1�l4T27y6,14jz e_st,/'yf Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting , 67.84 17,kfl 2
Business name: 4i%t.Tf]/c it,4,5"M.) Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 2
Address: /6oD5 Vr t_ /2 771 CJ7 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
City/State/ZIP: U at/C)ttC u//r 49g41°er Investigation(I hr min) 66.25/hr
Phone:(U) 940 3 ,- 54/4/,7 Fax:( ) Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 9000/hr
CCB Lic.: /93£/yam Electrical Lic.: S I6,,_64/ Suprv.Lic.:ac..z 3 specifically listed(%z hr min)
Suprv.Electrician signature,required: ELECTRICAL PERMIT FEES
i'�A i f6A1 Subtotal: /p 7.
Print name: #x�L�T.Ad fj6I'+ Date: '1�`f/y Plan review(25%of permit fee): �-'
Ir �"� State surcharge(12%of permit fee): g./I
Authorized signature ,(5611 TOTAL PERMIT FEE: 75--.9g
•
Print name:���/L/ /J/ j Date:-7/7 This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
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
13880 SW PACIFIC HWY, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2014-00393
Herb Stabenow
Sign install only not connected to a circuit yet
Violation Summary:
Inspector Contractor