Permit Y N CITY OF TIGARD ELECTRICAL PERMIT
' • COMMUNITY DEVELOPMENT Permit#: ELC2014-00550
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/25/2014
Parcel: 1 S 126DC04700
Jurisdiction: Tigard
Site address: 9575 SW LOCUST ST
Project: Double Tree Subdivision: LEHMANN ACRE TRACT Lot: 5
Project Description: (4)sign lightings(3 wall signs&1 freestanding sign)
Contractor: VANCOUVER SIGN COMPANY INC Owner: DOUBLE TREE
2600 NE ANDRESEN RD#50 9575 SW LOCUST ST
VANCOUVER,WA 98661 TIGARD,OR 97223
PHONE: 360-693-4773 PHONE:
FAX: 360-693-2747
FEES
Quantity Description Date Amount
4 ea Sign or Outline Lighting 09/25/2014 $271.36
Specifics: 1 ea 12%State Surcharge- 09/25/2014 $32.56
Electrical
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $303.92
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 thr AR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332. 44.
Issued By: Permittee Signature: U�
-
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 USE ONLY
City of Tigard Received Date/B : � ;/ Permit No.: G( /,41 6'57)
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review d. 0�1,/-�lPo
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Other Permit: /eXL� 7 O
I I,, ,,,I, Inspection Line: 503.639.4175 Date Ready/By: Ions: 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑New construction .Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked below):
El Demolition ❑Other: ❑Service or feeder 400 amps or more ❑Building over three stories.
where the available fault current ❑Marinas and boatyards.
RY 0` exceeds 10,000 amps at 150 volts or ❑Floating buildings.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ I-and 2-family dwelling 6 Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE RMATION ANI)i )CATION 'I11 ❑Emergency system larger separately derived system.
❑Addition of new motor load of ❑"A" "E" "1-2" "1-3"
Job no.: I Job site address: cis- 100HP or more. occupancy.
1 7,� s W o C U�5 t 5 r ❑Six or more residential units. ❑Recreational vehicle parks.
? ❑Health-care facilities. ❑Supply voltage for more than
City/State/ZIP:
�i a�.Da., 0 A !7 2 Z 3 ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: ` I Project name: Do , e.„ Tie e, ❑Service or feeder 600 amps or more.
'^�� FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee, I Total I *
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq.ft.or less 168.54 4
-../ Ea.add'l 500 sq.ft.or portion 33.92 1
Tax map/parcel no.: /5 2 G D i`p q 7°O Limited energy,residential 75 00
--
DESCRIPTION OF WORK (with above sq.ft.)
Limited energy.multi-family 75.00
I I( 51Ch residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
ic re e-C.-ray) 1✓�.q S 1 i/ Services or feeders installation,alteration,and/or relocation
CI PROPERTY O I ® TENANT 200 amps or less 100.70 2J
Name: Double- amps to 400 amps 133.56 2
Na
Da u b l e. Tr e>= 401 amps to 600 amps 200.34 2
Address: S 601 amps to 1,000 amps 301.04 2
q S S S rill La e.0�t Over 1,000 amps or volts 552.26 2
City/State/ZIP: re/ QA 7?Z Temporary services or feeders installation,alteration,and/or
Phone:( ) Fax:( ) relocation
200 amps or less 59.36 I
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, panel
® APPL A.Fee for branch circuits with
above service or feeder fee,
Business name: Vancouver Sign each branch circuit 7.42 2
•
— 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 2
Phone:(360)693-4773 Fax: :(360)693-2747 dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail:reids @vansignco.com Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting (q) 67.84 a7],94Q 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 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.Lic , s ecificall listed(A hr min)
----��" `"" LECTRICAL PERMIT FEES
Suprv.Electrician signature,requir Subtotal: 71 .'JlG'
Print name: c1 i� Date:
Plan review(25%of permit fee): —�
1�/ State surcharge(12%of permit fee): 3iZ, r 4'
Authorized signature: ` TOTAL PERMIT FEE: 3().5, �Y
�1Q 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.
I:\Building\Permits\ELC_I'crmiiApp_EI.R_ERE.doc Rev 05/21/2013 440-46151(1l/05/COM/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
9575 SW LOCUST ST, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2014-00550
Jeff Grove
Violation Summary:
Inspector Contractor