Permit CITY OF TIGARD ELECTRICAL PERMIT
1 - COMMUNITY DEVELOPMENT Permit#: ELC2015-00137
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/18/2015
Parcel: 1 S134BC00200
Jurisdiction: Tigard
Site address: 12164 SW SCHOLLS FERRY RD
Project: Edward Jones Subdivision: GREENWOOD TERRACE CONDO Lot: 17
Project Description: Sign lighting for(1)wall sign.
Contractor: VANCOUVER SIGN COMPANY INC Owner: ATLAS GREENWAY LLC
2600 NE ANDRESEN RD#50 333 NW NINTH AVE, STE 1009
VANCOUVER,WA 98661 PORTLAND, OR 97209
PHONE: 360-693-4773 PHONE:
FAX: 360-693-2747
FEES
Quantity Description Date Amount
1 ea Sign or Outline Lighting 03/18/2015 $67.84
Specifics:
1 ea 12%State Surcharge- 03/18/2015 $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 copy e ru es ect questions to OUNC by calling 503.232.1987 or 1 00 2.2344.
Issued 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.
EElectrical pU l + rical Permit A licatiJiECEIVEP FOR OFFICE USE ONLY
1,, __ City of Tigard Received `` f /� et 7
Re Date/By:
ive / i yJ Permit No.: ��/ a �3
13125 SW Hall Blvd.,Tigard,OR 972648 4 2015 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
l I c,.\i;I Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Jam 10 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
T
1' I) :�L'ISi: 1 • ' PLAN REVIE
❑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.
TEGORY 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
❑Emergency system larger separately derived system.
JOB SITE TION AND LOCATION ❑Addition of new motor load of ❑ `A"."E",'1-2","1-3",
Job no.: I Job site address: l Z/�y S W 5 c,hoc�`S Fe.0 100 or or more.residential Recreational C y ❑Six or more resi�ntial units. 0 vehicle parks.
City/State/ZIP: r�Gl._C el,, OP, —1 7 7.7_/
r ❑Health-care facilities. 0 Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: I Project name: EOLIAjctel Sortes ❑Service or feeder 600 amps or more.
FEE SCHEDULE ,
Cross street/directions to job site: Description I Qt,. I Fee. I Total I •
, ` New residential single-or multi-family dwelling unit.
_ S W 1 2-1 ST AJ E Includes attached garage.
Subdivision: I Lot no.: 1,000 sq.ft.or less 168.54 4
Tax map/parcel no.: Ea.add'l 500 sq.ft.or portion 33.92 l
i 5/3 LI$O Do ZOO Limited energy,residential
75.00 2
DESCRIPTION OF WORK (with above sq.ft.)
I.i mited energy,multi-family 7500 2
residential(with above sq.ft.)
oil i 1�l c YVI i I/la f w a1 l 5'15_0_
Renewable Energy 1:1 See Page 2
Services or feeders installation,alteration,and/or relocation
ROPERTY OWNER ilik [at ® TENANT la 200 amps or less I00.70 , 2
201 amps to 400 amps 133.56 2
Name: b) ,'J 5OYLed s 401 amps to 600 amps 200.34 . 2
Address: F-3.1,1.,, 601 amps to 1,000 amps 301.04 2
121 y 5[� scholls �
_ R J Over 1,000 amps or volts 552.26 2
City/State/ZIP: ,, at,A, OR Temporary services or feeders installation,alteration,and/or
relocation
Phone:( ) I Fax:( ) 200 amps or less 59.36 l
Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 1 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
°' CT 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 67.84 2
CONTRACT O Sign or outline lighting (i) 67.84 6Z. 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(I 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
td iii, Inspections for which no fee is 90.00/hr
CCB Lic.: 63951 Electrical Lic.: 37-46CLS Suprv.Lie.:c 1 specifically listed(s hr min)
Suprv.Electrician signature,required( Subtotal: t,7_
Print name: ��11- 40 L�- Date: .21244.5'.----- Plan review(2596 of permit fee):
State surcharge(12%of permit fee): ��- 4
Authorized signature: /�� •� S..„ ________ TOTAL PERMIT FEE: e,7, l T'
YW /I This permit application expires if a permit is not obtained within 180
Print name: Reid Storm A e i d. St O C( Date: Z/Z(o / $' days after it has been accepted as complete.
* Number of inspections allowed per permit.
1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(II/05/COM/WEB
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12164 SW SCHOLLS FERRY RD, TIGARD, OR,
97223
Record Type: Record ID:
Commercial - Electrical ELC2015-00137
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor